补阳还五汤加减联合扩大颅骨钻孔引流术治疗慢性硬脑膜下血肿临床研究  

Clinical Study on Modified Buyang Huanwu Decoction Combined with Extended Burr Hole Drainage of Skull for Chronic Subdural Hematoma

作　　者：毛伟龙 姜一鸣 徐卫新 MAO Weilong;JIANG Yiming;XU Weixin

机构地区：[1]金华市中医医院外三科,浙江金华321000

出　　处：《新中医》2023年第5期54-58,共5页New Chinese Medicine

摘　　要：目的:观察补阳还五汤加减联合扩大颅骨钻孔引流术治疗慢性硬脑膜下血肿的临床疗效。方法:将83例因外伤所致慢性硬脑膜下血肿患者随机分为观察组42例与对照组41例。2组均经扩大颅骨钻孔引流术治疗,观察组配合服用补阳还五汤治疗,连续治疗90 d。比较2组治疗前及治疗后10 d、30 d、90 d内神经功能缺损程度评分(CSS)、日常生活活动能力(ADL)评分,并比较2组治疗后10 d、30 d、90 d术后血肿残余百分比及治疗后临床疗效。结果:治疗后10 d,2组血肿残余量百分比比较,差异无统计学意义(P>0.05);治疗后30 d、90 d 2组血肿残余量百分比均降低(P<0.05),且观察组低于对照组(P<0.05)。治疗前,2组CSS、ADL评分比较,差异无统计学意义(P>0.05);治疗后10 d、30 d、90 d,2组CSS评分逐渐降低(P<0.05),ADL评分逐渐升高(P<0.05),且观察组同一时间点CSS评分低于对照组(P<0.05),ADL评分高于对照组(P<0.05)。观察组治疗总有效率95.24%,高于对照组70.73%(P<0.05)。结论:补阳还五汤加减联合扩大颅骨钻孔引流术治疗慢性硬脑膜下血肿,可通络、活血、补气、补脾,纾解病情,降低患者血肿残余量,缓解患者临床症状,提升临床疗效。Objective:To observe the clinical effect of modified Buyang Huanwu Decoction combined with extended burr hole drainage of skull on chronic subdural hematoma. Methods:A total of 83 patients with chronic subdural hematoma caused by external injury were randomly divided into the observation group and the control group,with 42 and 41 cases in each group. The two groups were given extended burr hole drainage of skull,and the observation group was additionally treated with Buyang Huanwu Decoction for90 days. Before treatment and after treatment for 10 days,30 days and 90 days,the scores of Chinese Stroke Scale(CSS) for neurological severity,and Activity of Daily Living(ADL) were compared,respectively.After treatment for 10 days,30 days and 90 days,the postoperative percentage of residual hematoma and clinical effects in both groups were also compared, respectively. Results: After treatment for 10 days,there was no significant difference being found in the comparison of percentage of residual hematoma between the two groups(P>0.05);after treatment for 30 days and 90 days,the percentages of residual hematoma in the two groups were decreased(P<0.05),and the percentage of residual hematoma in the observation group was lower than that in the control group(P<0.05). Before treatment, there was no significant difference being found in the comparisons of scores of CSS and ADL between the two groups(P>0.05);after treatment for 10 days,30 days and 90 days,the CSS scores in both groups were gradually decreased(P<0.05),and the ADL scores were gradually increased(P<0.05),and the CSS scores at the same time points in the observation group were lower than those in the control group(P<0.05),and the ADL scores were higher than those in the control group(P<0.05). The total effective rate of observation group was 95.24%, higher than that of 70.73% in the control group(P<0.05). Conclusion: Modified Buyang Huanwu Decoction combined with extended burr hole drainage of skull for chronic subdural hematoma can free the collateral vessels,invigo

关 键 词：慢性硬脑膜下血肿 扩大颅骨钻孔引流术 补阳还五汤 神经功能缺损程度评分 日常生活活动能力评分 

分 类 号：R651.15[医药卫生—外科学]