通窍活血汤辅以醒脑开窍针刺法联合微创血肿引流术治疗重症丘脑出血的效果分析  

Analysis of the effect of Tongqiao Huoxue Decoction supplemented with Xingnao Kaiqiao acupuncture combined with minimally invasive hematoma drainage in the treatment of severe thalamic hemorrhage

作　　者：卢致金 汤涛[1] 蒋满香 郭世万 LU Zhijin;TANG Tao;JIANG Manxiang;GUO Shiwan(Orthopedic Trauma Emergency Center,Ganzhou People's Hospital,Jiangxi Province,Ganzhou,341000,China;Department of Traditional Chinese Medicine,Ganzhou People's Hospital,Jiangxi Province,Ganzhou,341000,China)

机构地区：[1]江西省赣州市人民医院创伤急救中心创伤骨科,江西赣州341000 [2]江西省赣州市人民医院中医科,江西赣州341000

出　　处：《中国当代医药》2023年第24期143-147,共5页China Modern Medicine

基　　金：江西省中医药管理局科技计划项目(2022B586)。

摘　　要：目的探讨通窍活血汤辅以醒脑开窍针刺法联合微创血肿引流术治疗重症丘脑出血的效果。方法选取2020年3月至2022年12月赣州市人民医院收治的90例重症丘脑出血患者作为研究对象,按随机数字表法分为常规组和联合组,每组各45例。给予常规组微创血肿引流术联合醒脑开窍针刺法治疗,联合组在常规组的基础上再增加通窍活血汤辅以治疗,两组均持续治疗14 d,比较两组治疗的总有效率、运动能力[Fugl-Meyer量表(FMA)]、脑损伤情况[S100钙结合蛋白B(S100B)、神经元特异性烯醇化酶(NSE)、脑源性神经营养因子(BDNF)、血清转铁蛋白(TRF)]、院内情况及并发症发生情况。结果联合组治疗总有效率高于常规组,差异有统计学意义(P<0.05)。重复测量方差分析结果显示,两组患者的FMA评分及S100B、NSE、BDNF、TRF水平时间、组间、交互作用比较,差异有统计学意义(P<0.05)。两组患者治疗后7、14 d的FMA评分、BDNF水平均高于本组治疗前,S100B水平、NSE水平、TRF水平均低于本组治疗前,两组患者治疗后14 d的FMA评分、BDNF水平均高于治疗7 d,S100B水平、NSE水平、TRF水平均低于本组治疗7 d时,差异有统计学意义(P<0.05);联合组治疗7、14 d的FMA评分、BDNF水平均高于常规组,S100B水平、NSE水平、TRF水平均低于常规组,差异有统计学意义(P<0.05)。联合组患者引流管留置时间、ICU入住时间、意识恢复时间、出院时间均短于常规组,差异有统计学意义(P<0.05);联合组并发症总发生率低于常规组,差异有统计学意义(P<0.05)。结论重症丘脑出血微创术后予通窍活血汤、醒脑开窍针刺可以提高治疗有效率,加速运动能力恢复,减轻脑损伤,且安全性高。Objective To investigate the effect of Tongqiao Huoxue Decoction supplemented with Xingnao Kaiqiao acupuncture combined with minimally invasive hematoma drainage in the treatment of severe thalamic hemorrhage.Methods A total of 90 patients with severe thalamic hemorrhage admitted to Ganzhou People's Hospital from March 2020 to December 2022 were selected as the research objects.According to the random number table method,they were divided into the conventional group and the combined group,with 45 cases in each group.The conventional group was treated with minimally invasive hematoma drainage combined with Xingnao Kaiqiao acupuncture,and the combined group was treated with Tongqiao Huoxue Decoction on the basis of the conventional group.The two groups were treated for 14 days.The total effective rate,motor ability(Fugl-Meyer scale[FMA]),brain injury(S100 calcium-binding protein B[S100B],neuron-specific enolase[NSE],brain-derived neurotrophic factor[BDNF],serum transferrin[TRF]),hospital conditions and complications were compared between the two groups.Results The total effective rate of the combined group was higher than that of the conventional group,and the difference was statistically significant(P<0.05).Repeated measures analysis of variance showed that there were statistically significant differences in FMA score,S100B,NSE,BDNF and TRF levels between the two groups(P<0.05).The FMA scores and BDNF levels of the two groups 7 and 14 days after treatment were higher than those before treatment,and the levels of S100B,NSE and TRF were lower than those before treatment,the FMA scores and BDNF levels of the two groups 14 days after treatment were higher than those 7 days after treatment,the levels of S100B,NSE and TRF were lower than those 7 days after treatment,with statistically significant differences(P<0.05).The FMA score and BDNF level of the combined group were higher than those of the conventional group,and the levels of S100B,NSE and TRF were lower than those of the conventional group 7 and 14 days after tre

关 键 词：通窍活血汤 醒脑开窍针 微创血肿引流术 重症丘脑出血 

分 类 号：R743.34[医药卫生—神经病学与精神病学]