微创穿刺引流术联合中药保留灌肠治疗急性期高血压脑出血痰热腑实证临床观察  

Clinical observation of minimally invasive puncture and drainage combined with retention enema with traditional Chinese medicine on acute hypertensive intracerebral hemorrhage of phlegm-heat fu-organ syndrome

作　　者：孙龙[1] 王革生[2] 高先政 SUN Long;WANG Gesheng;GAO Xianzheng(Department of Surgery,Beijing Huairou Hospital of Traditional Chinese Medicine,Beijing 101400;Third Department of Encephalology,Dongfang Hospital,Beijing University of Chinese Medicine,Beijing 100078)

机构地区：[1]北京市怀柔区中医医院外科,北京101400 [2]北京中医药大学东方医院脑病三科,北京100078

出　　处：《河北中医》2024年第2期193-197,共5页Hebei Journal of Traditional Chinese Medicine

基　　金：国家中医药管理局国家中医临床基地业务建设科研专项(编号:JDZX2015043)。

摘　　要：目的 观察微创穿刺引流术联合中药保留灌肠治疗急性期高血压脑出血(HICH)痰热腑实证的临床疗效。方法 将76例急性期HICH痰热腑实证患者按照随机数字表法分为2组,对照组38例予微创穿刺引流术,术后予西医常规治疗,治疗组38例在对照组治疗基础上加用中药保留灌肠。2组均治疗14天。比较2组疗效;比较2组治疗前后美国国立卫生研究院卒中量表评分(NIHSS)、格拉斯哥昏迷评分(GCS);比较2组治疗前后C反应蛋白(CRP)、神经元特异性烯醇化酶(NSE)水平变化;比较2组治疗前后血清促炎因子、抗炎因子水平变化。结果 治疗组总有效率89.47%(34/38),对照组总有效率68.42%(26/38),治疗组疗效优于对照组(P<0.05)。2组治疗后NIHSS评分均较本组治疗前降低(P<0.05),GCS评分均较本组治疗前升高(P<0.05);治疗后治疗组NIHSS评分低于对照组(P<0.05),GCS评分高于对照组(P<0.05)。2组治疗后CRP、NSE水平均较本组治疗前降低(P<0.05),且治疗组降低更明显(P<0.05)。2组治疗后白细胞介素6(IL-6)、IL-17、肿瘤坏死因子α(TNF-α)、干扰素γ(IFN-γ)均较本组治疗前降低(P<0.05),且治疗组降低更明显(P<0.05)。2组治疗后IL-4、IL-10均较本组治疗前升高(P<0.05),且治疗组升高更明显(P<0.05)。结论 微创穿刺引流术联合中药保留灌肠治疗急性期HICH痰热腑实证,可有效改善患者术后症状,降低炎症水平。Objective To investigate the effect of minimally invasive puncture and drainage combined with retention enema with traditional Chinese medicine(TCM)on acute hypertensive intracerebral hemorrhage(HICH)of phlegm-heat fu-organ syndrome.Methods A total of 76 patients with acute HICH of phlegm-heat fu-organ syndrome were The patients were randomly assigned into treatment group(n=38)and control group(n=38).All patients were managed by minimally invasive puncture and drainage,and routine Western medicine after operation,and the patients in the treatment group were additionally treated with TCM retention enema.A 14-day treatment was performed in the both groups,aiming to compare the clinical efficacy,the scores of National Institutes of Health Stroke Scale(NIHSS),Glasgow Coma Scale(GCS),and the levels of C-reactive protein(CRP)and neuron-specific enolase(NSE)between the two groups before and after treatment.The changes of serum cytokines of pro-inflammatory and anti-inflammatory were assessed.Results The total effective rate in the treatment group was better than that of the control group(89.47%[34/38]vs 68.42%[26/38],P<0.05).After treatment,significantly decreased NIHSS score(P<0.05)and significantly increased GCS score(P<0.05)were detected in the two groups.The treatment group was superior to the control group in NIHSS and GCS(all P<0.05).After treatment,the levels of CRP and NSE in the two groups were lower than those in the group before treatment(P<0.05),and the decrease in the treatment group was more significant(P<0.05).After treatment,the levels of interleukin-6(IL-6),IL-17,tumor necrosis factor-α(TNF-α)and interferon-γ(IFN-γ)in the two groups significantly decreased(P<0.05),and the decrease in the treatment group was more pronounced(P<0.05).After treatment,IL-4 and IL-10 in the two groups were significantly higher than those in the group before treatment(P<0.05),and the increase in the treatment group was more obvious(P<0.05).Conclusion For patients with acute HICH of phlegm-heat fu-organ syndrome,the minimal

关 键 词：高血压 并发症 脑出血 中西医结合疗法 

分 类 号：R544.1[医药卫生—心血管疾病] R743.340.58[医药卫生—内科学]