半夏白术天麻汤联合尼卡地平治疗高血压脑出血临床研究  

Clinical Study on Banxia Baizhu Tianma Decoction Combined with Nicardipine for Hypertensive Cerebral Hemorrhage

作　　者：邱琳琳 吴琪芬 黄学才[1] 詹小莹 QIU Linlin;WU Qifen;HUANG Xuecai;ZHAN Xiaoying(Department of Neurosurgery,Lishui Municipal Central Hospital,Lishui Zhejiang 323000,China)

机构地区：[1]丽水市中心医院神经外科,浙江丽水323000

出　　处：《新中医》2024年第12期17-20,共4页New Chinese Medicine

摘　　要：目的:观察半夏白术天麻汤联合尼卡地平在高血压脑出血患者中的应用及对患者血清D-二聚体(D-D)、胱抑素C(CysC)水平的影响。方法:选取高血压脑出血患者108例,采用随机数字表法分为对照组与试验组各54例。对照组采用口服尼卡地平治疗,试验组采用半夏白术天麻汤联合尼卡地平治疗。2组均治疗14 d,比较2组治疗前后血压、颅内血肿、颅内压、脑血流灌注[局部脑血流量(rCBF)、达峰时间(TPP)及平均通过时间(MTT)]变化情况,血清D-D、CysC水平,格拉斯哥昏迷量表(GCS)及日常生活能力量表(ADL)评分。结果:治疗7、14 d,2组收缩压(SBP)、舒张压(DBP)水平均较治疗前降低(P<0.05),且试验组SBP、DBP水平在相同时间点均低于对照组(P<0.05)。治疗后,2组颅内血肿体积、颅内压均较治疗前降低(P<0.05),且试验组颅内血肿体积、颅内压均低于对照组(P<0.05)。治疗后,2组rCBF水平均较治疗前升高(P<0.05),TPP、MTT水平均较治疗前降低(P<0.05);且试验组rCBF水平高于对照组(P<0.05),TPP、MTT水平低于对照组(P<0.05)。治疗后,2组D-D、CysC水平均较治疗前降低(P<0.05),且试验组D-D、CysC水平均低于对照组(P<0.05)。治疗后,2组GCS、ADL评分均较治疗前升高(P<0.05),且试验组2项评分均高于对照组(P<0.05)。结论:半夏白术天麻汤联合尼卡地平治疗高血压脑出血可有效控制血压,促进颅内血肿吸收,改善凝血功能、CysC水平及脑血流灌注,保护患者神经系统,提高其生活自理能力。Objective:To observe the application of Banxia Baizhu Tianma Decoction combined with Nicardipine in patients with hypertensive cerebral hemorrhage and its effect on serum D-dimer(D-D),cystatin C(CysC).Methods:A total of 108 cases of patients with hypertensive cerebral hemorrhage were selected and divided into the control group and the trial group according to the random number table method,with 54 cases in each group.The control group was given the oral administration of Nicardipine,and the trial group was treated with Banxia Baizhu Tianma Decoction combined with Nicardipine.Both groups were treated for 14 days.Before and after treatment,the changes in blood pressure,intracranial hematoma,intracranial pressure,cerebral blood perfusion[regional cerebral blood flow(rCBF),time to peak(TPP)and mean transit time(MTT)],the levels of serum D-D and CysC,and the scores of Glasgow Coma Scale(GCS)and Activities of Daily Living(ADL)were compared between the two groups.Results:After 7 and 14 days of treatment,the levels of systolic pressure(SBP)and diastolic pressure(DBP)in the two groups were decreased when compared with those before treatment(P<0.05),and the levels of SBP and DBP in the trial group were lower than those in the control group at the same time point(P<0.05).After treatment,the intracranial hematoma volume and intracranial pressure in the two groups were decreased when compared with those before treatment(P<0.05),and the intracranial hematoma volume and intracranial pressure in the trial group were lower than those in the control group(P<0.05).After treatment,rCBF levels in the two groups were increased when compared with those before treatment(P<0.05),and the length of TPP and MTT were decreased when compared with those before treatment(P<0.05);the rCBF level in the trial group was higher than that in the control group(P<0.05),and the length of TPP and MTT were lower than those in the control group(P<0.05).After treatment,the levels of D-D and CysC in the two groups were decreased when compared with those befo

关 键 词：脑出血 高血压 半夏白术天麻汤 尼卡地平 D-二聚体 胱抑素C 脑血流灌注 

分 类 号：R743.34[医药卫生—神经病学与精神病学]