摘要
目的:观察补阳还五汤联合超早期尿激酶给药对高血压脑出血微创术后患者的疗效。方法:选取2018年5月~2021年2月在遂宁市中医院经CT扫描、实验室检查等确诊为高血压脑出血的患者104例,根据奇偶数分组法分为对照组和观察组。两组患者均在发病48h内给予颅内血肿微创穿刺引流术治疗,术后均给予降颅内压、抗感染等常规治疗,对照组术后给予超早期尿激酶给药治疗,观察组在对照组基础上给予补阳还五汤口服或鼻饲治疗。比较两组疗效、并发症情况及美国国立卫生研究院卒中量表(NIHSS)评分、Barthel(BI)评分、相关细胞因子的变化。结果:观察组治疗总有效率为90.38%(47/52),高于对照组的75.00%(39/52),差异有统计学意义(P<0.05)。治疗14d,两组粒细胞巨噬细胞集落刺激因子(GM-CSF)、白细胞介素-6(IL-6)、一氧化氮(NO)、内皮素-1(ET-1)及观察组的同型半胱氨酸(Hcy)均较治疗前降低,但对照组的Hcy与治疗前比较差异无统计学意义(P>0.05)。与对照组比较,观察组治疗14d的GM-CSF、Hcy、IL-6、NO、ET-1明显更低(P<0.05)。治疗14d,两组BI评分较治疗前升高,NIHSS评分较治疗前降低(P<0.05)。与对照组比较,观察组治疗14d的BI评分明显更高,NIHSS评分明显更低(P<0.05)。两组在颅内感染、肺部感染、消化道出血、脑水肿等并发症的发生率比较,差异无统计学意义(P>0.05)。结论:补阳还五汤联合超早期尿激酶给药可调节高血压脑出血微创术后患者GM-CSF、Hcy、IL-6等因子的表达,提高疗效,改善神经功能。
Objective:To observe the effect of Buyang Huanwu Decoction combined with ultra-early urokinase administration on minimally invasive postoperative patients with hypertensive intracerebral hemorrhage.Methods:A total of 104 patients with hypertensive intracerebral hemorrhage diagnosed by CT scans and laboratory examinations in the Hospital between May 2018 and February 2021 were selected and divided into two groups according to the odd and even number grouping method.All 104 patients were treated with intracranial hematoma minimally invasive drainage within 48 hours of onset,and routine treatments such as lowering intracranial pressure and anti-infection were given after the operation.The controlled group was given ultra-early urokinase treatment after the operation,and the observation group was on the basis of the controlled group,they were given Buyang Huanwu Decoction orally or by nasal feeding.The curative effects,complications,and changes in the National Institutes of Health Stroke Scale(NIHSS)score,Barthel(BI)score,and related cytokines were compared between the two groups.Results:16 cases were cured in the observation group,31 cases were markedly effective and effective,47 cases were total effective,and the total effective rate was 90.38%,which was higher than that of the controlled group.The difference was statistically significant(P<0.05).Treatment for 14 days,two groups of granulocyte macrophage colony stimulating factor(GM-CSF),interleukin-6(IL-6),nitric oxide(NO),endothelin-1(ET-1)and the observation group Homocysteine(Hcy)was lower than before treatment,but the Hcy of the controlled group was not significantly different from before treatment(P>0.05).Compared with the controlled group,the observation group had significantly lower GM-CSF,Hcy,IL-6,NO and ET-1 after 14 days of treatment(P<0.05).After 14 days of treatment,the BI scores of the two groups were higher than before treatment,and the NIHSS scores were lower than before treatment(P<0.05).Compared with the controlled group,the BI score of the observation group was significantly higher on the 14day of treatment,and the NIHSS score was significantly lower(P<0.05).There was no statistically significant comparison between the two groups in the incidence of intracranial infection,lung infection,gastrointestinal hemorrhage,cerebral edema and other complications(P>0.05).Conclusion:Buyang Huanwu Decoction combined with ultra-early urokinase administration can regulate the expression of GM-CSF,Hcy,IL-6 and other factors in patients with hypertensive intracerebral hemorrhage after minimally invasive surgery,improve curative effect and improve neurological function.
作者
侯德文
朱勇军
张东
HOU Dewen;ZHU Yongjun;ZHANG Dong(Department of Neurosurgery,Suining Hospital of Traditional Chinese Medicine,Suining Sichuan 629000,China)
出处
《四川中医》
2022年第9期124-127,共4页
Journal of Sichuan of Traditional Chinese Medicine
关键词
补阳还五汤
超早期
尿激酶
高血压脑出血
Buyang Huanwu Decoction
Ultra-early period
Urokinase
Hypertensive cerebral hemorrhage
作者简介
侯德文,本科,副主任医师,主要从事脑血管病研究,E-mail:hdq1979@126.com。
