摘要
目的:探讨中医辨证干预方式联合微创骨窗入路血肿清除术治疗高血压脑出血患者的效果。方法:选取2020年10月—2022年5月南华大学附属第二医院收治的104例高血压脑出血患者为研究对象,根据随机数表法将患者分为辨证组和对照组,各52例。对照组给予微创骨窗入路血肿清除术治疗,辨证组在对照组基础上使用中医辨证干预方式联合治疗,比较两组临床疗效及治疗前后认知功能、精神状态、神经功能评分、血肿情况、血脂水平和不良反应发生情况。结果:辨证组治疗总有效率(94.23%)明显高于对照组(80.77%),差异有统计学意义(χ^(2)=6.954,P=0.031)。两组治疗前简易精神状态评价量表(MMSE)、蒙特利尔认知评估量表(MoCA)、神经功能缺损评分(NIHSS)评分比较,差异无统计学意义(P>0.05);辨证组治疗后MMSE评分和MoCA评分高于对照组,NIHSS评分低于对照组,差异有统计学意义(P<0.05)。治疗前两组患者血肿情况比较,差异无统计学意义(P>0.05);辨证组治疗后脑血肿体积和脑水肿体积均小于对照组,差异有统计学意义(P<0.05)。治疗前两组血脂水平比较,差异无统计学意义(P>0.05);辨证组治疗后总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)均明显低于对照组,高密度脂蛋白胆固醇(HDL-C)高于对照组,差异有统计学意义(P<0.05)。辨证组不良反应发生率(5.77%)明显低于对照组(25.00%),差异有统计学意义(χ^(2)=7.386,P=0.007)。结论:中医辨证干预方式联合微创骨窗入路血肿清除术可提高高血压脑出血患者临床疗效,改善认知功能和精神状态,减轻血肿情况,改善血脂水平,减少不良反应。
Objective:To investigate the effect of traditional Chinese medicine(TCM)syndrome differentiation intervention combined with minimally invasive bone window approach hematoma removal in the treatment of hypertensive cerebral hemorrhage.Method:A total of 104 patients with hypertensive cerebral hemorrhage who admitted to the Second Affiliated Hospital,University of South China from October 2020 to May 2022 were selected as the objects and divided into the syndrome differentiation group and the control group according to random number table method,52 cases in each group.The control group was treated with minimally invasive bone window approach hematoma removal,and the syndrome differentiation group was treated with TCM syndrome differentiation intervention on the basis of the control group.The clinical efficacy,scores of cognitive function,mental state,neurological function,changes of hematoma and blood lipid levels before and after treatment,and the occurrence of adverse reactions were compared between two groups.Result:The total effective rate of the syndrome differentiation group(94.23%)was significantly higher than that of the control group(80.77%),the difference was statistically significant(χ^(2)=6.954,P=0.031).There were no significant differences the scores of mini-mental state examination(MMSE),Montreal cognitive assessment(MoCA)and National Institutes of Health stroke scale(NIHSS)between two groups before treatment(P>0.05);the MMSE score and MoCA score in the syndrome differentiation group after treatment were higher than those in the control group,and NIHSS score was lower than that in the control group,the differences were statistically significant(P<0.05).There were no significant differences in hematoma between two groups before treatment(P>0.05);the volume of cerebral hematoma and volume of cerebral edema in the syndrome differentiation group after treatment were smaller than those in the control group,and the differences were statistically significant(P<0.05).There were no significant differences in blood lipid levels between two groups before treatment(P>0.05);the total cholesterol(TC),triglycerides(TG),low-density lipoprotein cholesterin(LDL-C)in the syndrome differentiation group after treatment were significantly lower than those in the control group,while high-density lipoprotein cholesterin(HDL-C)was higher than that in the control group,the differences were statistically significant(P<0.05).The incidence of adverse reactions in the syndrome differentiation group group(5.77%)was significantly lower than that in the control group(25.00%),and the difference was statistically significant(χ^(2)=7.386,P=0.007).Conclusion:TCM syndrome differentiation intervention combined with minimally invasive bone window approach hematoma removal can improve the clinical efficacy of patients with hypertensive cerebral hemorrhage,improve the cognitive function and mental state,reduce hematoma,improve hematoma level,reduce adverse reactions.
作者
谭慧
TAN Hui(The Second Affiliated Hospital,University of South China,Hengyang 421001,China)
出处
《中外医学研究》
2023年第19期33-37,共5页
CHINESE AND FOREIGN MEDICAL RESEARCH
关键词
中医辨证干预
高血压脑出血
认知功能障碍
微创骨窗入路血肿清除术
Traditional Chinese medicine syndrome differentiation intervention
Hypertensive cerebral hemorrhage
Cognitive dysfunction
Minimally invasive bone window approach hematoma removal
