逐瘀化痰汤对脑出血急性期患者颅内压影响的临床与实验研究

Clinical and Experimental Studies on Influence of Zhuyu Huatan Decoction on Intracranial Pressure in Acute Cases of Cerebral Hemorrhage

观察逐瘀化痰汤加一般疗法与西医治疗对44例脑出血急性期患者的疗效,使用脑室内压监测法对20例基底节区脑出血急性期患者分别进行逐瘀化痰汤和甘露醇降颅压作用的连续监测;观察逐瘀化痰汤、甘露醇对经颈总动脉注射橄榄油致实验性脑水肿家兔的降颅压作用。结果:逐瘀化痰汤加一般疗法在改善患者意识状态方面较西医治疗为优;临床使用逐瘀化痰汤颅压降低幅度为40.44%,与甘露醇比较,降颅压作用缓慢而持久,回升平缓,无“反跳现象”,颅压下降幅度较甘露醇小;动物实验结果与临床监测结果相似,但逐瘀化痰汤降低颅压的幅度大于甘露醇,这与临床监测结果相反,其原因有待进一步探讨。

The effect of the Zhuyu Huatan Decoction (ZHD) plus general therapy was observed in 44 cases with western drug as control. Continuous monitoving on the lowering intracranial pressure effect of ZHD and mannitol was made on 20 cases of acute cerebral hemorrhage at the basilar gonglion region by intraventricular pressure monitoring method. The effect of both remedies for lowering intracranial pressure was observed on experimental cerebral edema in rabbit by injecting olive oil through common carotid artery. Results: ZHD plus general therapy group yielded better action on improving consciousness than that of the western drug group. Clinically, the amplitude of decrease of intracranial pressure was 40. 44%. The action is mild and protracted than that in the mannitol group, with mild rising and no ' rebound', the amplitude of decreased pressure is smaller than that of the mannitol group. Animal experiments yielded the similar results as that of clinical therapy. yet the amplitude of lowering pressure was greater in the ZHD group than the mannitol group, the result was just the reverse as compared with that clinically. This deserve further study.