醒脑静注射液在治疗重症颅脑损伤中抗高热和促醒作用的疗效观察

The observation on therapeutic efficacy of antihyperthermal and revival effects of Xingnaojing Injection in treatment for severe craniocerebral injuries

目的：探讨醒脑静注射液在治疗重症颅脑损伤患者中抗高热和促醒作用的疗效以及对预后的影响。方法：按随机分组法将１４１例颅脑损伤患者〔格拉斯哥昏迷评分（ＧＣＳ）≤８分〕分为２组。Ａ组（治疗组）７０例，伤后或术后在常规治疗基础上加用醒脑静注射液；Ｂ组（对照组）７１例只用常规治疗，比较用药７２小时内２组间高热发生率的差异；将Ｂ组治疗７２小时后出现高热患者又随机分为Ｂ１和Ｂ２２组。Ｂ１组加用醒脑静注射液降温，Ｂ２组用冬眠药物降温，观察Ｂ１，Ｂ２组间的降温效果及不良反应；并按格拉斯哥预后评分（ＧＯＳ）对Ａ组、Ｂ组的１周内意识好转率及预后作比较。结果：Ａ组患者高热发生率（２５．７％）明显低于Ｂ组（５７．７％，Ｐ＜０．０１）；Ａ组患者１周内清醒率（５５．７％），显著高于Ｂ组（２５．４％，Ｐ＜０．０１）。Ｂ１组无不良反应发生，Ｂ２组有１１例发生不良反应（Ｐ＜０．０１）。Ａ组患者预后恢复良好及中度恢复的百分率（５１．４％和２４．３％）均明显高于Ｂ组（分别为２６．７％和１８．３％），Ｐ均＜０．０５；２组患者病死率（分别为１２．９％和１４．１％）无显著性差异。结论：醒脑静注射液在治疗重症颅脑损伤患者时，早期能有效控制高热发生率，并对?

Objective:To investigate the curative effects of Xingnaojing Injection(醒脑静注射液) on antihyperthermia,promoting revival and prognostic influence in treatment for severe craniocerebral injuries.Methods:141 cases with craniocerebral injuries (GCS≤8 scores) were randomly divided into two groups,A (treatment) and B (control) group.In A group ( n =70),Xingnaojing Injection was added on the basis of conventional treatment after injury or operation,and in group B ( n =71) only conventional treatment used.The occurance rate of hyperthermia was compared between A and B groups,furthermore,the patients with hyperthermia in B group were randomly divided into B 1 and B 2 group again.Xingnaojing Injection was added into B 1 group for lowering the body temperature,but hibernation therapy used in B 2 group.The efficacy of lowering body temperature and undesirable adverse reactions were observed.According to the GCS scores the recovering rate of conciousness within 1 week and prognosis between A and B group were compared.Results:The occurance rate of hyperthermia (25 7%) in A group was significantly lower than that in B group (57 7%, P <0 01).The revival rate within 1 week (55 7%) in A group was significantly higher than that (25 4%) in B group ( P <0 01).There were no adverse reactions in B 1 group,but they occured in 11 cases of B 2 group,and they were markedly lowerer in B 1 group than in B 2 group.In A group the percentages of good and moderate recoveries were 51 4% and 24 3%,respectively,and significantly higher than those (26 7% and 18 3% respectively) in B group (both P <0 05).The mortality,however,in both A and B group (12 9% and 14 1% respectively) was not different.Conclusions:The Xingnaojing Injection is effective on controlling the incidence rate of hyperthermia in treatmeat for severely craniocerebral trauma in the early stage,may make patients pass the acute period safely and has significantly clinical actions on promoting revival and improving life qualities.