软通道血肿抽吸术联合中药分期治疗高血压脑出血的临床研究

Clinical study of the combination of soft tunnel suction of hematoma and traditional chinese medicine stage therapeutics in hypertensive cerebral hemorrhage

目的研究软通道血肿抽吸术联合中药分期治疗高血压脑出血的临床疗效。方法将55例患者经软通道血肿抽吸术治疗后,随机分为常规组和分期中药组,两组均采用西医内科常规治疗方案。分期中药组:在常规组治疗基础上按早、中、后期不同病程选用中药治疗,早期利水消肿,活血止血;中期益气解毒,活血化瘀;后期补益气血,祛瘀生新。观察两组患者的血肿量和临床神经功能缺损程度评分(CNDS)的变化,并分析两组的临床疗效。结果两组治疗后21 d的血肿量较治疗后24 h均减少明显(P<0.05),分期中药组治疗后21 d的血肿量较常规组减少明显(P<0.05);两组治疗后21 d的CNDS较治疗前均降低明显(P<0.05),分期中药组治疗后21 d的CNDS较常规组降低明显(P<0.05)。分期中药组的治疗效果较常规组好(P<0.05)。结论软通道血肿抽吸术联合中药分期治疗高血压脑出血使血肿量迅速减少,神经功能缺损程度减轻,提高患者生存质量。

Objective To study the clinical effects of the combination of soft tunnel suction of hematoma and tradi- tional Chinese medicine （TCM） stage therapeutics in hypertensive cerebral hemorrhage. Methods 55 patients treated by soft tunnel suction of hematoma were divided into two groups, the regular group and TCM stage group. The patients of two groups were treated by western medical regular treatment. TCM stage group was given the TCM according to the three different stages on the basis of the regular group. The early stage with diuresis, detumescence, blood-activating, hemostatic; the middle stage with tonifying Qi, detoxification, promoting blood circulation by removing blood stasis; the later stage with tonifying Qi and blood, eliminating stasis, producing renew. The changes of the hematoma measure and CNDS were observed in the two groups, the clinical effect of two groups was analysed. Results The hemat0ma measure after treatment 21 days decreased obviously than after treatment 24 hours （P 〈 0.05）, and the hematoma measure after treatment 21 days in TCM stage group decrease more than the regular group （P 〈 0.05）. The CNDS after treatment 21 days decreased obviously than before treatment in two groups （P 〈 0.05）, and the CNDS after treatment 21 days in TCM stage group decrease more than the regular group （P 〈 0.05）. The treatment effect in TCM stage group was better than the regular group （P 〈 0.05）. Conclusion The combination of soft tunnel suction of hematoma and TCM stage therapeutics in hypertensive cerebral hemorrhage can effectively reduce the hematoma, alleviate the clinical neurologic deficit and promote the survival quality in patients.