活血化瘀法对重型颅脑外伤术后患者血液流变学及神经功能的影响

Effect of activating blood and resolving stasis on hemorheology and neurofunction in the patients after surgical operation for severe cerebral injury

目的评价中医活血化瘀法在重型颅脑外伤术后的应用效果及对血流变学及神经功能的影响。方法将80例重型颅脑外伤患者随机分为治疗组与对照组各40例,对照组给予术后常规治疗,治疗组在此基础上加用通窍活血汤加减治疗,比较2组临床疗效,治疗前后血液流变学、神经功能的变化。结果随访6个月后,治疗组GOS评分总有效率(92%)明显高于对照组(78%)(P<0.05);治疗组全血液流变学指标均较治疗前和同期对照组明显改善(P均<0.05);治疗14 d时治疗组GCS评分及治疗结束、随访结束时GOS评分均较同期对照组明显升高(P均<0.05)。结论重型颅脑外伤术后给予中药活血化瘀法治疗可有效促进神经功能康复,可能通过改善血液流变学指标发挥作用,对改善患者预后有重要价值。

Objective It is to evaluate the effect of activating blood and resolving stasis in the surgical operation for severe cerebral injury and the effect on hemorheology and neurofunction. Methods 80 patients with severe cerebral injury were randomly divided into treatment group and control group,with 40 cases in each group. The control group was treated with post-operative normal therapy,and the treatment group was added with Tongqiao Huoxue decoction on the basis of treatment in the control group. The clinical curative effects,changes of hemorheology and neurofunction before and after treatment were compared between the two groups. Results After 6 months＇ following up,the total effective rate of GOS scores in treatment group was 92%,which was higher than that 78% in control group（ P 0. 05）; The indexes of hemorheology were improved significantly in treatment group compared with that before therapy and in control group（ P 0. 05）; GCS scores after 14 days＇ treatment,and GOS scores after treatment and at the end of following up in treatment group were higher than those in control group at the same time（ P 0. 05）. Conclusion The therapy with activating blood and resolving stasis after urgical operation for severe cerebral injury can effectively promote the recovery of neurofunction,this effect may be related with the improvements of hemorheology,and has an important value for the prognosis of these patients.