超早期手术结合增液承气汤加减方治疗高血压脑出血临床疗效观察

Clinical Effect of Extra Early Operation Combined with Zengye Chengqi Decoction in Treatment of Patients with Hypertensive Cerebral Hemorrhage

目的评价超早期手术结合增液承气汤加减方治疗高血压脑出血的临床疗效,探索中西医结合综合治疗重症高血压脑出血的新思路、新方法。方法采用回顾性分析,选取116例高血压脑出血患者,根据治疗方法不同分为两组,所有患者均于发病后6 h内手术清除血肿,其中西医对照组61例患者在超早期手术清除血肿的基础上采用西医基础治疗,中西医治疗组55例在西医治疗的基础上于超早期手术清除血肿术后第3天给予口服增液承气汤加减方,两组患者疗程均为21 d。疗程结束后分别比较两组格拉斯哥昏迷量表(GCS)评分、神经功能缺损程度评分、日常生活活动能力(ADL)评分、术后第21天临床疗效。结果两组患者术后第21天GCS评分、神经功能缺损程度评分、ADL评分与术前比较差异具有统计学意义(P<0.05),且术后第21天中西医治疗组GCS评分、神经功能缺损程度评分、ADL评分、临床疗效与西医对照组比较差异具有统计学意义(P<0.05)。结论超早期手术结合增液承气汤加减方综合治疗高血压脑出血能显著改善患者预后,提高临床疗效。

Objective To investigate the clinical effect of extra early operation combined with Zengye Chengqi Decoction in treatment of hypertensive cerebral hemorrhage and to explore the new methods of integrated TCM-WM comprehensive treatment of severe hypertensive cerebral hemorrhage. Methods The retrospective analysis was performed for 116 patients with hypertensive cerebral hemorrhage, and then the patients were divided into two groups. Hematomas were removed in all the patients within 6 h of onset by operation, among whom, 61 patients （western medicine group） were treated with basic treatment of western medicine, and other 55 patients （Chinese medicine group） were given additional Zengye Chengqi Decoction orally on the 3^rd d after the operation based on western medicine treatment, and the course of treatment was 21 d in the two groups. After the treatment, the Glasgow coma score （GCS） score, neurologic impairment score, ability of daily living （ADL） score and clinical effect on the postoperative 21^th d in the two groups were compared. Results The differences in scores of GCS, neurologic impairment and ADL on the postoperative 21^th d were statistically significant compared with those before the operation （ P 〈 0. 05）, and differences in scores of GCS, neurologic impairment and ADL, and clinical effect on the postoperative 21^th d in integrated TCM-WM group were also statistically significant, compared with those in western medicine group （P 〈 0. 05）. Conclusion The extra early operation combined with Zengye Chengqi Decoction in treatment of hypertensive cerebral hemorrhage can obviously improve the prognosis and clin- ical efficacy.