安宫牛黄丸联合大剂量纳洛酮对Ⅲ-Ⅳ级弥漫性轴索损伤患者促醒疗效观察

Observation of Wake Promoting Effect on Angongniuhuang Pill Combined with Large Dose of Naloxone on III- IV Level Diffuse Axonal Injury Patient

目的探讨安宫牛黄丸联合大剂量纳洛酮对Ⅲ-Ⅳ级弥漫性轴索损伤患者促醒临床疗效。方法分析陕西中医学大学附属医院神经外科2010年6月～2013年6月收治的48例Ⅲ-Ⅳ级弥漫性轴索损伤患者,随机分对照组24例,治疗组24例,对照组给予西医常规促醒方法,治疗组采用安宫牛黄丸鼻饲联合大剂量纳洛酮泵注促醒,比较两组3 w清醒率、并发症发生率及格拉斯哥预后评分。结果治疗组3 w清醒率及预后质量明显优于对照组,差异均有统计学意义（P〈0.05）。结论安宫牛黄丸联合大剂量纳洛酮能明显缩短Ⅲ-Ⅳ级弥漫性轴索损伤昏迷患者清醒周期,提高生存质量,减少死残率。

Objective： To investigate the wake promoting effect on Angongniuhuang pill combined with large dose of naloxone on III- IV level diffuse axonal injury patient. Methods： 48 cases of III- IV diffuse axonal injury patients from neurosurgery Department of Affiliated Hospital of Shaanxi University of Chinese Medicine,from June 2010 to June2013,were randomly divided into control group and treatment group each 24 cases. The control group was treated with conventional western medicine,The treatment group adopted the method of nasal feeding of Angong Niuhuang Pill Combined with large dose of naloxone infusion of awaking. 3 weeks awake rate,complication rate and prognosis were investigated between two groups. Results： the scores of 3week awake rate and prognosis quality in treatment group was better than in the control group,the difference was statistically significant（ P〈0. 05）. Conclusion： Angong Niuhuang Pill Combined with large dose of naloxone can significantly reduce the III- IV diffuse axonal injury in awaking patients with coma period,improving the quality of life,reducing the rate of disability and death.