通腑开窍汤鼻饲对脑卒中急性期昏迷患者GCS、NIHSS、ADL评分的影响

The Effect of Nasal Feeding of Tongfukaiqiao Tang Combined With Conventional Western Treatment on GCS,NIHSS,ADL Scores of Acute Cerebral Infarction Coma Patients

目的:观察通腑开窍汤鼻饲联合西医常规治疗脑卒中急性期昏迷患者的临床疗效,并观察其对患者GCS、NIHSS、ADL评分的影响。方法:将110例脑卒中急性期昏迷患者随机分为对照组和观察组,两组各55例。对照组采用西医常规治疗,观察组在对照组治疗基础上加用通腑开窍汤鼻饲治疗。通腑开窍汤方药组成:大黄6 g,芒硝(冲服)6 g,枳实9 g,厚朴12 g,瓜蒌15 g,清半夏9 g,石菖蒲15 g,川芎15 g,麝香(冲服)0.15 g,黄芪30 g,大枣12 g,生姜9 g。水煎取汁200 m L,每日鼻饲3次,共14 d。观察两组患者的格拉斯昏迷评分(Glasgow coma scale,GCS)、神经功能缺损程度评分(National Institutes of Health Stroke Scale,NIHSS)、日常生活能力评分(activity daily liviing,ADL)和临床疗效。结果:与治疗前比较,两组治疗后的GCS、NIHSS和ADL评分都有改善(P<0.05);与对照组比较,观察组GCS、NIHSS和ADL评分的改善程度均优于对照组(P<0.05)。观察组有效率为92.73%,对照组有效率为78.18%,两组比较,差异有统计学意义(P<0.05)。结论:通腑开窍汤鼻饲联合西医常规治疗能够明显改善脑卒中急性期昏迷患者GCS、NIHSS、ADL评分,提高临床疗效。

Objective：To observe GCS,NIHSS,ADL scores and effect in the coma patients with acute cerebral infarction who received nasal feeding of Tongfukaiqiao Tang combined with conventional Western treatment. Methods：110 cases of acute cerebral infarction coma patients were randomly divided into control group（55 cases） and experimental group（55 cases）. Control group received conventional western treatment. while experimental group employed Tongfukaiqiao Tang in addition to conventional Western treatment. Herbal composition：Dahuang（ Chinese Rhubarb） 6 g,Mangxiao（ Mirabilite） 6 g（ infused with water）,Zhishi（ Fructus Aurantii Immaturus） 9 g,Houpu（ Magnolia Officinalis） 12 g,Gualou（ Trichosanthes Kirilowii） 15 g,Qingbanxia（ Alum Processed Pinellia） 9 g,Shichangpu（ Acorus Tatarinowii）15 g,Chuanxiong（ Rhizoma Chuanxiong） 15 g,Shexiang（ Musk） 0. 15 g,Huangqi（Astragalus） 30 g,Dazao（Jujube） 12 g,Shengjiang（Ginger） 9 g. Decocted in water and concentrated to 200 m L,nasal feeding three times a day,14 days altogether. Glasgow coma scale（ GCS）,NIH Stroke Scale（ NIHSS）,activity of daily living（ ADL） scores and clinical efficacy in both groups were observed. Results：GCS,NIHSS and ADL scores were improved（ P〈0. 05） after treatment in two groups;compared with the control group,the improvement of GCS,NIHSS and ADL scores in experimental group was greater（P〈0. 05）. After treatment,the effective rate of the experimental group was superior to that of the control group（P〈0. 05）. Conclusion：Nasal feeding of Tongfukaiqiao Tang combined with conventional Western treatment can significantly improve the GCS,NIHSS,ADL scores and the clinical efficacy.