通腑醒神汤治疗高血压脑出血微创术后病人神经损伤的临床研究

Clinical Observation on Tongfu Xingshen Decoction in the Treatment of Nerve Injury after Minimally Invasive Surgery in Patients with Hypertensive Cerebral Hemorrhage

目的探讨通腑醒神汤治疗高血压脑出血微创术后病人神经损伤的临床疗效及安全性。方法选取海南省人民医院2013年6月—2014年10月收治的高血压脑出血微创术后病人96例,将其随机分为对照组与研究组,每组48例。对照组病人在常规治疗基础上加用依达拉奉治疗,研究组在对照组治疗基础上使用通腑醒神汤治疗。比较两组治疗前后脑水肿体积、血清白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、基质金属蛋白酶-9(MMP-9)水平及美国国立卫生研究院卒中量表(NIHSS)、Barthel指数,比较两组病人临床疗效及不良反应发生率。结果研究组治疗2周、6周后脑水肿体积均小于对照组(P<0.05);研究组治疗后血清IL-6、TNF-α、MMP-9水平低于对照组(P<0.05);研究组病人治疗后NIHSS评分及Barthel指数改善情况均好于对照组(P<0.05);研究组临床疗效总有效率为85.42%,明显高于对照组的62.50%(P<0.05);研究组不良反应率低于对照组(P<0.05)。结论高血压脑出血病人微创术后使用依达拉奉联合通腑醒神汤治疗可快速改善神经功能损伤。

Objective To discuss the clinical treatment effect and safety of Tongfu Xingshen decoction （TXD） in the treatment of nerve injury after minimally invasive surgery in patients with hypertensive cerebral hemorrhage.Methods Ninety-six patients with hypertensive cerebral hemorrhage and nerve injury after minimally invasive surgery in our hospital from June 2013 to October 2014 were selected,who were randomly divided into control group and study group.The patients in control group were treated with edaravone based on the conventional therapy,while the patients in study group were treated with TXD based on the control group.The cerebral edema volume,levels of serum and interleukin-6 （IL-6）,tumor necrosis factor alpha （TNF-α） and matrix metalloproteinase （MMP）-9,and scores of National Institutes of Health Stroke Scale （NIHSS） and Barthel indexes were compared between the two groups,as well as the clinical treatment effect and incidence rates of adverse reactions.Results The cerebral edema volume at 7 d and 15 d after treatment in the study group was less than that in the control group （P〈0.05）.The serum indexes in the study group were better than those in the control group （P〈0.05）.The score of NIHSS and Barthel indexe in the study group after treatment were better than those in the control group （P〈0.05）.The total effective rate in the study group was 85.42%,obviously higher than that of 62.50% in the control group （P〈0.05）.The incidence rate of adverse reactions in the study group was less than that in the control group （P〈0.05）.Conclusion The application of decoction of Tongfuxingshen in the treatment of nerve injury after minimally invasive surgery in patients with hypertensive cerebral hemorrhage can rapidly improve the nerve function injury,with high safety,which is worthy of promotion and application.