尼莫地平注射液联合参附注射液治疗创伤性蛛网膜下腔出血的临床研究

Clinical trial of nimodipine injection combined with Shenfu injection in the treatment of traumatic subarachnoid hemorrhage

目的观察创伤性蛛网膜下腔出血用于尼莫地平注射液联合参附注射液的临床疗效。方法将84例创伤性蛛网膜下腔出血患者随机分为对照组与试验组,每组42例。对照组给予尼莫地平注射液20 mg,qd,静脉滴注;试验组在对照组的基础上给予参附注射液30 mL+5%葡萄糖注射液250 m L,bid,静脉滴注。2组均连续用药14 d。比较2组患者的临床疗效、炎症因子水平、凝血功能及药物不良反应发生情况。结果治疗后,试验组预后良好率为69.05%(29/42例),对照组为47.62%(20/42例),差异有统计学意义(P<0.05)。试验组白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、凝血酶原时间、部分凝血活酶时间分别为(0.85±0.11)μg·L^(-1),(0.57±0.07)μg·L^(-1),(12.40±1.66)s,(33.75±3.88)s,对照组分别为(1.06±0.15)μg·L^(-1),(1.06±0.13)μg·L^(-1),(14.69±1.63)s,(36.69±4.44)s,差异均有统计学意义(P<0.05)。对照组出现脑梗死4例,脑积水2例,脑出血6例,脑血管痉挛6例,药物不良反应率为42.86%(18/42例);试验组出现脑梗死和脑积水各1例,脑出血和脑血管痉挛各2例,药物不良反应率为14.28%(6/42例),差异有统计学意义(P<0.05)。结论尼莫地平注射液联合参附注射液用于创伤性蛛网膜下腔出血的临床效果较好,能够利于患者预后,改善炎症反应及凝血功能。

Objective To observe the clinical effect of nimodipine combined with Shenfu injection in the treatment of traumatic subarachnoid hemorrhage. Methods Eighty-four cases of traumatic subarachnoid hemorrhage patients were randomized divided into control group and treatment group,42 cases in each group. Control group was intravenous drip nimodipine injection 20 mg,qd. Treatment group was intravenous drip Shenfu injection 30 m L,with 5% glucose injection 250 m L,bid. All patients were treated for 14 d. Clinical effect,levels of inflammation,blood coagulation function and adverse drug reactions were compared in two groups. Results After treatment,good prognosis rates in treatment group and control group were 69. 05%（ 29/42 cases）,47. 62%（ 20/42cases）,with significant difference（ P〈0. 05）. The levels of interleukin-6（ IL-6）,tumor necrosis factor-α（ TNF-α）,prothrombin time,partial thromboplastin time in treatment group were（ 0. 85 ± 0. 11） μg·L^-1,（ 0. 57 ±0. 07） μg · L^-1,（ 12. 40 ± 1. 66） s,（ 33. 75 ± 3. 88） s,had significant difference with those in control group,which were（ 1. 06 ± 0. 15） μg·L^-1,（ 1. 06 ± 0. 13） μg·L^-1,（ 14. 69 ± 1. 63） s,（ 36. 69 ± 4. 44） s（ all P〈0. 05）. There were 4 cases of cerebral infarction,2 cases of hydrocephalus,6 cases of cerebral hemorrhage,6 cases of cerebral vasospasm in control group,with the incidence of 42. 86%（ 18/42 cases）. There were 1 case of cerebral infarction,1 case of hydrocephalus,2 cases of cerebral hemorrhage,2cases of cerebral vasospasm,with the incidence of 14. 28%（ 6/42 cases）. The incidence of adverse drug reactions had significant difference in two groups（ P〈0. 05）. Conclusion The clinical effect of nimodipine combined with Shenfu injection in the treatment of traumatic subarachnoid hemorrhage is great,can benefit the patients＇ prognosis,improve the inflammation and coagulation function.