安宫牛黄丸结合Lund概念治疗重型颅脑损伤效果观察

Effect of Angongniuhuang pill combined Lund concept in the treatment of severe craniocerebral injury

目的探讨安宫牛黄丸结合Lund概念治疗重型颅脑损伤的方法及临床疗效。方法将56例重型颅脑损伤术后患者随机分为观察组与对照组各28例,对照组给予常规治疗,观察组给予Lund概念结合安宫牛黄丸等治疗,比较治疗前、治疗1、3、7d后2组患者颅内压、大脑中动脉平均血流速度、CPP水平,治疗期间并发症发生情况,以及术后3个月时临床疗效。结果治疗前、治疗1d后2组ICP、MCA平均血流速度、CPP比较差异无统计学意义(P>0.05),治疗3、7d观察组ICP、MCA平均血流速度、CPP均显著优于对照组(P<0.01);治疗前、治疗后1、3d2组GCS评分比较差异无统计学意义(P>0.05);治疗7d后观察组GCS评分明显优于对照组(P<0.05);给药期间观察组高热、抽搐发生率显著低于对照组(P<0.05),肺部感染、肾功能损害发生率组间比较差异无统计学意义(P>0.05);损伤后3个月观察组良好率、病死率与对照组比较差异均有统计学意义(P<0.05)。结论安宫牛黄丸结合Lund概念治疗重型颅脑损伤可有效降低患者颅内容积,提高脑灌注压,改善昏迷症状,提高临床疗效,减少并发症。

Objective To observe the methods and clinical effects of Angongniuhuang pill combines Lund concept in the treatment of severe craniocerebral injury. Methods We randomly divided 56 postoperative patients with severe craniocerebral injury into observation group and control group,28 cases in each group.Control group was treated with conventional therapy and the observation group was treated with Lund concept combined Angongniuhuang pill.The intracranial pressure,the CPP level,the average blood flow velocity of the middle cerebral artery and the complication occurrence during the therapy of the patients before and 1,3 and 7 days after the treatment were compared and the clinical effects 3 months after the treatment was also compared. Results There was no significant difference on the ICP,the average blood flow velocity of MCA and the CPP in the two groups before and 1 day after the treatment（ P 〉0.05）;3 and 7 days after the treatment,the ICP,the average blood flow velocity of MCA and the CPP in the observation group were obviously superior to that in control group;the GCS scores of the two groups 1 and 3 days before and after the treatment had no significant difference（ P 〉0.05）.7 days after the treatment,the GCS scores of the observation group was obviously superior to that in control group（ P 〈0.05）.The hyperpyrexia and convulsion occurrence rate of the observation group was obviously lower to that in control group（ P 〈0.05）,the occurrence rate of the pulmonary infection and renal function damage between the two groups had no significant difference（ P 〉0.05）.The in commission rate and death rate between the two groups had a significant difference（ P 〈0.05） 3 moths post injury. Conclusion The Angongniuhuang pill combines Lund concept can reduce the intracranial volume of the patients,enhance cerebral perfusion pressure,improve the coma symptom,enhance the clinical effect and reduce the complication in the treatment of severe craniocerebral injury.