桃核承气汤结合甘露醇治疗高血压性脑出血急性期脑水肿的临床研究

Clinical effects of mannitol combined with Taohe Chengqi decoction on encephaledema in acute stage of hypertensive cerebral hemorrhage

目的评价桃核承气汤与甘露醇联合治疗高血压性脑出血急性期脑水肿的临床疗效。方法采用回顾性分析的方法,选取86例高血压性脑出血病人,根据治疗方法的不同分为2组,试验组采用桃核承气汤及甘露醇联合治疗,对照组采用单纯甘露醇脱水治疗,共治疗21 d,疗程结束后对2组治疗前后神经功能缺损评分(NIHSS)、日常生活功能(ADL)评分、中医症状及体征评分、头颅CT出血灶血肿大小进行比较,记录并发症的发生率并进行组间比较。结果 2组病人治疗21 d后NIHSS评分、ADL评分、中医症状及体征积分、血肿大小与治疗前比较差异具有统计学意义(P<0.05),且2组比较差异具有统计学意义(P<0.05)。2组并发症比较,差异无统计学意义。结论桃核承气汤与甘露醇联合治疗高血压性脑出血能显著改善病人出血后脑水肿及预后,提高临床疗效,降低并发症发生率,值得临床上推广应用。

Objective To investigate the clinical effects of mannitol combined with Taohe Chengqi decoction on encephaledema in acute stage of hypertensive cerebral hemorrhage. Methods The retrospective analysis was performed in 86 patients with hypertensive cerebral hemorrhage,and the patients were divided into two groups according to different intervention methods. The experimental group received the treatment of mannitol combined with Taohe Chengqi decoction,and the control group received mannitol dehydration treatment,and the treatment course was 21 d in the two groups. Before or after the treatment,National Institutes of Health Stroke Scale（ NIHSS） score,ability of daily living（ ADL） score,symptoms and signs of traditional Chinese medicine integral score and the hematoma size were recorded and compared. The incidence rate of complications in the two groups was compared. Results The scores of NIHSS,ADL,symptoms and signs of traditional Chinese medicine 21 d after treatment were statistically different from those before the treatment（ P〈0. 05） in two groups, especially in the experimental group（ P〈0. 05）. The incidence rate of the complications showed no significant differences between the two groups. Conclusions Taohe Chengqi decoction combined with mannitol in treatment of encephaledema of hypertensive cerebral hemorrhage can obviously improve the cerebral edema,clinical efficacy and prognosis.