补肾逐瘀化痰方治疗急性脑出血的临床观察

Clinical observation on treating acute cerebral hemorrhage withthe Bushen Zhuyu Huatan decoction

目的:观察补肾逐瘀化痰方治疗急性脑出血的临床疗效.方法:将80例急性脑出血患者随机分为对照组与治疗组各40例,两组均予常规基础治疗,对照组在常规基础治疗的基础上采用血塞通胶囊治疗,观察组在常规基础治疗的基础上采用补肾逐瘀化痰方治疗.两组均治疗21 d.结果:两组治疗后14 d、21 d、90 d的神经功能缺损评分(National Institute Of Health Stroke Scale,NIHSS)较治疗前均有降低(P<0.05),且观察组治疗后14 d、21 d、90 d评分低于对照组(P<0.05);两组治疗后21 d、90 d的日常生活能力评分(Barthel指数)较治疗前均升高(P<0.05),且观察组21 d、90 d评分高于对照组(P<0.05);两组治疗后(14±2)d血肿及其周围水肿体积较治疗前均降低(P<0.05),且观察组均低于对照组(P<0.05);两组治疗后21 d中医证候积分、血清神经元特异性烯醇化酶(Neuron-Specific Enolase,NSE)、超敏C反应蛋白(Hypersensitive C-reactive Protein,hs-CRP)较治疗前均降低(P<0.05),且观察组均低于对照组(P<0.05);治疗组总有效率高于对照组(P<0.05).结论:补肾逐瘀化痰方能够降低急性脑出血NSE、hs-CRP表达水平,促进血肿及血肿周围水肿的吸收,改善中医证候评分及神经功能缺损评分,提高日常生活能力及临床疗效.

Objective:To observe the clinical efficacy of the Bushen Zhuyu Huatan decoction(补肾逐瘀化痰方)on acute cerebral hemorrhage.Methods:80 patients were randomly divided into the control group and the treatment group,40 cases in each group.The groups were given conventional basic treatment.The control group was treated with the Xuesaitong capsule(血塞通胶囊)more.The observation group was treated with the Bushen Zhuyu Huatan decoction more,for 21 days.Results:The NIHSS scores at 14 days,21 days and 90 days after treatment were lower than before treatment(P<0.05),and the scores in the observation group were lower than the control group at 14 days,21 days and 90 days after treatment(P<0.05).The scores of Barthel index at 21 days and 90 days were higher than before treatment(P<0.05),and the scores in the observation group were higher than the control group at 21 days and 90 days(P<0.05).The volume of hematoma and the volume of surrounding edema after treatment were lower than before treatment(P<0.05),and those in the observation group were lower(P<0.05).The scores of TCM syndrome,NSE and hs-CRP were lower than before treatment(P<0.05),and those in the observation group were lower(P<0.05).The total efficiency in the treatment group was higher(P<0.05).Conclusion:The Bushen Zhuyu Huatan decoction can reduce the expression of NSE and hs-CRP,promote the absorption of edema around hematoma and hematoma,reduce TCM syndrome score and neurological deficit score,and improve daily living ability and clinical efficacy.