生地大黄汤辅助治疗高血压脑出血微创钻孔引流术后患者的临床观察

Clinical observation of Shengdi Dahuang Decoction in treating patients with hypertensive intracerebral hemorrhage after minimally invasive trepanation and drainage therapy

目的:观察生地大黄汤辅助治疗高血压脑出血(HICH)微创钻孔引流术后患者的临床疗效。方法:纳入接受微创钻孔引流术治疗的106例HICH患者,随机分为观察组和对照组,每组各53例。两组患者均接受微创钻孔引流术治疗,术后给予西医常规疗法;在此基础上,观察组患者从术后第1天开始予生地大黄汤口服或鼻饲,连续14 d。比较两组患者手术前后的血肿体积及格拉斯哥昏迷量表(GCS)评分;治疗后随访6个月,评价并比较两组患者的Barthel指数(BI)评分和扩展格拉斯哥结局量表(GOS-E)评分;比较两组患者的住院天数。结果:研究过程中,对照组和观察组均有1例患者脱落,最终对照组52例、观察组52例纳入统计分析。(1)术后,两组患者的血肿体积均显著缩小(P<0.05),且术后7 d、14 d,观察组患者的血肿体积较对照组明显缩小(P<0.05)。(2)术后14 d,两组患者的GCS评分均明显升高(P<0.05),但组间GCS评分比较,差异无统计学意义(P>0.05)。(3)治疗后1个月、3个月、6个月,观察组患者的BI评分均明显高于对照组(P<0.05);治疗后6个月,观察组患者的GOS-E评分亦明显高于对照组(P<0.05)。(4)观察组患者的平均住院天数较对照组明显缩短(P<0.05)。结论:生地大黄汤辅助治疗HICH微创钻孔引流术后患者,能够加快术后血肿的吸收、促进脑损伤功能的恢复、提高患者的生活自理能力、缩短住院天数,值得临床推广。

Objective: To observe the clinical efficacy of Shengdi Dahuang Decoction in treating patients with hypertensive intracerebral hemorrhage(HICH) after minimally invasive trepanation and drainage therapy. Methods: A total of 106 patients with HICH who were treated with minimally invasive trepanation and drainage therapy were included, and randomly divided into the observation group and control group, 53 cases in each group. The patients in both groups were treated with minimally invasive trepanation and drainage therapy and routine western medicine after operation. Based on above, the patients in the observation group were treated with Shengdi Dahuang Decoction by oral administration or nasogastric feeding from the first day after operation, with a course of 14 days. The hematoma volume and the score of Glasgow coma scale(GCS) before and after operation were compared between the two groups. After treatment, all patients were followed-up for 6 months, the scores of Barthel index(BI) and extended Glasgow outcome scale(GOS-E) in both groups were evaluated and compared, and the hospitalization days of the two groups were compared. Results: In the course of research, one patient in the control group and one patient in the observation group shed,finally 52 cases in the control group and 52 cases in the observation group were included in the statistical analysis.(1)After operation,the hematoma volume of the two groups were significantly reduced( P<0.05),and on the 7 th and 14 th days after operation,the hematoma volume of the observation group was significantly smaller than that of the control group( P<0.05).(2)On the 14 th day after operation,the GCS scores of the two groups were significantly increased( P<0.05),while there was no statistically significant difference in GCS score between the two groups( P>0.05).(3)One month,three months and six months after treatment,the BI score of the observation group was higher than that of the control group( P<0.05). Six months after treatment,the GOS-E score of the observation group was also higher than that of the control group( P<0.05).(4)The average hospitalization days of the observation group were significantly less than those of the control group( P < 0. 05). Conclusion: Shengdi Dahuang Decoction can accelerate the absorption of postoperative hematoma in treating patients with HICH after minimally invasive trepanation and drainage therapy,promote the recovery of brain injury function,enhance the life self-care ability and shorten the hospitalization days,which is worthy of clinical popularization.