活血涤痰利脑汤联合尼莫地平对高血压脑出血患者术后神经功能的影响

Effect of Huoxue Ditan Linao decoction combined with nimodipine on neurological function in patients with hypertensive intracerebral hemorrhage after operation

目的:探讨活血涤痰利脑汤联合尼莫地平对高血压脑出血(HICH)患者微创血肿清除术后神经功能的影响。方法:根据治疗方法不同将100例HICH患者分为对照组(n=50)与观察组(n=50)。对照组术后予以尼莫地平,观察组在对照组基础上加用活血涤痰利脑汤,两组均联连续治疗14 d。比较两组治疗总有效率,治疗前后进行格拉斯哥昏迷指数(GCS)、美国国立卫生研究院卒中量表(NIHSS)、Fugl-Meyer运动功能量表评价,并测定脑血管平均血流、脑血管平均流速、血管外周阻力等脑血流动力学参数,血清可溶性细胞间黏附分子-1(sICAM-1)、基质金属蛋白酶-9(MMP-9)、活性氧簇(ROS)水平,且观察两组的不良反应。结果:观察组患者的治疗总有效率为92.00%,高于对照组的76.00%(P<0.05)。治疗后,观察组GCS、Fugl-Meyer评分均高于对照组(P<0.05),NIHSS评分低于对照组(P<0.05);观察组脑血管平均流量、脑血管平均流速高于对照组(P<0.05),血管外周阻力低于对照组(P<0.05);观察组血清sICAM-1、MMP-9、ROS水平均低于对照组(P<0.05)。两组不良反应发生率对比,差异无统计学意义(P>0.05)。结论:活血涤痰利脑汤联合尼莫地平可有效改善HICH患者微创术后脑血流动力学,降低血清sICAM-1、MMP-9、ROS水平,促进神经功能恢复,且安全性较高。

Objective:To investigate the effect of Huoxue Ditan Linao decoction combined with nimodipine on neurological function in patients with hypertensive intracerebral hemorrhage(HICH)after minimally invasive hematoma evacuation.Methods:100 patients with HICH were selected as the research subjects,and they were divided into the control group(n=50)and the observation group(n=50)according to the different treatment methods.The control group was given nimodipine after surgery,whereas the observation group was additionally treated with Huoxue Ditan Linao decoction on the basis of control group,and the two groups were continuously treated for 14 d.The total effective rate of treatment,scores of Glasgow Coma Scale(GCS),National Institutes of Health Stroke Scale(NIHSS)and Fugl-Meyer Motor Assessment before and after treatment were compared between the two groups.Cerebral hemodynamic parameters and levels of serum sICAM-1,MMP-9 and ROS were measured,and the adverse reactions were observed in the two groups.Results:The effective rate of the observation group was higher than that of the control group(92.00%vs.76.00%,P<0.05).After treatment,the scores of GCS and Fugl-Meyer in the observation group were higher than those in the control group(P<0.05),the NIHSS score was lower than that in the control group(P<0.05).After treatment,the mean cerebrovascular blood flow and mean cerebrovascular velocity of the observation group were higher than those of the control group(P<0.05),the peripheral vascular resistance was lower than that of the control group(P<0.05).After treatment,the levels of serum sICAM-1,MMP-9 and ROS in the observation group were lower than those in the control group,with statistically significant differences(P<0.05).There were no significant differences in the incidence rates of adverse reactions between the two groups(P>0.05).Conclusion:Huoxue Ditan Linao decoction combined with nimodipine can effectively improve cerebral hemodynamics,reduce levels of serum sICAM-1,MMP-9 and ROS,and promote the recovery of neurological function in patients with HICH after minimally invasive surgery,with good safety.