通窍化瘀醒神汤联合标准大骨瓣手术治疗重度颅脑损伤患者的有效性研究

The effectiveness of Tongqiao Huayu Xingshen Decoction combined with standard large bone flap surgery in treatment of severe brain injury

目的观察通窍化瘀醒神汤联合标准大骨瓣手术治疗重度颅脑损伤患者的有效性。方法将我院收治的重度颅脑损伤78例患者依不同治疗方法分为对照组与治疗组各39例。两组均进行标准大骨瓣手术治疗,对照组采用奥拉西坦治疗,研究组采用奥拉西坦联合通窍化瘀醒神汤治疗。比较两组治疗结果、脑灌注压值(CCP)、脑功能障碍评分(DRS)情况及生存质量、炎症因子水平、不良反应情况。结果研究组患者临床治疗优良率高于对照组(P<0.05);治疗后,研究组CCP评分大于对照组(P<0.05),DRS评分小于对照组(P<0.05);研究组生存质量评分优于对照组(P<0.05);研究组超敏C反应蛋白(hs-CPR)、肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)等炎症因子水平低于对照组(P<0.05);研究组不良反应发生率低于对照组(P<0.05)。结论通窍化瘀醒神汤联合标准大骨瓣手术治疗重度颅脑损伤患者有效性较好,值得临床应用推广。

Objective To observe the efficacy of Tongqiao Huayu Xingshen Decoction combined with standard large bone flap surgery in patients with severe craniocerebral injury.Methods A total of 78 patients with severe craniocerebral injury were divided into control group and treatment group according to different treatment methods.Both groups were treated with standard large bone flap surgery control group was treated with olacetam,and study group was treated with olacetam combined with Tongqiao Huayu Xingshen Decoction.The treatment results,cerebral perfusion pressure(CCP);brain dysfunction(DRS),quality of life inflammatory factor levels and adverse reactions were compared between the two groups.Results The excellent and good rate of clinical treatment in study group was higher than control group(P<0.05);after treatment,CCP in study group was higher than control group(P<0.05) and DRS score was lower(P<0.05),the score of quality of life in study group was better than control group(P<0.05);the levels of high sensitivity C-reactive protein(hs-CPR),tumor necrosis factor-α(TNF-α),inflammatory factors such as interleukin-6(IL-6) were lower than control group(P<0.05),the incidence of adverse reactions was lower than control group(P<0.05).Conclusion Tongqiao Huayu Xingshen Decoction combined with standard large bone flap surgery is effective in treatment of severe craniocerebral injury,which is worthy of clinical application and promotion.