活血化瘀法治疗慢性硬膜下血肿临床疗效

Clinical efficacy of the promoting blood circulation and removing blood stasis method in the treatment of chronic subdural hematoma

目的基于活血化瘀法治疗慢性硬膜下血肿,探讨消瘀康胶囊治疗慢性硬膜下血肿的临床疗效。方法选取硬膜下血肿患者137例,随机分为观察组56例,对照组81例。对照组进行常规治疗,观察组在对照组的基础上加用消瘀康胶囊治疗(当归、苏木、木香、赤芍等)。观察患者出入院时MGS-GCS评分、GCS评分、Barthel指数评分、ADL评分;记录服药前后CT结果显示的血肿量变化及拔除引流管时间;评价2组临床疗效。结果至出院时,观察组GCS评分较治疗前升高、MGS-GCS评分较治疗前降低,且优于对照组(P<0.05);观察组拔除引流管时间(3.49±1.30)d,优于对照组(4.38±1.51)d(P<0.05);血肿改善情况比较,观察组良好率为44.64%,显著率为30.36%,明显优于对照组的12.50%和2.5.%,差异有统计学意义(P<0.05);观察组总有效率为92.85%,优于对照组58.03%(P<0.05)。结论基于活血化瘀法组方的消瘀康胶囊,可以改善慢性硬膜下血肿术后患者神经功能,促进血肿吸收,缩短引流管拔除时间,改善生活能力。

Objective To explore the clinical efficacy of Xiaoyukang Capsules in the treatment of chronic subdural hematoma based on the method of promoting blood circulation and removing blood stasis.Methods A total of 137 patients with subdural hematoma were enrolled as the study subjects and randomly divided into an observation group(56 cases)and a control group(81 cases).The control group received a conventional treatment,while the observation group was treated with Xiaoyukang Capsules(Chinese angelica,sappan wood,common aucklandia root,peony root,etc.)on that basis.The MGS-GCS score,Barthel index score and ADL score were observed upon the patients’admission and discharge,while the changes of hematoma volume shown by the CT results before and after medication and the drainage tube removal time were recorded,and the clinical efficacy of the two groups was evaluated.Results At discharge,the GCS score of the observation group was higher than before treatment,while the MGS-GCS score was lower and both significantly better than those of the control group(P<0.05).The drainage tube removal time in the observation group[(3.49±1.30)days]was better than that in the control group[(4.38±1.51)days](P<0.05).The hematoma improvement rate(44.64%)and its significant rate(30.36%)in the observation group were significantly better than 12.50%and 2.5.%in the control group(P<0.05).The total effective rate in the observation group was 92.85%,significantly better than 58.03%in the control group(P<0.05).Conclusion Xiaoyukang Capsules,whose prescription is formulated on the basis of the method of promoting blood circulation and removing blood stasis,can improve the neurological function,promote the absorption of hematoma,shorten the drainage tube removal time,and improve their living ability of patients with chronic subdural hematoma.