加味星蒌承气汤联合常规治疗对痰热腑实证脑室出血微创锥颅术后患者的临床疗效

Clinical effects of Supplemented Xinglou Chengqi Decoction combined with conventional treatment on patients with intraventricular hemorrhage due to Phlegm-Heat and Bowel-Excess Syndrome after minimally invasive craniotomy

目的 考察加味星蒌承气汤联合常规治疗对痰热腑实证脑室出血微创锥颅术后患者的临床疗效。方法 92例患者随机分为对照组和观察组,每组46例,对照组给予常规治疗(营养脑神经、脱水、降颅压等),观察组在对照组基础上加用加味星蒌承气汤,疗程2周。检测临床疗效、意识清楚时间、NIHSS评分、FMA评分、Barthel指数、MMSE评分、痰热腑实证评分、神经因子(NSE、S100β、GFAP、NGF)、炎症因子(IL-1β、IL-6、hs-CRP、TNF-α)、凝血功能指标(FIB、D-D)、脑水肿指标(AQP-1、AQP-4)变化。结果 观察组临床疗效优于对照组(P<0.05),意识清楚时间更短(P<0.05)。治疗后,2组NIHSS评分、痰热腑实证评分、NSE、S100β、GFAP、炎症因子、凝血功能指标、脑水肿指标降低(P<0.05),FMA评分、Barthel指数、MMSE评分、NGF升高(P<0.05),以观察组更明显(P<0.05)。结论 加味星蒌承气汤联合常规治疗可抑制痰热腑实证脑室出血微创锥颅术后患者炎症,调节神经因子水平,改善血液高凝状态和脑水肿,促进神经功能恢复,提高日常生活活动能力。

AIM To investigate the clinical effects of Supplemented Xinglou Chengqi Decoction combined with conventional treatment on patients with intraventricular hemorrhage due to Phlegm-Heat and Bowel-Excess Syndrome after minimally invasive craniotomy.METHODS Ninety-two patients were randomly assigned into control group(46 cases) for 2-week intervention of conventional treatment(nourishing brain nerves,dewatering,lowering intra cranial pressure,etc.),and observation group(46 cases) for 2-week intervention of both Supplemented Xinglou Chengqi Decoction and conventional treatment.The changes in clinical efficacy,consciousness time,NIHSS score,FMA score,Barthel index,MMSE score,Phlegm-Heat and Bowel-Excess Syndrome score,neurological factors(NSE,S100β,GFAP,NGF),inflammatory factors(IL-1β,IL-6,hs-CRP,TNF-α),coagulation function indices(FIB,D-D) and brain edema indices(AQP-1,AQP-4) were detected.RESULTS The observation group demonstrated better clinical efficacy than the control group(P<0.05),along with shorter consciousness time(P<0.05).After the treatment,the two groups displayed decreased NIHSS score,Phlegm-Heat and Bowel-Excess Syndrome score,NSE,S100β,GFAP,inflammatory factors,coagulation function indices and brain edema indices(P<0.05),and increased FMA score,Barthel index,MMSE score and NGF(P<0.05),especially for the observation group(P<0.05).CONCLUSION For the patients with intraventricular hemorrhage due to Phlegm-Heat and Bowel-Excess Syndrome after minimally invasive craniotomy,Supplemented Xinglou Chengqi Decoction combined with conventional treatment can inhibit inflammation,regulate nerve factor levels,improve blood hypercoagulability and cerebral edema,promote nerve function recovery and enhance daily living activity.