滋阴活血通下法治疗亚急性期幕上脑出血临床观察

Clinical observation on the nourishing Yin,activating blood and purgation method in treating subacute supratentorial intracerebral hemorrhage

目的:探讨滋阴活血通下法治疗幕上脑出血亚急性期的临床疗效。方法:收集潍坊市中医院脑病重症急救科住院治疗的亚急性期幕上脑出血患者60例,按随机数字表法分为观察组与对照组,每组30例,所有脑出血患者均给予西医常规治疗(参照《2019年中国脑出血诊治指南》),观察组同时给予滋阴活血通下法中药口服,疗程为14 d,通过颅脑CT平扫计算两组患者治疗前后的血肿及水肿体积,同时收集两组患者治疗前后血肿及水肿体积、美国国立卫生研究院卒中量表(National Institute of Health Stroke Scale,NIHSS)评分、中医症状评分、C反应蛋白(C-reactive Protein,CRP)、神经元特异性烯醇化酶(Neuron Specific Enolase,NSE)等数据,比较两组的临床疗效。结果:两组患者治疗14 d后的血肿及水肿体积较治疗前均明显降低(P<0.01),且观察组均低于对照组(P<0.05);两组患者治疗14 d后的NIHSS评分较治疗前均明显降低(P<0.01),且观察组明显低于对照组(P<0.01);两组患者治疗14 d后的中医症状评分较治疗前均明显降低(P<0.01),且观察组明显低于对照组(P<0.01);两组患者治疗14 d后的CRP、NSE指标较治疗前均明显降低(P<0.01),且观察组均明显低于对照组(P<0.01)。结论:在幕上脑出血亚急性期联合应用滋阴活血通下法治疗能显著促进血肿的吸收及水肿的消退,同时能提高临床疗效,改善患者的预后。

Objective:To explore the clinical effect of the nourishing Yin(阴),activating blood and purgation method on subacute supratentorial intracerebral hemorrhage.Methods:A total of 60 cases of subacute supratentorial intracerebral hemorrhage from the intensive care and emergency department of encephalopathy of Weifang Traditional Chinese Hospital were collected and randomly divided into the observation group and the control group,with 30 cases in each group;all patients with intracerebral hemorrhage were given conventional Western medicine treatment(reference to 2019 Guidelines for the Diagnosis and Treatment of Cerebral hemorrhage in China),the observation group was given nourishing Yin,activating blood and purgation method at the same time,and the course of treatment was 14 days.The volumes of hematoma and edema in the two groups before and after treatment were calculated by brain CT scan,and the volumes of hematoma and edema,NIHSS score,TCM syndrome score,C-reactive protein(CRP),and neuronspecific enolase(NSE)in the two groups before and after treatment were collected;the clinical efficacy in the two groups was compared.Results:The hematoma and edema volume after 14 days of treatment in both groups were significantly lower than those before treatment(P<0.01),and the hematoma and edema volumes in the observation group were lower than the control group(P<0.05);the NIHSS score after 14 days of treatment in both groups were significantly lower than those before treatment(P<0.01),and in the observation group was significantly lower than the control group(P<0.01).The TCM symptom scores after 14 days of treatment in both groups was significantly lower than those before treatment(P<0.01),and in the observation group were significantly lower than the control group(P<0.01).The CRP and NSE after 14 days of treatment in both groups were significantly lower than those before treatment(P<0.01),and in the observation group were lower than the control group(P<0.05).Conclusions:Combination with the nourishing Yin,activating blood and purgation method can significantly promote the absorption of hematoma and the regression of edema,improve the clinical efficacy and prognosis of patients with subacute supratentorial intracerebral hemorrhage.