海派中医流派石氏伤科辨证论治颅脑损伤120例临床研究

Clinical Study on 120 Cases of Traumatic Brain Injury Treated by Shi’s Traumatology of Shanghai TCM School

目的:探讨海派中医流派石氏伤科中药、针刺与手法治疗颅脑损伤的临床疗效及其机制,进而优化本流派颅脑损伤特色病种诊疗体系。方法:收集上海市静安区闸北中心医院(原上海市闸北区中心医院)2012年8月—2015年7月的颅脑损伤病例共120例,随机分为中药治疗组与综合治疗组,每组60例。中药治疗组予以中药辨证论治,1帖/d,4周为1个疗程;综合治疗组在中药辨证论治基础上,结合石氏伤科针刺、手法治疗,均隔日1次,4周为1个疗程。治疗前后采用眩晕量表、简易精神状态检查表与功能独立性评测,分别检测其眩晕、认知功能与日常功能独立性;并检测血清脂蛋白(a)。结果:与中药治疗组相比,综合治疗组眩晕量表评分明显改善(P<0.01),认知功能量表评分明显提高(P<0.01),功能独立性评分的子项目中运动评分明显升高(P<0.01),而功能独立性评分总分并未明显提高(P>0.05)。同时,综合治疗组血清脂蛋白(a)水平明显降低(P<0.05)。结论:石氏伤科中药辨证论治结合石氏针刺、手法,能够更好改善颅脑损伤患者眩晕状况、认知与运动功能。石氏针刺、手法优势在于疏通经络、畅达气血进而整体协同调治。从改善患者眩晕、认知功能尤其是运动功能方面评估,石氏针刺、手法作用不可或缺。

Objective:To explore the clinical efficacy and mechanism of Shi’s traumatological Chinese medication,acupuncture and manipulation in treatment of traumatic brain injury(TBI),and to optimize the diagnosis and treatment system of characteristic diseases in Shi's traumatology.Methods:120 patients of TBI were randomly divided into the Chinese medication group and the comprehensive treatment group,with 60 cases in each group.The Chinese medication group was treated with Chinese medication based on syndrome differentiation,1 dose a day for 4 weeks;on which basis,the comprehensive treatment group was also treated with Shi's acupuncture and manipulation,once every other day for 4 weeks.Vertigo scale,Mini Mental State Examination(MMSE)and Functional Independence Measure(FIM)were used to detect the conditions of vertigo,cognitive function and daily function independence;Serum lipoprotein(α)was detected.Results:Compared with those in the Chinese medication group,the scores of vertigo scale and cognitive function scale were significantly improved(P<0.01),and the motor scores in the sub-items of FIM were significantly increased(P<0.01),although the total score of FIM was not significantly improved in the comprehensive treatment group(P>0.05).The serum lipoprotein(α)was decreased significantly in the comprehensive treatment group(P<0.05).Conclusion:Shi's traumatological Chinese mediation combined with Shi's traumatological acupuncture and manipulation can better improve the vertigo,cognitive and motor function of the patients with TBI.The advantage of Shi's traumatological acupuncture and manipulation is to dredge meridians,smooth Qi and blood,and then regulate the whole body.Shi's traumatological acupuncture and manipulation are indispensable to improve patients vertigo,cognitive function,especially motor function.