祛风活血汤联合艾灸治疗重型颅脑损伤效果观察

Effect of Qufeng Huoxue Decoction combined with moxibustion on severe craniocerebral injury

目的 观察祛风活血汤联合艾灸对重型颅脑损伤的治疗效果。方法 将220例重型颅脑损伤患者按照随机数字表法分为对照组和治疗组,每组110例。对照组予西医常规治疗,治疗组在对照组治疗基础上加祛风活血汤和艾灸,治疗4周。比较2组疗效。比较2组治疗前和治疗第7天功能综合评定量表(FCA)评分和格拉斯哥昏迷评定量表(GCS)评分,治疗前及治疗第3、7天白细胞介素6(IL-6)、IL-8和肿瘤坏死因子α(TNF-α)水平,治疗前和治疗4周脑损伤区脑血流量(CBF)、脑血容量(CBV),2组治疗过程中并发症发生率。结果 治疗组总有效率为93.64%(103/110),对照组总有效率为74.54%(82/110),治疗组高于对照组(P<0.05)。治疗7天,2组FCA和GCS评分均较本组治疗前提高(P<0.05),且治疗组均高于对照组(P<0.05)。治疗3天,2组IL-6、IL-8及TNF-α水平均较本组治疗前升高(P<0.05),但治疗组明显低于对照组(P<0.05);治疗7天,2组IL-6、IL-8及TNF-α水平均较本组治疗前显著降低(P<0.05),且治疗组明显低于对照组(P<0.05)。治疗4周,2组CBV及CBF均较本组治疗前提高(P<0.05),且治疗组高于对照组(P<0.05)。治疗组肺部感染、消化道出血、肝功能损伤及肾功能损伤发生率明显均低于对照组(P<0.05)。结论 祛风活血汤联合艾灸治疗重型颅脑损伤,能控制炎症反应,减轻继发性脑损伤,增加脑血流量,促进神经功能恢复。

Objective To observe the therapeutic effect of Qufeng Huoxue Decoction combined with moxibustion on severe craniocerebral injury(SCI).Methods A total of 220 SCI patients were randomly assigned into the treatment group(n=110)and the control group(n=110).All patients were managed by routine Western medicine,and those in observation group were additionally treated with Qufeng Huoxue Decoction combined with moxibustion,and the treatment lasted for 4 weeks.Before treatment and each time point after treatment,the curative effect,functional comprehensive assessment scale(FCA)and Glasgow coma scale(GCS),the levels of interleukin-6(IL-6),IL-8 and tumor necrosis factor-α(TNF-α),the cerebral blood flow(CBF)and cerebral blood volume(CBV)of the brain injury area,and the incidence of complications were included as comparisons between groups.Results After treatment,the total effective rate in the treatment group,was significantly higher than that in the control group(93.64%[103/110]vs 74.54%[82/110],P<0.05).The 7-day scores of FCA and GCS in the both group were significantly higher than those before treatment(P<0.05),which were more pronounced in the treatment group(P<0.05).The 3-day levels of IL-6,IL-8 and TNF-αin the both groups were significantly higher than those before treatment(P<0.05),the increased in the treatment group were more(P<0.05);but 7-day levels of IL-6,IL-8 and TNF-αin the both groups were significantly lower than those before treatment(P<0.05),and the decreased in the treatment group were significant(P<0.05).The 4-week level of CBV and CBF were increased in the both groups(P<0.05),which in the treatment group were more common(P<0.05).The incidences of complications such as pulmonary infection,gastrointestinal bleeding,liver and kidney injury in the treatment group was significantly lower than those in the control group(P<0.05).Conclusion For SCI patients,Qufenghuoxue decoction combined with Moxibustion can control inflammatory reaction,relieve secondary brain injury,increase cerebral blood flow,promote recovery of nerve function.