亚低温联合安宫牛黄丸治疗重型颅脑损伤的临床效果及对神经功能和脑血流指标的影响

Effects of Angong Niuhuang pill combined with mild hypothermia in treatment of severe traumatic brain injury and its effect on nerve function and cerebral blood flow index

目的探讨安宫牛黄丸联合亚低温治疗重型颅脑损伤(severe traumatic brain injury,STBI)的临床效果及对神经功能和脑血流指标的影响。方法选取2016年1月—2021年4月河南省人民医院收治的重型颅脑损伤患者98例,根据治疗方式不同分成观察组和对照组,各49例。给予亚低温治疗者设为对照组,在对照组基础上联用安宫牛黄丸治疗者设为观察组。比较两组患者治疗后的临床效果,采用格拉斯哥的昏迷量表评分(Glasgow coma scale,GCS)及神经功能的缺损程度分级评分(National Institutes 0f Heahh Stroke Scale,NIHSS)对两组患者的治疗前后神经功能进行评估,并观察两组患者治疗前后的脑血流指标[均匀血流量(Qmean)、均匀血流速度(Vmean)及脑血管脉搏波的波速(Wv)]。结果治疗后观察组治疗总有效率95.9%(47/49)明显高于对照组79.6%(39/49),差异有统计学意义,P<0.05;治疗后两组GCS评分均升高,且观察组显著高于对照组,治疗后两组NIHSS评分均下降,且观察组显著低于对照组,差异有统计学意义,P<0.05;治疗后两组Qmean、Vmean均升高,且观察组明显高于对照组,治疗后两组Wv均下降,而且观察组明显低于对照组,差异具有统计学意义,P<0.05。结论宫牛黄丸联合亚低温可明显提高重型颅脑损伤的临床效果,并改善神经功能及脑血流,值得临床进一步推广。

Objective To explore the effect of angong niuhuang pill combined with mild hypothermia in the treatment of severe traumatic brain injury and its effect on nerve function and cerebral blood flow index.Methods Ninety-eight pa-tients with severe craniocerebral injury admitted to our hospital from January 2016 to April 2021 were selected and divid-ed into observation group and control group according to different treatment methods,with 49 cases in each group.The control group was treated with mild hypothermia,and the observation group was treated with Angong Niuhuang Pill on the basis of the control group.The clinical effects after treatment were compared between the two groups.Before and after treatment of two groups,used the Glasgow coma scale(GCS)and the neurological deficit scale(NIHSS)to evaluate the neurological function.The cerebral blood flow indexluniform blood flow(Qmean),uniform blood flow rate(Vmean)and the wave velocity of cerebral blood vessel pulse(Wv)J of the two groups before and after treatment were observed.Results After treatment,total effective rate of clinical treatment in observation group was 95.9%(47/49),signifi-cantly higher than 79.6%(39/49)in control group,the difference was significant and statistically significant,P<0.05.GCS score afer treatment in two group were higher,and observation group was significantly higher than that of the control group,NIHSS score after treatment in two group were lower,and observation group was significantly lower than that of the control group,the difference was significant and statistically significant,P<0.05.Two groups after treatment,Qmean,Vmean were increased,and observation group was higher than that of the control group,two groups after treatment Wv were decreased,and observation group was lower than that of the control group,the difference was significant and statistically significant,P<0.05.Conclusion Angong niuhuang pill combined with mild hypothermia can obviously improve the clinical effect of severe traumatic brain injury and improve nerve function and cerebral blood flow,which is worth further promotion in the clinical.