自拟通窍祛瘀汤治疗外伤性气滞血瘀型脑内血肿51例

Clinical effect of self-made stuffiness-relieving and blood stasis-removing decoction in treatment of traumatic intracerebral hematoma with Qi stagnation and blood stasis:An analysis of 51 cases

目的:观察自拟通窍祛瘀汤治疗外伤性气滞血瘀型脑内血肿的临床疗效。方法:选取外伤性气滞血瘀型脑内血肿患者100例,将其随机分为治疗组(51例)和对照组(49例)。2组均予以基础治疗,对照组在基础治疗上加用西医常规治疗,治疗组在对照组基础上加用自拟通窍祛瘀汤口服治疗。治疗2周后观察2组中医证候疗效,治疗前、治疗1周后、治疗2周后观察2组血肿吸收、水肿吸收、神经功能缺失(NIHSS)评分、中医证候积分情况。结果:总有效率治疗组为94.11%(48/51),明显高于对照组的75.51%(37/49),2组比较,差异有统计学意义(P<0.05)。治疗后2组血肿体积、水肿体积、NIHSS评分、中医证候积分均较治疗前减少,且治疗组与对照组治疗后同时间节点比较,差异均有统计学意义(P<0.05或P<0.01)。结论:外伤性气滞血瘀型脑内血肿患者在常规治疗的基础上使用自拟通窍祛瘀汤治疗可以促进神经功能恢复,改善中医证候,促进血肿和水肿吸收。

Objective:To investigate the clinical effect of self-made stuffiness-relieving and blood stasis-removing decoction in the treatment of traumatic intracerebral hematoma with Qi stagnation and blood stasis.Methods:A total of 100 patients with traumatic intracerebral hematoma with Qi stagnation and blood stasis were enrolled and randomly divided into treatment group with 51 patients and control group with 49 patients.The patients in the control group received basic treatment and conventional Western medicine treatment,and those in the treatment group received the oral administration of self-made stuffiness-relieving and blood stasis-removing decoction in addition to the treatment in the control group.The two groups were observed in terms of the treatment outcome of TCM syndrome after 2 weeks of treatment,as well as hematoma absorption,edema absorption,neurological deficit(NIHSS) score,and TCM syndrome score before treatment and after 1 and 2 weeks of treatment.Results:The treatment group had a significantly higher overall response rate than the control group [94.11%(48/51) vs 75.51%(37/49),P<0.05].After treatment,both groups had significant reductions in hematoma volume,edema volume,NIHSS score,and TCM syndrome score,and there were significant differences in these indices between the two groups at each time point after treatment(P<0.05 or P<0.01).Conclusion:For patients with traumatic intracerebral hematoma with Qi stagnation and blood stasis,self-made stuffiness-relieving and blood stasis-removing decoction in addition to conventional treatment can promote neurological function recovery,improve TCM syndrome,and promote hematoma and edema absorption.