黄芪桂枝五物汤加味联合阿托伐他汀治疗老年慢性硬膜下血肿钻孔引流术后的临床效果

Clinical Efficacy of Modified Huangqi Guizhi Wuwu Decoction Combined with Atorvastatin in Elderly Chronic Subdural Hematoma after Trepanation and Drainage

目的:分析黄芪桂枝五物汤加味联合阿托伐他汀对慢性硬膜下血肿(CSDH)钻孔引流术后患者的影响。方法:选择2020年3月—2021年7月贵溪市中医院收治的120例CSDH患者。随机分为治疗组和对照组,各60例。两组均接受标准的钻孔引流手术治疗,在此基础上,治疗组给予黄芪桂枝五物汤加味联合阿托伐他汀治疗;对照组仅给予阿托伐他汀治疗。比较两组术后恢复速度、血肿消散情况、神经功能恢复情况及并发症发生率。结果:治疗组总有效率显著高于对照组,差异有统计学意义(P<0.05)。治疗后,两组日常生活活动能力(ADL)评分均高于治疗前,神经功能缺损评分标准(CSS)评分、超敏C反应蛋白(hs-CRP)和白细胞介素-6(IL-6)均低于治疗前,且治疗组ADL评分高于对照组,CSS评分、hs-CRP、IL-6均低于对照组,差异均有统计学意义(P<0.05)。治疗组复发率低于对照组,差异有统计学意义(P<0.05)。两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:黄芪桂枝五物汤加味联合阿托伐他汀治疗CSDH钻孔引流术后患者,可促进术后恢复,改善患者生活能力和神经功能,减少并发症的发生。

Objective:To analyze the effect of Modified Huangqi Guizhi Wuwu Decoction combined with Atorvastatin on patients with chronic subdural hematoma(CSDH)after trepanation and drainage.Method:A total of 120 patients with CSDH admitted to Guixi City Traditional Chinese Medicine Hospital from March 2020 to July 2021 were selected.They were randomly divided into treatment group and control group,with 60 cases in each group.Both groups were treated with standard trepanation and drainage,on this basis,the treatment group was given Modified Huangqi Guizhi Wuwu Decoction combined with Atorvastatin treatment;the control group was only given Atorvastatin treatment.The speed of postoperative recovery,the dissipation of hematoma,the recovery of nerve function and the incidence of complications were compared between the two groups.Result:The total effective rate of the treatment group was significantly higher than that of the control group,the difference was statistically significant(P<0.05).After treatment,activities of daily living(ADL)scores in two groups were higher than those before treatment,Chinese stroke scale(CSS)score,hypersensitive C reactive protein(hs-CRP)and interleukin-6(IL-6)in two groups were lower than those before treatment,ADL score in treatment group was higher than that in control group,CSS score,hs-CRP and IL-6 in treatment group were lower than those in control group,the differences were statistically significant(P<0.05).The recurrence rate of the treatment group was lower than that of the control group,and the difference was statistically significant(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion:Modified Huangqi Guizhi Wuwu Decoction combined with Atorvastatin in the treatment of CSDH patients after trepanation and drainage can promote postoperative recovery,improve patients'life ability and neurological function,and reduce the occurrence of complications.