血府逐瘀汤联合脑室腹腔-分流术治疗常压性脑积水临床疗效评价

Clinical Evaluation of Xuefu Zhuyu Decoction Combined with Ventriculoperitoneal Shunt in the Treatment of Normal Pressure Hydrocephalus

目的:探讨血府逐瘀汤联合脑室-腹腔分流术治疗常压性脑积水的临床疗效。方法:选取2011年1月—2018年4月我院收治的脑积水患者60例,采用随机数字表法分为对照组和治疗组,各30例。其中对照组予以脑室-腹腔分流术治疗,治疗组在对照组的基础上联合血府逐瘀汤治疗。比较两组患者临床疗效、巴氏指数评分(BI)、格拉斯哥昏迷指数评分(GCS)、神经功能缺损评分(NIHSS)、中医症状积分及随访情况。结果:治疗组患者临床总有效率为97.44%,对照组患者临床总有效率为84.62%,差异具有统计学意义(P<0.05);经治疗,与对照组相比,治疗组患者BI、GCS、NIHSS评分及中医证候积分改善情况更明显,差异具有统计学意义(P<0.05);经治疗,与对照组相比,随访时治疗组患者脑积水程度更轻(P<0.05)。结论:血府逐瘀汤联合脑室-腹腔分流术的治疗方案显著优于单纯脑室-腹腔分流术的常规举措,有利于脑室水肿的吸收消退,可有效降低头痛程度、频率及其并发症的发生风险。血府逐瘀汤具有行气活血、祛瘀止痛的功效,在改善脑水肿患者临床相关评分及中医证候积分方面,取得满意效果,值得临床推广。

Objective:The purpose of this study was to investigate the clinical effect of Xuefu ZhuyuDecoction combined with ventriculoperitoneal shunt in the treatment of normal pressure hydrocephalus.Methods:60 hydrocephalus patients admitted to our hospital from January 2011 to April 2018 were randomly divided into treatment group and control group with 30 cases in each group according to the table of random number. The control group was treated with ventriculoperitoneal shunt,while the treatment group was treated with Xuefu Zhuyu Decoction on the basis of the control group. The improvement of clinical efficacy,barthel index(BI),Glasgow coma scale(GCS),National Institute of Health stroke scale(NIHSS),TCM symptom scores and the curative efficacy were observed after the treatment were compared between the two groups. Results:The total clinical effective rate of treatment group and control group were 97.44% and 84.62%,respectively,and the difference was statistically significant(P<0.05);After treatment,the improvements of BI,GCS,NIHSS scores and the TCM symptom scores in the treatment group were more significant than those in the control group,and the difference was statistically significant(P<0.05);After treatment,compared with the control group,the degree of hydrocephalus was lower in the treatment group at follow-up(P<0.05). Conclusion:The treatment scheme of Xuefu Zhuyu Decoction combined with ventricular peritoneal shunt is significantly superior to the conventional method of ventricular peritoneal shunt alone,which is beneficial to the absorption and retreat of ventricular edema,and can effectively reduce the degree,frequency of headache and the risk of related complication. Xuefu Zhuyu Decoction has the effects of promoting Qi and to activating blood,dispelling blood stasis and relieving pain,and can improve clinical related scores and TCM syndrome scores of cerebral edema patients and achieve satisfactory results. So it is worthy of clinical promotion.