BIS在醒脑静注射液促醒疗效评估中的应用

发布时间：2018-05-18 06:44

  本文选题：昏迷 + 醒脑静　； 参考：《广州中医药大学》2015年硕士论文

【摘要】：目的：本研究旨在观察醒脑开窍法代表方药醒脑静注射液对中医辨证属于热闭型昏迷患者的影响,通过对比脑电双频指数(bispectral index, BIS)及格拉斯哥昏迷指数(glasgow coma scale, GCS)的变化评价其促醒效果,并且评价BIS在意识障碍患者意识状态监测中的应用。方法：以48例中医辨证属于热闭型的昏迷患者为研究对象,随机分为试验组和对照组,两组均进行BIS监测,治疗方面,试验组和对照组均给予西医常规治疗(包括开放气道、稳定生命体征、病因治疗、改善脑循环、控制脑水肿、降低颅内压、抗感染、抗惊厥、营养脑细胞、基本营养支持、护理支持及其它对症治疗等),试验组在西医常规治疗的基础上加用醒脑静注射液(20ml qd),观察两组患者在用药前及用药后相同时间点(以开始用药为时间起点)BIS及GCS的变化,7天为观察时间终点。收集数据,统计分析。结果：1.两组患者治疗前基线资料(性别、年龄、APACHE Ⅱ、GCS、发病至接受治疗的时间)的对比,差异无统计学意义(P0.05),说明两组资料具有可比性；2.治疗前后的组内对比,两组患者的GCS和BIS均有所升高,差异有显著统计学意义(P0.01)；3.治疗后两组间的对比,试验组的GCS和BIS均高于对照组,差异有统计学意义(P0.05);4.第7天(观察时间终点)时,实验组的患者状况优于对照组,差异有统计学意义(P0.05)；5.治疗前,所有患者的BIS与GCS具有显著相关性(r=0.949,P0.01)；治疗后试验组患者的BIS与GCS具有显著相关性(r=0.851,P0.01),对照组患者的BIS与6CS具有显著相关性(r=0.928,P0.01)。结论：1.无论是西医常规治疗,还是西医常规治疗联合应用醒脑静注射液,均能改善昏迷患者的病情；2.与西医常规治疗相比,联合应用醒脑静注射液能够更好的改善昏迷患者的病情；3.在昏迷患者的意识状态监测方面,BIS与GCS具有良好的相关性,且属于客观指标,值得临床进一步推广。
[Abstract]:Objective: to observe the effect of XingnaoKaiqiao method on the syndrome differentiation of Chinese medicine patients in coma of heat closure type, and to observe the effect of Xingnaojing injection on the syndrome differentiation of traditional Chinese medicine. The effects of bispectral index (BISs) and Glasgow coma scale, GCS) were evaluated by comparing bispectral index (BISs) and Glasgow coma scale, GCS), and the application of BIS in consciousness state monitoring in patients with consciousness disorder was evaluated. Methods: 48 cases of coma patients with heat shut-down syndrome differentiation were randomly divided into two groups: experimental group and control group. Both groups were monitored by BIS. The treatment group and control group were treated with routine western medicine treatment (including open airway). Stabilization of vital signs, treatment of etiology, improvement of cerebral circulation, control of brain edema, reduction of intracranial pressure, anti-infection, anti-convulsion, nutritious brain cells, basic nutritional support, Nursing support and other symptomatic treatment, the trial group was treated with Xingnaojing injection 20ml QDX on the basis of routine western medicine treatment. The patients in the two groups were observed before and after medication at the same time point (taking the beginning of medication as the starting point of time) and GCS. The change of 7 days was the end of observation time. Collect data and analyze statistics. The result is 1: 1. There was no significant difference between the two groups in baseline data before treatment (sex, age, Apache 鈪，

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