香蒲醒神汤联合高压氧治疗重型颅脑损伤后意识障碍的临床研究

发布时间：2018-04-27 18:03

本文选题：香蒲醒神汤 + 高压氧　；参考：《中国临床药理学杂志》2016年22期

【摘要】：目的观察香蒲醒神汤联合高压氧治疗重型颅脑损伤后意识障碍的临床疗效。方法 54例重型颅脑损伤后意识障碍患者随机分为对照组及试验组,各27例。对照组在常规治疗的基础上给予高压氧治疗,每次60 min,每天1次,试验组在对照组基础上加用香蒲醒神汤(以麝香、蒲黄、石菖蒲、冰片等为主的中药复方),每次125 m L,每天2次,鼻饲;2组均治疗1个月。比较2组患者治疗前后血清S100蛋白(S100-B)、髓鞘碱性蛋白(MBP)、神经元特异性烯醇化酶(NSE)水平、清醒时间、格拉斯哥预后评分(GOS)及临床疗效情况。结果治疗后,试验组有效率为77.78%(21/27例),对照组为62.97%(17/27例),差异有统计学意义(P0.05)。治疗后,对照组血清S100-B为(1.06±0.15)μg·L~(-1),MBP为(6.56±0.75)μg·L~(-1),NSE为(12.65±1.53)μg·L~(-1),试验组血清S100-B为(0.54±0.07)μg·L~(-1),MBP为(1.72±0.24)μg·L~(-1),NSE为(6.48±0.92)μg·L~(-1),差异有统计学意义(P0.05)。对照组患者清醒时间为(24.73±3.52)d,GOS评分为(2.73±0.36)分;试验组患者清醒时间为(15.28±2.16)d,GOS评分为(3.86±0.55)分,差异有统计学意义(P0.05)。药物不良反应主要表现为烦躁、恶心,2组药物不良反应发生率差异无统计学意义(P0.05)。结论香蒲醒神汤联合高压氧治疗能够显著降低重型颅脑损伤后意识障碍患者的血清S100-B、MBP及NSE水平,缩短清醒时间,改善患者预后,有较好的临床疗效,且安全性较高。
[Abstract]:Objective to observe the clinical effect of Huangpu Xingshen decoction combined with hyperbaric oxygen on consciousness disorder after severe craniocerebral injury. Methods 54 patients with severe craniocerebral injury were randomly divided into control group (n = 27) and experimental group (n = 27). The control group was treated with hyperbaric oxygen once a day for 60 minutes on the basis of routine treatment. The experimental group was treated with Typha Xingshen decoction on the basis of the control group. Borneol and other traditional Chinese medicine compound compound, 125 mL per time, twice a day, nasal feeding group 2 were treated for 1 month. The levels of serum S100 protein, myelin basic protein (MBP), neuron-specific enolase (NSE), waking time, Glasgow prognosis score (Glasgow prognosis score) and clinical efficacy were compared before and after treatment. Results after treatment, the effective rate was 77.78 / 21 / 27 in the trial group and 62.97 / 17 / 27 in the control group. The difference was statistically significant (P 0.05). After treatment, the serum S100-B of the control group was 1.06 卤0.15 渭 g / L, the MBP of the control group was 6.56 卤0.75) 渭 g / L, the NSE of the control group was 12.65 卤1.53 渭 g / L, and the serum S100-B of the experimental group was 0.54 卤0.07) 渭 g / L, the MBP of the control group was 1.72 卤0.24) 渭 g / L / L of NSE was 6.48 卤0.92 渭 g / L ~ (-1) (P 0.05). The GOS scores of the patients in the control group were 24.73 卤3.52 卤2.73 卤0.36, and those in the test group were 15.28 卤2.16 days and 3.86 卤0.55, respectively. The difference was statistically significant (P 0.05). Adverse drug reactions were mainly dysphoric. There was no significant difference in the incidence of adverse drug reactions between the two groups (P 0.05). Conclusion the combination of Huangpu Xingshen decoction and hyperbaric oxygen therapy can significantly reduce the levels of serum S100-BX MBP and NSE in patients with severe craniocerebral injury, shorten the waking time, improve the prognosis of the patients, and have better clinical efficacy and higher safety.
【作者单位】：衢州市柯城区人民医院神经外科;
【基金】：浙江省中医药科技计划基金资助项目(2010ZB156)
【分类号】：R651.15

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