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通窍活血逐水方治疗急性大面积脑梗死的临床疗效观察

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目的:观察通窍活血逐水方治疗急性大面积脑梗死(LHI)的临床疗效及安全性.方法:将符合纳排标准的60例患者随机分为对照组和治疗组,每组30例,对照组给予西医基础治疗,治疗组在对照组基础上给予通窍活血逐水方,连续治疗14 d.观察两组患者治疗后3个月的改良Rankin量表(mRS)评分,治疗前后神经功能缺损症状[美国国立卫生研究院卒中量表(NIHSS)、格拉斯哥昏迷量表(GCS评分)],头颅CT梗死直径、中线移位,血渗透压水平,以及治疗期间病死率、去骨瓣手术率、总住院时间、重症加强护理病房住院时间及安全性情况.结果:治疗组3个月mRS评分、病死率显著低于对照组(P＜0.05);治疗组在第7天的NIHSS评分、头颅CT中线移位显著低于对照组(P＜0.05,P＜0.01),第7天血渗透压水平显著高于对照组(P＜0.05).治疗期间,有1例患者因腹泻减药半量,其他患者无严重不良反应发生.治疗组每天大便平均次数显著高于对照组(P＜0.01).结论:通窍活血逐水方能够减轻LHI脑水肿,改善患者神经功能,降低病死率.
Clinical effect observation of Tongqiao Huoxue Zhushui Decoction in the treatment of acute large hemispheric infarction
Objective:To observe the clinical efficacy and safety of Tongqiao Huoxue Zhushui Decoction in the treatment of acute large hemispheric infarction(LHI).Methods:Sixty patients who met the inclusion and exclusion criteria were randomly divided into control group and treatment group,30 cases in each group.The control group was given western medicine basic treatment plan.The treatment group was treated with Tongqiao Huoxue Zhuishui Decoction on the basis of the control group.Both groups were treated 14 days.The mRS score of the two groups were observed at 3 months after treatment.Neurological deficits(NIHSS,GCS score),head CT infarct diameter,midline shift,blood osmolality level,case fatality rate within 14 days of enrollment,craniectomy rate,total length of hospital stay,and length of intensive care unit stay were compared between two groups after treatment.Results:After treatment,the mRS score at 3 months and case fatality rate of the treatment group were significantly lower than those of the control group(P＜0.05).The NIHSS score and head CT midline shift of the treatment group on the 7th day were significantly lower than those of the control group(P＜0.05,P＜0.01),and the blood osmolality level on the 7th day was significantly higher than that of the control group(P＜0.05).During the treatment,one patient had half dose reduction due to diarrhea,and the other patients had no serious adverse reactions.The average stool frequency per day in treatment group was higher than that in control group(P＜0.01).Conclusion:Tongqiao Huoxue Zhushui Decoction can reduce the cerebral edema of LHI,improve the neurological function and reduce the case fatality rate of patients.

Tongqiao Huoxue Zhushui DecoctionLarge hemispheric infarction(LHI)Cerebral edemaClinical efficacyNeurological function

李惠平、王立新

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广州中医药大学第二附属医院,广州 510120

通窍活血逐水方 大面积脑梗死 脑水肿 临床疗效 神经功能

广东省中医院中医药科学技术研究专项广州中医药大学"双一流"与高水平大学学科协同创新团队重点项目国家中医药管理局高水平中医药重点学科建设项目

YN2016ML072021xk26zyyzdxk-2023154

2024

中华中医药杂志
中华中医药学会

中华中医药杂志

CSTPCD北大核心
影响因子：1.135
ISSN：1673-1727
年,卷(期)：2024.39(2)
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