凉血散瘀汤加减辅以醒脑开窍针刺联合微创穿刺引流治疗基底节脑出血的效果观察

Observation on the effect of Liangxue Sanyu Decoction with xingnao kaiqiao acupuncture combined with minimally invasive puncture and drainage in the treatment of basal ganglia cerebral hemorrhage

关键词:  凉血散瘀汤  醒脑开窍针刺  微创穿刺引流  基底节脑出血

Key words:  Liangxue Sanyu Decoction  xingnao kaiqiao acupuncture  minimally invasive puncture and drainage  basal ganglia cerebral hemorrhage

摘要:

[目的] 研究凉血散瘀汤加减辅以醒脑开窍针刺联合微创穿刺引流治疗基底节脑出血的效果。[方法] 选取2017年6月—2018年6月在定州市人民医院接受治疗的基底节脑出血患者100例，按照随机数字表法分为联合治疗组、引流治疗组各50例。联合治疗组患者使用凉血散瘀汤加减辅以醒脑开窍针刺联合微创穿刺引流进行治疗；引流治疗组患者使用微创穿刺引流进行治疗。对两组患者手术前后内皮素（ET）、血浆纤维蛋白原（FIB）进行检测，并统计认知功能评分、日常生活能力评分、神经功能缺损评分、脑水肿体积、治疗有效率及并发症发生率。[结果] 手术后联合治疗组患者ET、FIB水平低于引流治疗组（P<0.05）；手术后联合治疗组患者认知功能评分、日常生活能力评分高于引流治疗组（P<0.05）；手术后联合治疗组患者神经功能缺损评分及脑水肿体积低于引流治疗组（P<0.05）；手术后联合治疗组患者治疗总有效率高于引流治疗组治疗总有效率（χ²=4.332，P=0.037）；手术后联合治疗组患者再出血、应激性溃疡、颅内感染等并发症发生率低于引流治疗组（χ²=6.775，P=0.009）。[结论] 凉血散瘀汤加减辅以醒脑开窍针刺联合微创穿刺引流可以减少基底节脑出血患者脑水肿，促进神经功能恢复，提高患者日常生活能力，效果显著。

Abstract:

[Objective] To study the effect of Liangxue Sanyu Decoction plus xingnao kaiqiao acupuncture combined with minimally invasive puncture and drainage in the treatment of basal ganglia cerebral hemorrhage.[Methods] The 100 patients with basal ganglia cerebral hemorrhage treated in our hospital from June 2017 to June 2018 were selected and divided into combined treatment group and drainage treatment group according to complete random method,with 50 cases in each group. The patients in the combined treatment group were treated with Liangxue Sanyu Decoction plus xingnao kaiqiao acupuncture plus minimally invasive puncture and drainage,while the patients in the drainage treatment group were treated with minimally invasive puncture and drainage. Endothelin (ET) and plasma fibrinogen (FIB) were measured before and after the operation in the two groups,and the cognitive function score,daily living ability score,nerve function defect score,brain edema volume,effective rate of treatment and incidence of complications were calculated.[Results] The levels of ET and FIB in the combined treatment group were lower than those in the drainage treatment group (P<0.05),while the scores of cognitive function and daily living ability in the combined treatment group were higher than those in the drainage treatment group (P<0.05). The neurological deficit score and brain edema volume in the combined treatment group after operation were lower than those in the drainage treatment group (P<0.05). The total effective rate in the combined treatment group after operation was higher than that in the drainage treatment group (P<0.05). The incidence of complications such as rebleeding,stress ulcer and intracranial infection in the combined treatment group after operation was lower than that in the drainage treatment group (P<0.05).[Conclusion] Liangxue Sanyu Decoction plus xingnao kaiqiao acupuncture combined with minimally invasive puncture and drainage can reduce brain edema in patients with basal ganglia cerebral hemorrhage,promote the recovery of nerve function,and improve the daily living ability of patients,the effect is remarkable.