摘要
目的探讨急性高血压脑出血不同西医分期辨证使用自拟中药汤剂治疗的方法及临床疗效。方法将280例急性高血压脑出血患者随机分为两组。对照组（120例）给予调控血压与颅内压，吸氧，维持水、电解质平衡，使用脑保护剂等常规治疗；治疗组（160例）在对照组常规治疗基础上结合急性高血压脑出血超急性期、急性期、恢复期3期病机特点，分别采用杏林I、Ⅱ、Ⅲ号（杏林I号：全瓜萎、胆南星、天麻、钩藤、菊花、石菖蒲、生大黄、枳实，杏林Ⅱ号：半夏、白术、天麻、桃仁、丹参、当归尾、茯苓、三七、苏木，杏林III号：生黄芪、党参、白术、全当归、桃仁、赤芍、川芎、广地龙、鸡血藤、桑寄生、炒杜仲、怀牛膝）配合针灸（上肢：肩髑、合谷、曲池穴，下肢：环跳、阳陵泉、足三里、昆仑穴；口角歪斜者加地仓、夹车穴）施治；两组疗程均为30d。观察两组治疗前后血肿量、血肿吸收率、神经功能缺损程度评分（NDS）的变化及临床疗效。结果治疗组血肿吸收率[（0．84±0．18）％]高于对照组[（0．59±0．15）％，P〈0．05]，治疗后NDS评分[（13．1±11．3）分]低于对照组[（20．3±12．0）分]；且治疗组总有效率（95．0％）明显优于对照组（72．5％，P〈0．05）。结论运用自拟中药汤剂配合针灸结合西医分期辨证施治急性高血压脑出血患者，疗效显著，药剂价廉，无毒副作用，使用方法简便。
Objective To study the therapeutic effect of self-prepared traditional Chinese medicine （TCM） for treatment of acute hypertensive intra-cerebral hemorrhage based on TCM differentiating symptoms and signs and western clinical staging. Methods Two hundred and eighty cases with acute hypertensive cerebral hemorrhage were randomly divided into two groups. In control group, 120 patients received conventional treatment to control blood pressure and intracranial pressure, maintain water and electrolyte balance, protect cerebrum, and inhale oxygen. In treatment group, besides the conventional treatment used in the control group, 160 patients were additionally treated with self-prepared three types of TCM respectively, including Xinglin （杏林） I,II ,III recipes [Xinglin I ： Fructus trichosanthis （全瓜萎）, Arisaema cum bile （胆南星 ）, Rhizoma gastrodiae （天麻）, Ramulus uncariae cum uncis （钩藤）, Flos chrysanthemi （菊花）, Rhizoma acori tatarinowii （石草蒲）, Rhubarb （生大黄）, Fructus aurantii immaturus （枳实） ; Xinglin I ： Rhizoma pinelliae （半夏）, Rhizoma atractylodis macrocephalae （白术）, Rhizoma gastrodiae （天麻）, Semen persicae （桃仁）, Radix et rhizoma salviae miltiorrhizae （丹参）, Radix angelieae sinensis （当归尾）, Poria （茯苓）, Radix et rhizoma notoginseng （三七）, Lignum sappan （苏木）; Xinglin III： Radix astragali （生黄芪）, Radix codonopsis （党参）, Rhizoma atractylodis macrocephalae （白术）, Radix angelicae sinensis （全当归）, Semen persicae （桃仁）, Radix paeoniae rubra （赤芍）, Rhizoma Chuanxiong （川芎）, Pheretima （广地龙）, Caulis spatholobi （鸡血藤）, Herba taxilli （桑寄生）, Cortex eucommiae （炒杜仲）, Radix achyranthis bidentatae （怀牛膝）]; according to the western clinical staging, the patients were divided into 3 stages z hyper-acute, acute and convalescent stages, and according to the characteristics of pathogenesis in different stages, Xinglin I , II , III recipes were respectively selected for treatment; the treatment was also combined with acupuncture [upper limb： Jianyu （肩髃）, Hegu （合谷）, Quchi （曲池）, lower limb： Huantiao （环眺）, Yanglingquan （阳陵泉）, Zusanli （足三里）, Kunlun （昆仑）; Dicang （地仓） and Jiache （夹车） were pointed in patients with distortion of mouth angle]. The course of treatment was 30 days. The changes of hematoma content before and after treatment, the rate of hematoma absorption, neurologic defect score （NDS） and the clinical efficacy were observed. Results Hematoma absorption rate [（0.84±0.18）%] of treatment group was higher than that in control group [（0. 59±0.15） %, P〈0.05], and the NDS （13.1±11.3） of the treatment group was lower than that in the control group （20.3± 12.0）. The total therapeutic effective rate in treatment group （95.0%） was significantly better than that of the control group （72.5%, P〈0. 05）. Conclusion The use of self-prepared decoction and acupuncture based on TCM differentiating syndromes and western clinical staging for treatment of acute cerebral hemorrhage has significant efficacy without untoward side effects ; the method is not expensive, and easy to apply.
出处
《中国中西医结合急救杂志》
CAS
北大核心
2010年第4期234-236,共3页
Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care
关键词
高血压脑出血
急性
中医辨证
西医分期
杏林I
Ⅱ
Ⅲ号
针灸
Acute hypertensive cerebral hemorrhage
Traditional Chinese medicine
Differentiation of symptoms and signs
Clinical stage
Xinglin I , II , III
Acupuncture
