[1]李建民,王艳丽,王敏,等.中西医结合治疗高血压性脑出血微创术后患者临床疗效探讨[J].西部中医药,2020,33(S1):46.
　LI Jianmin,WANG Yanli,WANG Min,et al.Clinical Effects of Integrative Medicine in the Treatment for Hypertensive Intracerebral Hemorrhage after Minimally Invasive Surgery[J].Western Journal of Traditional Chinese Medicine,2020,33(S1):46.
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中西医结合治疗高血压性脑出血微创术后患者临床疗效探讨()
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《西部中医药》[ISSN:2096-9600/CN:62-1204/R]

卷:
33
期数:
2020年S1
页码:
46
栏目:
出版日期:
2025-06-30

文章信息/Info

Title:
Clinical Effects of Integrative Medicine in the Treatment for Hypertensive Intracerebral Hemorrhage after Minimally Invasive Surgery
作者:
李建民，王艳丽，王敏，尹云霞，张世棋，穆永茂，张前进
迁安市人民医院,河北 迁安 064400 ［
Author(s):
LI Jianmin, WANG Yanli, WANG Min, YIN Yunxia, ZHANG Shiqi, MU Yongmao, ZHANG Qianjin
Qianan City Peoples Hospital, Qianan 064400, China
关键词:
脑出血; 高血压性; 中西医结合; 通腑开窍涤痰; 手术; 作用机制 ［
Keywords:
TCM;  hypertensive intracerebral hemorrhage;  surgery;  mechanism
分类号:
R ［
文献标志码:
A
摘要:
目的:探讨通腑开窍涤痰中药辅助神经保护类西药治疗高血压性脑出血微创术后患者的临床疗效。方法：选取高血压脑出血微创术后患者共84例，以随机抽签法分为对照组和观察组，每组42例，对照组给予神经保护类西药，观察组在此基础上辅以通腑开窍涤痰中药治疗，比较2组患者临床疗效、治疗前后中医证候积分，美国国立卫生研究院卒中量表(NIHSS)评分，格拉斯哥昏迷指数(GCS)评分，日常生活能力评分(ADL)评分，炎症因子、氧化应激相关因子、巨噬细胞炎症蛋白-1α(MIP-1α)及胶质纤维酸性蛋白(GFAP)水平。结果：观察组临床疗效显著优于对照组（P＜0.05）；观察组治疗后中医证候积分、NIHSS评分、GCS评分及ADL评分均显著优于对照组、（P＜0.05）；观察组治疗后炎症因子和氧化应激相关因子水平均显著优于对照组（P＜0.05）；观察组治疗后MIP-1α和GFAP水平均显著低于对照组（P＜0.05）。结论：通腑开窍涤痰中药辅助神经保护类西药用于高血压性脑出血微创术后患者治疗能够显著减轻其神经功能损伤，改善生存质量，并有助于抑制脑部炎症和异常氧化应激反应；而有效下调MIP-1α和GFAP水平可能是其疗效优势的重要作用机制。
Abstract:
Objective: To explore curative effects of the herbs of dredging-viscera, opening-orifice and removing-phlegm as adjunctive therapy combined with neuroprotective Western medicine in the treatment for hypertensive intracerebral hemorrhage (HIH) after minimally invasive medicine. Methods: All 84 patients were allocated to the control group and the observation group using random lotting method, 42 cases each group, the control group took neuroprotective Western medicine, and the observation group took the herbs of dredging-viscera, opening-orifice and removing-phlegm as adjunctive therapy based on Western medicine, to compare clinical effects, TCM syndrome scale before and after treating, NIHSS scores, GCS scores, ADL scores, the levels of inflammatory factors, oxidative stress related factors, MIP-1α and GFAP. Results: The observation group was superior to the control group in clinical effects notably (P＜0.05); the observation group was better than the control group in TCM syndrome scores, NIHSS scores, GCS scores and ADL scores after treating notably (P＜0.05); in the levels of inflammatory factors and oxidative stress related factors (P＜0.05); the observation group was lower than the control group in the levels of MIP-1α and GFAP remarkably after treating (P＜0.05). Conclusion: The herbs of dredging-viscera, opening-orifice and removing-phlegm as adjunctive therapy combined with neuroprotective Western medicine for HIH patients after minimally invasive medicine could notbaly relieve nerve function injury, improve survival quality and it is helpful to inhibit brain inflammation and abnormal oxidative stress reaction; whlle the regimen could effectively down regulate the levels of MIP-1α and GFAP, and it might be the significant mechanism of the advantages of clinical effects.

参考文献/References:

[1] 郭强，张爱莲，宋志斌，等.基底核区高血压脑出血术后患者生命质量及影响因素分析[J].中华物理医学与康复杂志，2016，38(7)：514-523.

[2] 郑鲲，谭娟，冯辉斌，等.微创穿刺引流联合开颅血肿清除术对高血压脑出血合并脑疝患者预后的影响[J].山东医药，2015，55(30)：74-75.

[3] 兰德彬，邹兴军，陈锐.高血压脑出血术后高压氧联合依达拉奉治疗对脑血管功能的影响[J].医学研究杂志，2016，45(1)：166-169.

[4] 龙运军，吴兵兵，周德生，等.安脑平冲片对脑出血微创术后患者神经功能恢复及脑水肿和水通道蛋白的影响[J].中国中西医结合急救杂志，2016，23(4)：356-359.

[5] 中华医学会神经病学分会.中国脑出血诊治指南(2014)[J].中华神经科杂志，2015，48(6)：435-444.

[7] 孟靓靓，刘厚林.心脑血管疾病中西医治疗[M].北京：金盾出版社，2015：104-105.

[6] 于生元.脑血管病[M].北京：军事医学科学出版社，2014：204-205.

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备注/Memo

备注/Memo:
收稿日期：2019-06-25 作者简介：李建民(1977—)，男，副主任医师。
更新日期/Last Update: 2020-04-01