活血化瘀法治疗脑出血对血肿吸收影响-陈澈,院立新,张根明,等

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第16卷 第6期 2014 年 6 月

辽宁中医药大学学报

JOURNAL OF LIAONING UNIVERSITY OF TCM

Vol. 16 No. 6 Jun .，2014

脑出血是临床常见病，具有起病急、病情危重、预后不良的特点，多发于中老年人。部分患者有先兆表现，一般突然起病，神经系统症状发展迅速，如偏瘫、失语等，甚至很快出现意识障碍。急性期病死率约30%~40%，幸存者中半数以上留有严重后遗症。因此，积极对症治疗、减轻并发症、降低病死率就成为脑出血治疗中的关键点。本文在前期研究的基础上，形成了以“活血化瘀”为核心的中医综合治疗方案，取得满意疗效，报道如下。

1 资料与方法1.1 一般资料

228例住院患者随机分为治疗组和对照组各

114例，其中治疗组脱落12例，对照组脱落6例。治疗组男71例，女42例，平均年龄（59.27±12.10）岁；对照组男67例，女44例，平均年龄（62.06±10.76）岁。经统计学检验，两组性别、年龄、文化程度、发病时间等资料无统计学差异，具有可比性（P >0.05）。

1.2 纳入和排除标准

1.2.1 纳入标准

①符合1995年中华医学会第四届全国脑血管病学术会议讨论通过的脑出血诊断标准[1]，②适合内科保守治疗，③年龄18~80岁，④发病72 h 以内，⑤神经功能缺损程度NIHSS 评分为5~22分，⑥发病前改良Rankin 量表评分为0~1分，⑦自愿参加本研

活血化瘀法治疗脑出血对血肿吸收影响

陈澈1，院立新1，张根明2，周莉2，陈颖2，崔方圆2

（1.北京中医药大学第一临床医学院，北京 100029；2.北京中医药大学东直门医院脑病科，北京 100700）摘 要：

目的：观察脑出血活血化瘀法治疗方案对血肿吸收的影响。方法：228例脑出血患者随机分为两组。对照组114例予内科基础治疗，治疗组114例在此基础上予醒脑静注射液静滴14 d，辨证口服活血化瘀免煎颗粒21 d，21 d 后口服脑血疏口服液至发病后3个月。观察两组血肿体积吸收情况及神经功能缺损评分改善程度。结果：入组7 d 后血肿体积吸收情况与入组当天相比，治疗组吸收幅度优于对照组（P <0.05），治疗3个月后治疗组神经功能缺损评分治疗组低于对照组。结论：脑出血活血化瘀治疗方案可以很好地促进血肿吸收、改善神经功能缺损状况，且不良反应小，值得临床推广应用。

关键词：脑出血；活血化瘀；血肿吸收；临床观察

中图分类号：R743.34 文献标志码：A 文章编号：1673-842X (2014) 06- 0142- 03

收稿日期：2013-12-27

基金项目：北京市科委科技计划重大项目（D101107049310003）作者简介：陈澈（1989-），女，上海人，2012级硕士研究生，研究方向：中医药防治脑血管病的研究。通讯作者：张根明（1963-），男，北京人，教授、主任医师，博士，研究方向：中医药防治脑血管病。

Effect of Blood-Activating and Stasis-Removing Therapy on

Hematoma Absorption of Intracerebral Hemorrhage

CHEN Che 1，YUAN Lixin 1，ZHANG Genming 2，ZHOU Li 2，CHEN Ying 2，CUI Fangyuan 2

（1.Beijing University of Chinese Medicine，Beijing 100029，China；2.Department of Encephalopathy of

Dongzhimen Hospital Affiliated to Beijing University of Chinese Medicine，Beijing 100700，China）Abstract：Objective ：To observe the effect on hematoma absorption of intracerebral hemorrhage with blood-activating and stasis-removing therapy. Methods ：A total of 228 cases with cerebral hemorrhage were randomly divided into the treatment group（n =114）and the control group（n =114）. The control group was treated with the basic treatment of internal medicine. On the basis of ontrol group，the treatment group received intravenous infusion with Xingnaojing Injection for 2 weeks and given TCM granules for 21 days dynamically and dialectically. After these，the treatment group patients were asked to drink Naoxueshu Oral Liquid untill the 3rd month of incidence. The absorption of hematama and improvement NIHSS scale scores were reviewed in two groups. Results ：Compared with the first day，the hematoma absorption of the treatment group was superior to that of control group on 7th days after entering the group（P <0.05）. The NIHSS score in treatment group was better than that in control group after 3 months. Conclusion ：Intracerebral hemorrhage with blood-activating and stasis-removing therapy had an effective result in improving hematoma absorption and neurologic function deficits. In addition，the adverse reaction was few and it deserved the clinical application and popularization.

Key words：intracerebral hemorrhage；blood-activating and stasis-removing；hematoma absorption；clinical observation

DOI：10.13194/j.issn.1673-842x.2014.06.052