摘要
目的:观察利水通络化瘀方联合甘露醇治疗创伤性脑水肿患者脱水效果及对颅内压、炎症介质水平的影响。方法:将80例创伤性脑水肿患者随机分为对照组和观察组,每组40例。对照组给予甘露醇脱水治疗,观察组给予利水通络化瘀方联合甘露醇治疗。于治疗后检测全血高切粘度、全血低切粘度及血清纤维蛋白原(FIB)、肿瘤坏死因子-α(TNF-α)、C反应蛋白(CRP)、白细胞介素-1β(IL-1β)、降钙素基因相关肽(CGRP)、内皮素-1(ET-1)、Na^+、K^+水平,测定水肿体积、中线移位大小、颅内压,行格拉斯哥昏迷评分(GCS)及神经功能缺损程度评分(NIHSS)。结果:治疗后,观察组较对照组血清TNF-α、CRP、IL-1β、ET-1、FIB水平及全血高切粘度、全血低切粘度均明显降低(P<0.05),CGRP均明显升高(P<0.05)。治疗后,观察组较对照组脑水肿体积、中线移位明显减小,颅内压明显降低,GCS评分明显升高、NIHSS评分明显降低,差异均有统计学意义(P<0.05)。观察组治疗前后血清Na^+、K^+水平无明显变化(P>0.05),而对照组治疗后血清Na^+、K^+水平较治疗前明显降低(P<0.05)。结论:利水通络化瘀方辅治创伤性脑水肿,有效减轻炎症反应,改善血管内皮功能及微循环,促进水肿消除,降低颅内压,减轻神经缺损症状,且可预防甘露醇脱水所造成的电解质紊乱。
Objective:To observe the effect of Lishui Tongluo Huayu Formula combined with mannitol on dehydration and the levels of intracranial pressure and inflammatory mediators for patients with traumatic brain edema. Methods:80 cases of patients with traumatic brain edema were randomly divided into controlled group and observation group with 40 cases in each group. The controlled group was treated with Mannitol Dehydration and the observation group was treated with Lishui Tongluo Huayu Formula combined with Mannitol. The levels of whole blood high viscosity, whole blood low viscosity and serum fibrinogen(FIB), tumor necrosis factor-α(TNF-α), C reactive protein(CRP), interleukin-1β(IL-1β), calcitonin gene related peptide(CGRP), endothelin-1(ET-1), Na^+ and K^+ were detected after treatment, and the size of the edema, the size of the midline shift, the intracranial pressure, the Glasgow Coma Scale(GCS) and the neurological deficit severity score(NIHSS) were measured. Results:After treatment, the levels of serum TNF-α, CRP, IL-1β, ET-1 and FIB, whole blood high viscosity and whole blood low viscosity in the observation group were significantly decreased compared with those in the controlled group(P<0.05) while the CGRP level was significantly increased(P<0.05). After treatment, the volume of brain edema and the midline shift were significantly decreased while the intracranial pressure was significantly decreased, and the GCS score was significantly increased while the NIHSS score was significantly decreased in the observation group compared with those in the controlled group(P<0.05). There was no significant change in the levels of serum Na^+ and K^+ before and after treatment(P>0.05), but the levels of serum Na^+ and K^+ after treatment in the controlled group were significantly lower than those before treatment(P<0.05). Conclusions:Lishui Tongluo Huayu Formula can effectively reduce the inflammatory response, improve vascular endothelial function and microcirculation, promote edema elimination and reduce intracrani
作者
钟华萍
夏蕾
ZHONG Huaping;XIA Lei(Department of Neurology,the Peopled Hosptial of Rongchang District(Chongqin 402460,China)
出处
《四川中医》
2019年第11期138-141,共4页
Journal of Sichuan of Traditional Chinese Medicine
关键词
创伤性脑水肿
脱水
颅内压
炎症
利水通络化瘀方
Traumatic brain edema
Dehydration
Intracranial pressure
Inflammation
Lishui Tongluo Huayu Formula
