摘要
目的:观察醒神开窍针联合通窍活血汤对重度颅脑损伤(severe traumatic brain injury,STBI)后昏迷患者S100钙结合蛋白(S-100B)、髓磷脂碱性蛋白(myelin basic protein,MBP)、神经元特异性烯醇化酶(neuron specific endase,NSE)水平及促醒的影响。方法:104例STBI后昏迷的患者按照随机数字表法分为对照组和治疗组,每组各52例。对照组给予常规基础治疗(体质调理、对症康复疗法、感官刺激);治疗组在对照组治疗基础上给予通窍活血汤联合醒神开窍针,每日1次,每周5次,连续3个月。比较两组患者治疗前后患者的清醒时间和清醒率、格拉斯哥昏迷评分、大脑中动脉和基底动脉的脑血流速度、血浆脑损伤标志物水平、脑电图和脑干听觉诱发电位潜伏期。结果:①治疗组清醒率为94.23%(49/52),对照组为61.54%(32/52),治疗组清醒率高于对照组,两组清醒率比较,差异有统计学意义(P<0.05);治疗组清醒时间为(20.92±1.49)d,对照组清醒时间为(29.13±1.78)d,两组清醒时间比较,差异有统计学意义(P<0.05)。②两组患者治疗后格拉斯哥昏迷评分均高于本组治疗前(P<0.05);治疗组治疗后格拉斯哥昏迷评分为(14.12±1.81)分,对照组为(10.34±2.28)分,两组格拉斯哥昏迷评分比较,差异有统计学意义(P<0.05)。③治疗后,两组患者大脑中动脉、基底动脉血流速度均高于本组治疗前(P<0.05);治疗组治疗后大脑中动脉血流速度为(95.65±2.94)cm·s^(-1),对照组为(80.96±2.41)cm·s^(-1),两组大脑中动脉血流速度比较,差异有统计学意义(P<0.05);治疗组治疗后基底动脉血流速度为(39.04±2.71)cm·s^(-1),对照组为(30.04±2.28)cm·s^(-1),差异具有统计学意义(P<0.05)。④治疗后,两组患者S-100B、MBP、NSE水平均降低(P<0.05);治疗组S-100B水平为(1.04±0.01)μg·L^(-1)、MBP水平为(1.58±0.26)μg·L^(-1)、NSE水平为(7.08±0.68)μg·L^(-1),均显著低于对照组[(1.22±0.01)μg·L^(-1)、(5.50±0.19)μg·L^(-1)�
Objective:To observe the effects of Xingshen Kaiqiao needling combined with Tongqiao Huoxue Decoction on the levels of S100 calcium binding protein(S-100B),myelin basic protein(MBP),neuron specific enolase(NSE)and wake-up promotion in coma patients after severe brain injury(STBI).Methods:104 patients with coma after STBI were randomly divided into control group and treatment group,52 patients in each group.The control group was given routine basic treatment(physical conditioning,symptomatic rehabilitation therapy,sensory stimulation).On the basis of the treatment of the control group,the treatment group was given Tongqiao Huoxue Decoction and Xingshen Kaiqiao needling,once a day,five times a week,for three consecutive months.The awake time and awake rate,Glasgow coma score,cerebral blood flow velocity of middle cerebral artery and basilar artery,plasma brain injury marker level,EEG and brainstem auditory evoked potential(BAEP)latency were compared between the two groups before and after treatment.Results:①The conscious rate of the treatment group was 94.23%(49/52),and that of the control group was 61.54%(32/52).The conscious rate of the treatment group was higher than that of the control group.The difference between the two groups was statistically significant(P<0.05).The waking time of the treatment group was(20.92±1.49)days,while that of the control group was(29.13±1.78)days.The difference between the two groups was statistically significant(P<0.05).②The Glasgow coma scores of the two groups after treatment were higher than those before treatment(P<0.05).After treatment,the Glasgow coma score of the treatment group was(14.12±1.81)points,while that of the control group was(10.34±2.28)points.The difference between the two groups was statistically significant(P<0.05).③After treatment,the blood flow velocity of middle cerebral artery and basilar artery in both groups were higher than that before treatment(P<0.05).After treatment,the blood flow velocity of the middle cerebral artery in the treatment group
作者
张淑芹
李彦杰
秦合伟
华晓琼
牛丽
刘昊源
金小琴
ZHANG Shuqin;LI Yanjie;QIN Hewei;HUA Xiaoqiong;NIU Li;LIU Haoyuan;JIN Xiaoqin(Henan University of Chinese Medicine,Zhengzhou Henan China 450046;The Second Affiliated Hospital of Henan University of Chinese Medicine/Henan Provincial Hospital of Chinese Medicine,Zhengzhou Henan China 4500)
出处
《中医学报》
CAS
2023年第1期175-180,共6页
Acta Chinese Medicine
基金
河南省中医药拔尖人才培养项目{豫中医科教〔2018〕35号}。
