摘要
目的观察香蒲醒神汤联合高压氧治疗重型颅脑损伤后意识障碍的临床疗效。方法 54例重型颅脑损伤后意识障碍患者随机分为对照组及试验组,各27例。对照组在常规治疗的基础上给予高压氧治疗,每次60 min,每天1次,试验组在对照组基础上加用香蒲醒神汤(以麝香、蒲黄、石菖蒲、冰片等为主的中药复方),每次125 m L,每天2次,鼻饲;2组均治疗1个月。比较2组患者治疗前后血清S100蛋白(S100-B)、髓鞘碱性蛋白(MBP)、神经元特异性烯醇化酶(NSE)水平、清醒时间、格拉斯哥预后评分(GOS)及临床疗效情况。结果治疗后,试验组有效率为77.78%(21/27例),对照组为62.97%(17/27例),差异有统计学意义(P<0.05)。治疗后,对照组血清S100-B为(1.06±0.15)μg·L^(-1),MBP为(6.56±0.75)μg·L^(-1),NSE为(12.65±1.53)μg·L^(-1),试验组血清S100-B为(0.54±0.07)μg·L^(-1),MBP为(1.72±0.24)μg·L^(-1),NSE为(6.48±0.92)μg·L^(-1),差异有统计学意义(P<0.05)。对照组患者清醒时间为(24.73±3.52)d,GOS评分为(2.73±0.36)分;试验组患者清醒时间为(15.28±2.16)d,GOS评分为(3.86±0.55)分,差异有统计学意义(P<0.05)。药物不良反应主要表现为烦躁、恶心,2组药物不良反应发生率差异无统计学意义(P>0.05)。结论香蒲醒神汤联合高压氧治疗能够显著降低重型颅脑损伤后意识障碍患者的血清S100-B、MBP及NSE水平,缩短清醒时间,改善患者预后,有较好的临床疗效,且安全性较高。
Objective To evaluate the clinical effect of Xiangpu Xingshen decoction combined with hyperbaric oxygen therapy in patients with disturbance of consciousness after severe traumatic brain injury. Methods Fifty -four patients with disturbance of consciousness after severe traumatic brain injury were randomly divided into control group and treatment group, 27 cases in each group. Control group was given hyperbaric oxygen therapy on the basis of conventional treatment, 60 min a time, qd. Treatment group was treated with Xiangpu Xingshen decoction,125 mL a time, bid, nasal feeding patients were treated for 1 month on the basis of control group. All The levels of serum S100 protein （S100-B）, myelin basic protein （MBP）, neuron specific enzyme （NSE）, awake time, glasgow prognostic score （GOS） and clinicalefficiency were observed in two groups before and after treatment. Results The clinical efficiency in treatment group was 77.78 % （21/27 cases）, bad significant difference with 62.97 % （ 17/27 cases） in control group （P 〈 0. 05 ）. After treatment, the serum levels of S100 - B, MBP and NSE in control group were （ 1.06 ± 0. 15 ） , （ 6.56 ± 0. 75 ）, 12. 65 ± 1.53） μg . L-1, the serum levels of S100 - B, MBP and NSE in treatment group were （0. 54 ± 0.07 ） , 1.72 20. 24）, （6.48 20.92） μg. L-1 （P 〈0.05）. The awake time and GOS were（24.73 ±3.52） d , 2. 73 ±0. 36 m control group; and were（ 15.28 ± 2. 16） d, 3.86 ± 0. 55 in treatment group （ P 〈 0. 05 ）. The main adverse drug reactions were irritable and nausea, there was no significant difference in the incidence of adverse reactions between the two groups （P 〉 0. 05）. Conclusion The Xiangpu Xingshen decoction combined with hyperbaric oxygen therapy can significantly reduce the serum levels of S100 - B, MBP and NSE in patients with disturbance of consciousness after severe traumatic brain injury, shorten the awake time, improve the prognosis of patients, has a good clinical efficacy and safety.
出处
《中国临床药理学杂志》
CAS
CSCD
北大核心
2016年第22期2039-2041,2045,共4页
The Chinese Journal of Clinical Pharmacology
基金
浙江省中医药科技计划基金资助项目(2010ZB156)
关键词
香蒲醒神汤
高压氧
重型颅脑损伤
意识障碍
Xiangpu Xingshen decoction
hyperbaric oxygen
severe traumatic brain injury
disturbance ofconsciousness
