CAJ | 학술논문

目的：探讨血府逐瘀汤加味治疗颅脑损伤的临床效果。方法将颅脑损伤患者186例随机分为对照组和观察组各93例。对照组入院时给予抗感染、降颅内压、脱水、营养脑细胞等西医基础治疗；观察组在对照组治疗的基础上给予血府逐瘀汤化裁而成的汤剂治疗，7 d为1个疗程，连续治疗4个疗程。用神经功能缺损程度评分量表（ NIHSS）、格拉斯哥昏迷量表（ GCS）、格拉斯哥预后量表（ GOS）和日常生活能力Barthel指数对患者的神经功能缺损程度、昏迷严重程度、预后情况及日常生活能力进行评价；检测患者治疗前后血清高敏C反应蛋白（hs－CRP）、白细胞介素（IL）－1β、IL－6水平。结果治疗后2组患者NIHSS评分均明显降低（P均＜0．05），Barthel指数评分及GCS评分均显著升高（P均＜0．05），且观察组改善幅度更为明显（P均＜0．05），预后GOS评分也以观察组更高（P＜0．05）。2组患者血清hs－CRP、IL－1β、IL－6水平于治疗第4天出现明显上升，之后开始下降，至第28天水平降至低位；同时间段比较，观察组各指标水平明显低于对照组（ P均＜0．05）。结论血府逐瘀汤加味能有效改善颅脑损伤患者的神经功能，利于提高患者的日常生活能力，改善预后，值得临床深入研究探讨。
목적：탐토혈부축어탕가미치료로뇌손상적림상효과。방법장로뇌손상환자186례수궤분위대조조화관찰조각93례。대조조입원시급여항감염、강로내압、탈수、영양뇌세포등서의기출치료；관찰조재대조조치료적기출상급여혈부축어탕화재이성적탕제치료，7 d위1개료정，련속치료4개료정。용신경공능결손정도평분량표（ NIHSS）、격랍사가혼미량표（ GCS）、격랍사가예후량표（ GOS）화일상생활능력Barthel지수대환자적신경공능결손정도、혼미엄중정도、예후정황급일상생활능력진행평개；검측환자치료전후혈청고민C반응단백（hs－CRP）、백세포개소（IL）－1β、IL－6수평。결과치료후2조환자NIHSS평분균명현강저（P균＜0．05），Barthel지수평분급GCS평분균현저승고（P균＜0．05），차관찰조개선폭도경위명현（P균＜0．05），예후GOS평분야이관찰조경고（P＜0．05）。2조환자혈청hs－CRP、IL－1β、IL－6수평우치료제4천출현명현상승，지후개시하강，지제28천수평강지저위；동시간단비교，관찰조각지표수평명현저우대조조（ P균＜0．05）。결론혈부축어탕가미능유효개선로뇌손상환자적신경공능，리우제고환자적일상생활능력，개선예후，치득림상심입연구탐토。
Objective It is to investigate the clinical efficacy of Xuefu Zhuyu decoction on craniocerebral injury.Methods 186 cases of patients with cerebral injury were randomly divided into a control group of 93 cases and a observation group of 93 cases.The patients in the control group were treated with conventional western medicine foundation treatment, such as anti-inflammatory, reducing intracranial pressure, dehydration and nutrition brain cells;while the patients in the observation group were treated with Xuefu Zhuyu decoction on the basis of treatment above.7 days was one treatment course, and both groups were treated for four courses.The improvements of nerve function, coma, prognosis and living ability were evaluated by NIH-SS, GCS,GOS and Barthel index.The levels of hs-CRP,IL-1βand IL-6 were determined before and after treatment.Re-sults After treatment, the NIHSS scores were significantly diseased, while the Barthel index and GCS scores were increased compared with that before treatment (P<0.05), and the degree of changes in the observation group was more obviously(P<0.05), the GOS sores of the observation group were higher than that of the control group(P<0.05).The levels of hs-CRP, IL-1βand IL-6 went up clearly in 4 days after the treatment, and went down in the following days, the levels were the low-est in the 28th day.Every index above in the observation group was obviously higher than that at the same time in the control group (P<0.05).Conclusion Xuefu zhuyu decoction can effectively improve the neural function of patients suffering from cerebral injury, and is helpful for the improvement of patients'living ability and prognosis, and is worthy of further research and development.