活血化瘀法治疗老年慢性硬膜下血肿疗效观察
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摘要
目的:观察活血化瘀法治疗老年慢性硬膜下血肿的临床疗效。方法:将非手术治疗的老年慢性硬膜下血肿患者63例随机分为2组,对照组32例采用单纯西医对症支持治疗;治疗组31例采用西医对症支持联合活血化瘀中药内服。分别采用改良Rankin量表(Modified Rankin Scale,MRS)、Barthel指数(Barthel Index,BI)评价患者治疗前后病残程度、日常生活活动能力,检查颅脑CT评估血肿吸收情况,结合症状体征及血肿吸收情况,评价治疗效果,并进行安全性评价。结果:临床疗效总有效率治疗组77.4%,对照组50.0%,2组比较,差异有统计学意义(P<0.05)。治疗后,治疗组MRS评分低于对照组,治疗组BI高于对照组,治疗组血肿量低于对照组,治疗组血肿厚度低于对照组,2组各项指标比较,差异均有统计学意义(P<0.05)。治疗过程中,治疗组出现2例不良事件(6.5%),对照组出现3例不良事件(9.4%),2组比较,差异无统计学意义(P>0.05)。结论:活血化瘀法治疗老年慢性硬膜下血肿,能有效促进血肿的吸收,改善患者的日常生活能力,降低患者的致残率。
Objective: To observe the clinical effect of Huoxue Huayu therapy for senile chronic subdural hematoma.Methods:Divided 63 cases of senile chronic subdural hematoma patients receiving non-surgical treatment into two groups randomly. 32 cases in the control group were only treated with symptomatic and supportive treatment of western medicine,while 31 cases in the treatment group were treated with symptomatic and supportive treatment of western medicine combined with internal administration of Huoxue Huayu medicine. Modified Rankin scale(MRS) and Barthel index(BI) were respectively used to evaluate disabled degree and activity of daily living before and after treatment. Brain CT scan was conducted to assess hematoma absorption. The curative effect was evaluated by symptoms and signs combined with hematoma absorption,and safety assessment was carried out. Results:The clinical total effective rate was 77.4% in the treatment group and 50.0% in the control group,the difference being significant(P<0.05). After treatment,MRS score in the treatment group was lower than that in the control group,Barthel index in the treatment group was higher than that in the control group,hematoma volume in the treatment group was lower than that in the control group,hematoma thickness in the treatment group was lower than that in the control group,differences all being significant(P<0.05). During treatment,two cases of adverse reaction were found in the treatment group(6.5%),and three cases of adverse reaction were found in the control group(9.4%),there being no significance in the difference(P>0.05). Conclusion:Huoxue Huayu therapy for senile chronic subdural hematoma can promote hematoma absorption, improve activity of daily living and reduce disabled rate in patients.
Objective: To observe the clinical effect of Huoxue Huayu therapy for senile chronic subdural hematoma.Methods:Divided 63 cases of senile chronic subdural hematoma patients receiving non-surgical treatment into two groups randomly. 32 cases in the control group were only treated with symptomatic and supportive treatment of western medicine,while 31 cases in the treatment group were treated with symptomatic and supportive treatment of western medicine combined with internal administration of Huoxue Huayu medicine. Modified Rankin scale(MRS) and Barthel index(BI) were respectively used to evaluate disabled degree and activity of daily living before and after treatment. Brain CT scan was conducted to assess hematoma absorption. The curative effect was evaluated by symptoms and signs combined with hematoma absorption,and safety assessment was carried out. Results:The clinical total effective rate was 77.4% in the treatment group and 50.0% in the control group,the difference being significant(P<0.05). After treatment,MRS score in the treatment group was lower than that in the control group,Barthel index in the treatment group was higher than that in the control group,hematoma volume in the treatment group was lower than that in the control group,hematoma thickness in the treatment group was lower than that in the control group,differences all being significant(P<0.05). During treatment,two cases of adverse reaction were found in the treatment group(6.5%),and three cases of adverse reaction were found in the control group(9.4%),there being no significance in the difference(P>0.05). Conclusion:Huoxue Huayu therapy for senile chronic subdural hematoma can promote hematoma absorption, improve activity of daily living and reduce disabled rate in patients.
引文
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[7]院立新,陈澈,周莉,等.活血化瘀治疗对脑出血患者预后的影响[J].中国中西医结合杂志,2015,35(2):174-178.
[2]Chen JC,Levy ML.Causes,epidemiology,and risk factors of chronic subdural hematoma[J].Neurosurgery Clinics of North America,2000,11(3):399-406.
[3]孙成法,姜华,褚荣涛,等.慢性硬膜下血肿保守治疗适应症及疗程探讨[J].黑龙江医学,2014,38(2):125-126.
[4]王菲,施红,夏韵.血府逐瘀汤治疗心脑血管疾病研究进展[J].中医学报,2013,28(11):1732-1733.
[5]刘建仁,黎启明,易铭佳,等.血府逐瘀汤促进大鼠脑损伤修复机理的代谢组学研究[J].新中医,2014,46(5):206-209.
[6]唐汉庆,李吉武.血府逐瘀汤对血瘀衰老模型动物血流变学干预的实验研究[J].山西中医,2010,26(3):48-49.
[7]院立新,陈澈,周莉,等.活血化瘀治疗对脑出血患者预后的影响[J].中国中西医结合杂志,2015,35(2):174-178.