補陽還五湯聯(lián)合高壓氧治療腦外傷后綜合征的療效觀察

李曉興 王學軍 吳繼偉

摘 要：目的 研究補陽還五湯聯(lián)合高壓氧治療腦外傷后綜合征的療效，進一步分析聯(lián)合治療對TCD中椎-基底動脈血流速度改善機理。方法 選取我院收治的腦外傷后綜合征患者60例，隨機分為治療組和對照組，每組30例。兩組患者均給予常規(guī)治療，對照組使用高壓氧治療，治療組在對照組基礎(chǔ)上結(jié)合補陽還五湯治療。對比兩組患者治療前后中醫(yī)癥候總積分變化、TCD測量數(shù)據(jù)以及臨床療效。結(jié)果 治療后，患者中醫(yī)證候總積分均得到改善，治療組中醫(yī)證候總積分為（10.62±4.56）分，低于對照組的（30.36±6.63）分，差異具有統(tǒng)計學意義（P<0.05）。兩組患者Vpeak和Vedv均較治療前提高，治療組Vpeak和Vedv大于對照組，差異具有統(tǒng)計學意義（P<0.05）。治療組患者治療總有效率為96.27%，高于對照組的80.57%，差異具有統(tǒng)計學意義（P<0.05）。結(jié)論 補陽還五湯聯(lián)合高壓氧治療能夠明顯提高TCD椎-基底動脈收縮和舒張血流速度，可明顯改善腦外傷后綜合征瘀阻清竅證患者臨床癥狀。

關(guān)鍵詞：腦外傷后綜合征；補陽還五湯；高壓氧

中圖分類號：R651.1 文獻標識碼：A DOI：10.3969/j.issn.1006-1959.2018.23.042

文章編號：1006-1959（2018）23-0145-04

Abstract：Objective To study the curative effect of BuyangHuanwu Decoction combined with hyperbaric oxygen in the treatment of post-traumatic cerebral syndrome and further analyze the mechanism of improving the blood flow velocity of vertebral-basilar artery in TCD. Methods 60 patients with post-traumatic brain syndrome admitted to our hospital were randomly divided into treatment group and control group， 30 cases in each group. Both groups were given routine treatment， the control group was treated with hyperbaric oxygen， and the treatment group was treated with Buyanghuanwu Decoction on the basis of the control group. The total scores of TCM syndromes before and after treatment， TCD measurement data and clinical efficacy were compared between the two groups. Results After treatment， the total scores of TCM syndromes were improved. The total score of TCM syndromes in the treatment group was （10.62±4.56）， which was lower than that of the control group （30.36±6.63），the difference was statistically significant （P<0.05）. Both Vpeak and Vedv were higher in the two groups than in the control group. The Vpeak and Vedv in the treatment group were significantly higher than those in the control group （P<0.05）. The total effective rate of the treatment group was 96.27%， which was higher than that of the control group （80.57%），the difference was statistically significant （P<0.05）. Conclusion Buyanghuanwu Decoction combined with hyperbaric oxygen therapy can significantly improve the TCD vertebral-basal artery systolic and diastolic blood flow velocity， and can significantly improve the clinical symptoms of patients with post-traumatic brain injury syndrome.

Key words：Post-traumatic syndrome；BuyangHuanwu Decoction；Hyperbaric oxygen

腦外傷后綜合征（post-traumatic syndrome）指腦外傷患者在恢復期以后，長期存在的一組自主神經(jīng)功能失調(diào)或精神性癥狀，病情逐漸穩(wěn)定后患者常表現(xiàn)出各種遷延難愈的后遺癥，為常見病、多發(fā)病[1]。綜合以往該病癥療法，效果多不滿意。為此，2016年6月～2017年12月南京中醫(yī)藥大學泰州附屬醫(yī)院神經(jīng)外科自采用補陽還五湯聯(lián)合高壓氧治療腦外傷后綜合征，療效顯著，現(xiàn)現(xiàn)報告如下。

1資料與方法

1.1一般資料 選取2016年6月～2017年12月南京中醫(yī)藥大學泰州附屬醫(yī)院神經(jīng)外科收治的腦外傷后綜合征患者60例，本研究經(jīng)醫(yī)院倫理會批準。采用隨機數(shù)字表法將患者分為治療組和對照組，每組30例。治療組男性18例，女性12例，年齡12～79歲，平均年齡（47.16±6.42）歲；病程6～18個月，平均病程（12.03±4.01）個月。對照組男性17例，女性13例，年齡13～81歲，平均年齡（48.20±11.30）歲；……