半夏白术天麻汤联合尼卡地平治疗高血压脑出血临床研究

目的：观察半夏白术天麻汤联合尼卡地平在高血压脑出血患者中的应用及对患者血清D-二聚体（D-D）、胱抑素C（CysC） 水平的影响。方法：选取高血压脑出血患者108例，采用随机数字表法分为对照组与试验组各54例。对照组采用口服尼卡地平治疗，试验组采用半夏白术天麻汤联合尼卡地平治疗。2组均治疗14 d，比较2组治疗前后血压、颅内血肿、颅内压、脑血流灌注[局部脑血流量（rCBF）、达峰时间（TPP）及平均通过时间（MTT） ]变化情况，血清D-D、CysC水平，格拉斯哥昏迷量表（GCS） 及日常生活能力量表（ADL） 评分。结果：治疗7、14 d，2组收缩压（SBP）、舒张压（DBP） 水平均较治疗前降低（P＜0.05），且试验组SBP、DBP水平在相同时间点均低于对照组（P＜0.05）。治疗后，2组颅内血肿体积、颅内压均较治疗前降低（P＜0.05），且试验组颅内血肿体积、颅内压均低于对照组（P＜0.05）。治疗后，2组rCBF水平均较治疗前升高（P＜0.05），TPP、MTT水平均较治疗前降低（P＜0.05）；且试验组rCBF 水平高于对照组（P＜0.05），TPP、MTT 水平低于对照组（P＜0.05）。治疗后，2 组D-D、CysC 水平均较治疗前降低（P＜0.05），且试验组D-D、CysC 水平均低于对照组（P＜0.05）。治疗后，2 组GCS、ADL评分均较治疗前升高（P＜0.05），且试验组2项评分均高于对照组（P＜0.05）。结论：半夏白术天麻汤联合尼卡地平治疗高血压脑出血可有效控制血压，促进颅内血肿吸收，改善凝血功能、CysC水平及脑血流灌注，保护患者神经系统，提高其生活自理能力。

Clinical Study on Banxia Baizhu Tianma Decoction Combined with Nicardipine forHypertensive Cerebral Hemorrhage

Abstract： Objective： To observe the application of Banxia Baizhu Tianma Decoction combined withNicardipine in patients with hypertensive cerebral hemorrhage and its effect on serum D-dimer (D-D)，cystatin C (CysC). Methods：A total of 108 cases of patients with hypertensive cerebral hemorrhage wereselected and divided into the control group and the trial group according to the random number tablemethod，with 54 cases in each group. The control group was given the oral administration of Nicardipine，and the trial group was treated with Banxia Baizhu Tianma Decoction combined with Nicardipine. Bothgroups were treated for 14 days. Before and after treatment， the changes in blood pressure， intracranialhematoma， intracranial pressure， cerebral blood perfusion [regional cerebral blood flow (rCBF)， time topeak (TPP) and mean transit time (MTT)]，the levels of serum D-D and CysC，and the scores of GlasgowComa Scale (GCS) and Activities of Daily Living (ADL) were compared between the two groups. Results：After 7 and 14 days of treatment，the levels of systolic pressure (SBP) and diastolic pressure (DBP) in thetwo groups were decreased when compared with those before treatment (P＜0.05)，and the levels of SBPand DBP in the trial group were lower than those in the control group at the same time point (P＜0.05). Aftertreatment，the intracranial hematoma volume and intracranial pressure in the two groups were decreasedwhen compared with those before treatment (P＜0.05)， and the intracranial hematoma volume andintracranial pressure in the trial group were lower than those in the control group (P＜0.05). After treatment，rCBF levels in the two groups were increased when compared with those before treatment (P＜0.05)，andthe length of TPP and MTT were decreased when compared with those before treatment (P＜0.05)； therCBF level in the trial group was higher than that in the control group (P＜0.05)，and the length of TPP andMTT were lower than those in the control group (P＜0.05). After treatment，the levels of D-D and CysC inthe two groups were decreased when compared with those before treatment (P＜0.05)，and the levels ofD-D and CysC in the trial group were lower than those in the control group (P＜0.05). After treatment，thescores of GCS and ADL in the two groups were increased when compared with those before treatment (P＜0.05)， and the above two scores in the trial group were higher than those in the control group (P＜0.05).Conclusion： Banxia Baizhu Tianma Decoction combined with Nicardipine for patients with hypertensivecerebral hemorrhage can effectively control blood pressure， promote intracranial hematoma absorption，improve coagulation function，CysC levels and cerebral blood perfusion，protect their nervous system andimprove their self-care ability.