三步序贯法治疗急性脑出血临床研究

目的评估中医三步序贯法治疗急性脑出血的临床疗效。方法将92例急性脑出血患者随机分为观察组和对照组,观察组患者46例,采用中医三步序贯治疗,分3个阶段,有主次采用中药汤剂进行清肝息风,通腑化痰,活血化瘀治疗;对照组46例,采用西药常规治疗。比较2组患者治疗前和治疗90d后的血肿变化,神经功能改善情况及日常生活能力（ADL）。结果观察组治疗后颅内血肿与神经功能缺损评分降低趋势明显,差异有显著性意义（P〈0.05）。观察组治疗90d内患者死亡2例,对照组7例,观察组死亡率远低于对照组。同时观察组肺部感染例数与多脏器功能衰竭例数均明显低于对照组,差异均有显著性意义（P〈0.05）。治疗90d后,观察组日常生活能力恢复至Ⅰ级与Ⅱ级的例数明显高于对照组患者。且观察组处于Ⅴ级植物昏迷状态的患者明显低于对照组,因此观察组患者日常生活能力恢复情况优于对照组（P〈0.05）。结论中医三步序贯法治疗急性脑出血能有助于患者血肿消退,促进意识清醒,避免脑病理性损伤,加快患者日常生活能力恢复,是治疗急性脑出血的有效手段。

Clinical Study on Sequential Therapy of Traditional Chinese Medicine for Hypertensive Cerebral Hemorrhage

Objective To observe the clinical efficacy of sequential therapy of traditional Chinese medicine for hypertensive cerebral hemorrhage. Methods 92 patients with hypertensive cerebral hemorrhage were randomly divided into study group（n = 90 cases）and control group（n= 89 cases）. Study group was given sequential therapy of traditional Chinese medicine for three stages, while control group received routine western medicine. Variation of ohematoma,neural function improvement and ability of daily living（ADL） before the treatment and 90 days after the treatment were observed. Results The intracranial hematoma and neural function defect score of study group decreased significantly, the difference was significant（P〈0.05）. Meanwhile, the cases of lung infection and multiple organ failure cases of study group were significantly lower than that in the control group, the differences were significant（P〈0.05）. 90d after the treatment,the recovery of daily living ability of class Ⅰ and Ⅱ of the study group was higher than that in the control group. And the cases in grade Ⅴ was significantly lower than the control group. Conclusion The sequential therapy of traditional Chinese medicine for hypertensive cerebral hemorrhage could accelerate hematoma absorption,protect nerve cell,and improve the ability of daily living.