醒脑开窍法治疗弥漫性轴索损伤昏迷临床疗效观察

目的探讨中医醒脑开窍法对弥漫性轴索损伤（diffuse axonal injury,DAI）昏迷患者催醒作用及对预后的影响。方法将DAI患者（GCS≤8分）随机分成两组,治疗组31例在常规治疗基础上加用中药催醒。对照组30例常规西医治疗,两组伤后1个月按GCS评定预后。结果两组除死亡无差别外,良好、中残、重残、植物生存（pvs）均有统计学意义（P〈0.05）,治疗组良好（治愈）明显高于对照组,重残及植物生存发生率明显低于对照组。治疗组昏迷多在2周后清醒,清醒时间明显缩短,对照组多在4～6周后清醒,两组间差异均有统计学意义（P〈0.05）。对GCS 3～5分患者催醒无差异,但对GCS 6～8分患者催醒率有显著差异（P〈0.01）。结论醒脑开窍法治疗DAI昏迷能加快清醒,改善预后有一定作用。

Clinical observation of Chinese medicine in restoring consciousness of coma caused by diffuse axonal injury

Objective To explore the treating effects of Chinese medicine in restoring consciousness of coma caused by diffuse axonal injury（DAI） and its prognosis.Methods Patients with DAI（GCS 8 points）were randomly divided into two groups.31 patients in the experimental group were treated with routine therapy combined with Chinese medicine to restore consciousness.30 cases in the control group were treated with routine western medicine.After treatment for 1 month,the treating effects and its prognosis were assessed by GCS.Results There was significant difference between the 2 groups concerning the improved,moderate and severe disability as well as unconsciousness living except death rate（P 0.05）.The cure rate of the experimental group was remarkably higher than that of the controls.The severe disability rate and the unconsciousness living rate was obviously lower than that of the control group.Most of the patients in the experimental group restored consciousness after treating 2 weeks;while the majority of the patients in the control group regained consciousness after treatment for 4-6 weeks.There was a great difference between the 2 groups（P〈0.05）.To the patients with 3-5points of GCS,there was no significant difference between the two groups,but to the patients with 6-8 points of GCS there was significant difference（P〈0.01）.Conclusion Chinese medicine is quite effective in treating coma caused by DAI,which has the function to accelerate to regain consciousness and improve its prognosis.