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[目的]观察活血祛瘀方联合西药治疗急性脑出血疗效。[方法]使用随机平行对照方法,将100例住院患者按病志号抽签方法简单随机分为两组。对照组50例常规西医治疗:畅通呼吸道、降颅压、控制血压、利尿,预防控制感染,消化道出血(雷尼替丁或西咪替丁),促进脑细胞功能,保持水电解质平衡,加强褥疮和口腔护理,吸氧,头部冷敷,营养支持等。治疗组50例活血祛瘀方(鲜竹沥20mL,丹参、川贝、赤芍各15g,水蛭10g,牛膝、胆南星、生大黄、三七粉各9g,当归、川芎、红花各6g),高热烦躁加石膏、栀子、羚羊角、水牛角、黄芪;神昏久不苏醒加郁金、远志、石菖蒲、羚羊角;便血呕血将三七粉剂量调整为12g,去大黄,加大黄炭;呃逆加代赭石、柿蒂;咳痰且合并肺部感染加杏仁、鱼腥草、黄芩及瓜蒌壳;肾功能异常加旱莲草、杜仲、茯苓、生牡蛎,水煎400mL,1剂/d,分2~3次,口服,吞咽困难或意识不清,鼻饲;西药治疗同对照组。连续治疗3周为1疗程。观测临床症状、神经功能缺损评分、出血量、不良反应。治疗1疗程,判定疗效。[结果]治疗组基本痊愈18例,显效14例,有效14例,无效3例,恶化1例,总有效率92.00%。对照组基本痊愈10例,显效12例,有效10例,无效12例,恶化6例,总有效率64.00%。治疗组疗效优于对照组(P<0.05)。神经功能评分及出血量两组均明显改善(P<0.01),治疗组改善优于对照组(P<0.01)。[结论]活血祛瘀方联合西药治疗急性脑出血,疗效满意,无严重不良反应,值得推广。
[Objective] To observe the curative effect of Huoxue Quyu Decoction combined with western medicine on acute cerebral hemorrhage. [Methods] Using randomized parallel control method, 100 inpatients were randomly divided into two groups randomly according to the method of lot drawing. Control group of 50 cases of conventional Western medicine: smooth respiratory, reducing intracranial pressure, blood pressure control, diuretic, prevention and control of infection, gastrointestinal bleeding (ranitidine or cimetidine), promote brain cell function, maintain water and electrolyte balance, strengthen Pressure sores and oral care, oxygen, cold head, nutritional support. The treatment group, 50 cases of Huoxue Quyu Fang (fresh bamboo Lek 20mL, Salvia, Chuanbei, red peony 15g, leech 10g, Achyranthes, bile Southern Star, raw rhubarb, notoginseng 9g, Angelica, Chuanxiong, saffron 6g ), Hot and irritable plus gypsum, gardenia, antelope horn, buffalo horn, astragalus; God coma long wake up plus turmeric, Polygalaceae, Shichangpu, antelope horn; hematochezia hematemesis will Panax powder dose adjustment for 12g, to rhubarb, plus Phlegm and lung infection combined with almonds, Houttuynia, Scutellaria and melon shell; kidney dysfunction plus Eclipta, Eucommia, Poria, raw oysters, decoction 400mL, 1 Agent / d, 2 or 3 times, oral, dysphagia or unconsciousness, nasal feeding; western medicine treatment with the control group. Continuous treatment for 3 weeks for a course of treatment. Observation of clinical symptoms, neurological deficit score, amount of bleeding, adverse reactions. Treatment of a course of treatment to determine the efficacy. [Results] The treatment group basically cured in 18 cases, markedly effective in 14 cases, effective in 14 cases, 3 cases of ineffective, 1 case of deterioration, the total effective rate was 92.00%. The control group basically recovered in 10 cases, markedly effective in 12 cases, effective in 10 cases, ineffective in 12 cases, worsening in 6 cases, the total effective rate was 64.00%. The treatment group was better than the control group (P <0.05). The score of neurological function and the amount of bleeding were significantly improved in both groups (P <0.01), and the improvement in the treatment group was better than that in the control group (P <0.01). [Conclusion] Huoxue Quyu Decoction combined with Western medicine in the treatment of acute cerebral hemorrhage has satisfactory curative effect and no serious adverse reactions, which deserves promotion.