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目的:观察逐瘀泄毒法对脑出血患者血浆同型半胱氨酸(Hcy)水平的影响及疗效,同时探讨可能的机制。方法:将40例符合标准的患者,随机分两组,对照组采取西医常规内科治疗,实验组在对照组治疗基础上,加用逐瘀泄毒法治疗。7 d 1个疗程,共2个疗程;治疗前后进行Hcy检测。结果:实验组有效率明显优于对照组。两组治疗前后Glasgow评分、血肿吸收情况、NIHSS评分比较P<0.05,有明显差异。实验组Hcy值较对照组明显降低。结论:逐瘀泄毒法对脑出血后Hcy有明显干预性,证明逐瘀泄毒法联合常规内科治疗的方案优于单纯西医内科治疗。机制可能为抑制、清除或消耗出血灶及周围脑组织血浆Hcy氧化时形成的产物,减少血管内皮细胞损伤,改善血肿周围循环,缩小水肿,减轻脑水肿,促进神经功能恢复有奇效。
Objective: To observe the effect of Zhuyu toxin on plasma homocysteine (Hcy) level in patients with intracerebral hemorrhage and to explore its possible mechanism. Methods: Forty patients who met the criteria were randomly divided into two groups. The control group was treated by western medicine routine medical treatment. The experimental group was treated with the method of eliminating blood stasis and removing blood stasis by the treatment of the control group. 7 d 1 course, a total of 2 courses; Hcy test before and after treatment. Results: The experimental group was significantly better than the control group. Before and after treatment Glasgow score, hematoma absorption, NIHSS score P <0.05, there were significant differences. The experimental group Hcy value was significantly lower than the control group. Conclusion: The method of removing blood stasis and removing toxins has significant intervention on Hcy after intracerebral hemorrhage, which proves that the prescription of eliminating blood stasis and removing blood stasis combined with routine medical treatment is better than western medicine alone. Mechanisms may be to inhibit, remove or consume products formed when plasma Hcy oxidation in the hemorrhage and surrounding brain tissue, reduce vascular endothelial cell damage, improve circulation around the hematoma, reduce edema, reduce cerebral edema, and promote neurological recovery.