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目的观察香蒲醒神汤联合高压氧治疗重型颅脑损伤后意识障碍的临床疗效。方法 54例重型颅脑损伤后意识障碍患者随机分为对照组及试验组,各27例。对照组在常规治疗的基础上给予高压氧治疗,每次60 min,每天1次,试验组在对照组基础上加用香蒲醒神汤(以麝香、蒲黄、石菖蒲、冰片等为主的中药复方),每次125 m L,每天2次,鼻饲;2组均治疗1个月。比较2组患者治疗前后血清S100蛋白(S100-B)、髓鞘碱性蛋白(MBP)、神经元特异性烯醇化酶(NSE)水平、清醒时间、格拉斯哥预后评分(GOS)及临床疗效情况。结果治疗后,试验组有效率为77.78%(21/27例),对照组为62.97%(17/27例),差异有统计学意义(P<0.05)。治疗后,对照组血清S100-B为(1.06±0.15)μg·L~(-1),MBP为(6.56±0.75)μg·L~(-1),NSE为(12.65±1.53)μg·L~(-1),试验组血清S100-B为(0.54±0.07)μg·L~(-1),MBP为(1.72±0.24)μg·L~(-1),NSE为(6.48±0.92)μg·L~(-1),差异有统计学意义(P<0.05)。对照组患者清醒时间为(24.73±3.52)d,GOS评分为(2.73±0.36)分;试验组患者清醒时间为(15.28±2.16)d,GOS评分为(3.86±0.55)分,差异有统计学意义(P<0.05)。药物不良反应主要表现为烦躁、恶心,2组药物不良反应发生率差异无统计学意义(P>0.05)。结论香蒲醒神汤联合高压氧治疗能够显著降低重型颅脑损伤后意识障碍患者的血清S100-B、MBP及NSE水平,缩短清醒时间,改善患者预后,有较好的临床疗效,且安全性较高。
Objective To observe the clinical effect of Typha Prescription Decoction combined with hyperbaric oxygen on consciousness disturbance after severe craniocerebral injury. Methods 54 cases of severe brain injury patients with impaired consciousness were randomly divided into control group and experimental group, with 27 cases in each group. The control group was given hyperbaric oxygen therapy on the basis of routine treatment, each time being 60 min, once a day. The experimental group was treated with Shangpu Decoction (mainly Musk, Puhuang, Shichangpu, borneol, etc.) on the basis of the control group Chinese medicine compound), each 125 m L, 2 times a day, nasal feeding; 2 groups were treated for 1 month. The levels of serum S100 protein (S100-B), myelin basic protein (MBP), neuron specific enolase (NSE), awake time, GOS score and clinical efficacy were compared between the two groups before and after treatment. Results After treatment, the effective rate of the experimental group was 77.78% (21/27 cases) and that of the control group was 62.97% (17/27 cases), the difference was statistically significant (P <0.05). After treatment, the serum levels of S100-B in the control group were (1.06 ± 0.15) μg · L -1, (6.56 ± 0.75) μg · L -1 and (12.65 ± 1.53) μg · L -1, respectively (-1), S100-B in the experimental group was (0.54 ± 0.07) μg · L -1, MBP was (1.72 ± 0.24) μg · L -1 and NSE was (6.48 ± 0.92) μg · L -1, the difference was statistically significant (P <0.05). The awake time of the control group was (24.73 ± 3.52) d, and the GOS score was (2.73 ± 0.36) points. The awake time of the test group was (15.28 ± 2.16) days and the GOS score was (3.86 ± 0.55) Significance (P <0.05). Adverse drug reactions mainly manifested as irritability, nausea, two groups of adverse drug reaction rate was no significant difference (P> 0.05). Conclusions The combination of Cattail Pu Shen Shen Tang and hyperbaric oxygen therapy can significantly reduce the levels of serum S100-B, MBP and NSE, shorten the awake time, improve the prognosis of patients with severe disturbance of consciousness, and have better clinical efficacy and safety high.