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目的观察降炎平衡散对重症颅脑损伤患者临床疗效。方法将160例重症颅脑损伤患者随机数字表法分为研究组与对照组各80例。入院后2组患者均给予甘露醇、甘油果糖脱水降低颅内压、新凝灵、氨基环酸注射液止血、神经节苷脂营养脑神经、氨溴索保护肺功能、泮托拉唑、泮托拉唑抑制胃酸、防治应激性溃疡。发病后24h给予鼻饲肠内营养、给予抗生素控制吸入性肺炎等对症处理,所有患者入院后均给与鼻饲空肠营养管置管。发病24h后研究组患者给予自制方剂降炎平衡散,鼻饲肠内注入。对照组同期给予同等剂量的生理盐水鼻饲管注入。治疗14d后,使用美国国立卫生研究院卒中量表评分(NIHSS评分)、简易智能状态检查量表(MMSE评分)及格拉斯哥昏迷分(GCS评分)观察2组患者神经功能缺损程度;比较2组患者有创气管插管率、吸入性肺炎发生率、应激性溃疡发生率、急性肺损伤发生率、病死率;比较2组患者肝、肾功能异常及Na+水平变化。结果治疗后,研究组患者NIHSS评分低于对照组,GCS、MMSE评分均高于对照组,差异均有统计学意义(P<0.05)。治疗后14d内,研究组患者气管插管率、吸入性肺炎发生率、应激性溃疡发生率、急性肺损伤发生率、病死率均低于对照组,差异有统计学意义(P<0.05)。研究组患者血清中AST、ALT、SCr及Na+水平均低于对照组,差异均有统计学意义(P<0.05)。结论降炎平衡散辅助治疗重症颅脑损伤患者可以明显改善神经功能缺损程度评分,减轻继发脏器功能损伤程度,减少早期患者并发症发生,降低临床病死率。
Objective To observe the clinical effect of “Yan Yan He Shi Heng San” on patients with severe craniocerebral injury. Methods 160 patients with severe craniocerebral injury were randomly divided into study group and control group 80 cases. After admission, both groups were given mannitol, dehydration of glycerol and fructose to reduce intracranial pressure, Xin Geling, aminocyclobulin injection to stop bleeding, ganglioside nutrition brain, Ambroxol protect lung function, Pantoprazole, Pan Torazole inhibit gastric acid, prevention and treatment of stress ulcer. 24 hours after onset of nasal feeding enteral nutrition, giving antibiotics to control symptomatic treatment of aspiration pneumonia, all patients were given nasal feeding after feeding nasal tube. Patients in the study group were given homemade anti-inflammatory balance powder 24 hours after the onset of the disease and nasal gut injection. The control group was given the same dose of saline nasal feeding tube in the same period. After 14 days of treatment, the degree of neurological deficit in the two groups was observed by using the NIH Stroke Scale (NIHSS) score, the MMSE score and the Glasgow Coma Scale (GCS score) Invasive tracheal intubation rate, the incidence of aspiration pneumonia, the incidence of stress ulcer, the incidence of acute lung injury and mortality; liver and kidney dysfunction and Na + levels were compared between the two groups. Results After treatment, the scores of NIHSS in the study group were lower than those in the control group, and the scores of GCS and MMSE were higher than those in the control group (P <0.05). Within 14 days after treatment, the intubation rate, the incidence of aspiration pneumonia, the incidence of stress ulcer, the incidence of acute lung injury and mortality in the study group were significantly lower than those in the control group (P <0.05) . Serum levels of AST, ALT, SCr and Na + in the study group were lower than those in the control group, with statistical significance (P <0.05). Conclusion The adjuvant therapy of Jiangyan Balancing Powder in patients with severe craniocerebral injury can significantly improve the score of neurological deficit, reduce the degree of secondary organ damage, reduce the incidence of early complications and reduce the clinical mortality.