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BIS在醒腦靜注射液促醒療效評估中的應(yīng)用

發(fā)布時間:2018-05-18 06:44

  本文選題:昏迷 + 醒腦靜 ; 參考:《廣州中醫(yī)藥大學(xué)》2015年碩士論文


【摘要】:目的:本研究旨在觀察醒腦開竅法代表方藥醒腦靜注射液對中醫(yī)辨證屬于熱閉型昏迷患者的影響,通過對比腦電雙頻指數(shù)(bispectral index, BIS)及格拉斯哥昏迷指數(shù)(glasgow coma scale, GCS)的變化評價其促醒效果,并且評價BIS在意識障礙患者意識狀態(tài)監(jiān)測中的應(yīng)用。方法:以48例中醫(yī)辨證屬于熱閉型的昏迷患者為研究對象,隨機分為試驗組和對照組,兩組均進(jìn)行BIS監(jiān)測,治療方面,試驗組和對照組均給予西醫(yī)常規(guī)治療(包括開放氣道、穩(wěn)定生命體征、病因治療、改善腦循環(huán)、控制腦水腫、降低顱內(nèi)壓、抗感染、抗驚厥、營養(yǎng)腦細(xì)胞、基本營養(yǎng)支持、護(hù)理支持及其它對癥治療等),試驗組在西醫(yī)常規(guī)治療的基礎(chǔ)上加用醒腦靜注射液(20ml qd),觀察兩組患者在用藥前及用藥后相同時間點(以開始用藥為時間起點)BIS及GCS的變化,7天為觀察時間終點。收集數(shù)據(jù),統(tǒng)計分析。結(jié)果:1.兩組患者治療前基線資料(性別、年齡、APACHE Ⅱ、GCS、發(fā)病至接受治療的時間)的對比,差異無統(tǒng)計學(xué)意義(P0.05),說明兩組資料具有可比性;2.治療前后的組內(nèi)對比,兩組患者的GCS和BIS均有所升高,差異有顯著統(tǒng)計學(xué)意義(P0.01);3.治療后兩組間的對比,試驗組的GCS和BIS均高于對照組,差異有統(tǒng)計學(xué)意義(P0.05);4.第7天(觀察時間終點)時,實驗組的患者狀況優(yōu)于對照組,差異有統(tǒng)計學(xué)意義(P0.05);5.治療前,所有患者的BIS與GCS具有顯著相關(guān)性(r=0.949,P0.01);治療后試驗組患者的BIS與GCS具有顯著相關(guān)性(r=0.851,P0.01),對照組患者的BIS與6CS具有顯著相關(guān)性(r=0.928,P0.01)。結(jié)論:1.無論是西醫(yī)常規(guī)治療,還是西醫(yī)常規(guī)治療聯(lián)合應(yīng)用醒腦靜注射液,均能改善昏迷患者的病情;2.與西醫(yī)常規(guī)治療相比,聯(lián)合應(yīng)用醒腦靜注射液能夠更好的改善昏迷患者的病情;3.在昏迷患者的意識狀態(tài)監(jiān)測方面,BIS與GCS具有良好的相關(guān)性,且屬于客觀指標(biāo),值得臨床進(jìn)一步推廣。
[Abstract]:Objective: to observe the effect of XingnaoKaiqiao method on the syndrome differentiation of Chinese medicine patients in coma of heat closure type, and to observe the effect of Xingnaojing injection on the syndrome differentiation of traditional Chinese medicine. The effects of bispectral index (BISs) and Glasgow coma scale, GCS) were evaluated by comparing bispectral index (BISs) and Glasgow coma scale, GCS), and the application of BIS in consciousness state monitoring in patients with consciousness disorder was evaluated. Methods: 48 cases of coma patients with heat shut-down syndrome differentiation were randomly divided into two groups: experimental group and control group. Both groups were monitored by BIS. The treatment group and control group were treated with routine western medicine treatment (including open airway). Stabilization of vital signs, treatment of etiology, improvement of cerebral circulation, control of brain edema, reduction of intracranial pressure, anti-infection, anti-convulsion, nutritious brain cells, basic nutritional support, Nursing support and other symptomatic treatment, the trial group was treated with Xingnaojing injection 20ml QDX on the basis of routine western medicine treatment. The patients in the two groups were observed before and after medication at the same time point (taking the beginning of medication as the starting point of time) and GCS. The change of 7 days was the end of observation time. Collect data and analyze statistics. The result is 1: 1. There was no significant difference between the two groups in baseline data before treatment (sex, age, Apache 鈪,

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