| ObjectiveThe purpose of this study is to investigate the effect of Xuefu Zhuyu Decoction on early hypercoagulable state of patients with hypertensive intracerebral hemorrhage after operation by clinical intervention with Xuefu Zhuyu Decoction.The changes of hemorheological indexes and clinical efficacy before and after treatment are compared.The purpose of this study is to provide a basis for clinical application of Xuefu Zhuyu Decoction after Hypertensive Intracerebral Hemorrhage.MethodsAccording to the inclusion criteria,60 inpatients with hypertensive intracerebral hemorrhage who were hospitalized in the Department of Craniocerebral Medicine,First Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine from January 2018 to January 2019 were collected.All the patients were confirmed by cranial CT before operation after trepanation and drainage of hypertensive intracerebral hemorrhage.The patients were divided into treatment group and control group according to whether they took Xuefu Zhuyu Decoction after drilling and drainage,30 in each group.There was no significant difference in age,sex,hypertension grade and intracranial hematoma volume between the two groups before operation.Both groups were discussed and analyzed by more than two senior neurosurgeons,which accorded with the indication of drilling and drainage operation.The control group was treated with routine western medicine,such as lowering intracranial pressure,alleviating brain edema,improving brain function and maintaining water and electrolyte balance.The treatment group was treated with Xuefu Zhuyu Decoction on the 2nd day after operation on the basis of the treatment of the control group.The hemorheological indexes,the volume of edema zone around the hematoma,the occurrence of new cerebral infarction in other parts of the brain were taken as the observation indexes on the 7th and 14th day after operation.The scores of neurological deficit(CSS)and daily activity(ADL)Barthel index on the 14th and 28th day after operation were taken as the clinical therapeutic indexes,and the abnormal liver and kidney functions and serious adverse events were also taken.To explore the clinical efficacy and mechanism of Xuefu Zhuyu Decoction in the treatment of Hypertensive Intracerebral Hemorrhage after trepanation and drainage,and to evaluate its safety.Results(1)Comparing the difference of sex,age,hypertension grade and intracranial hemorrhage volume between the traditional Chinese medicine treatment group and the conventional western medicine treatment group before the beginning of treatment,the statistical analysis showed that there was no significant difference(P>0.05).(2)The hemorheological indexes of the two groups on the 7th and 14th day after treatment were lower than those at admission,P<0.05 was obtained by independent sample t test,but the indexes of the patients treated with Xuefu Zhuyu Decoction improved more obviously(P<0.05).The hemorheological indexes of the patients at admission were slightly lower than those on the first day after operation,but they had changed into hypercoagulable state.After treatment with traditional Chinese medicine decoction and routine western medicine respectively,they gradually became normal.(3)On the 7th and 14th day after operation,the volume of edema zone around the hematoma in both groups decreased compared with that before treatment.The volume of edema zone around the hematoma in the treatment group was significantly smaller than that in the control group(P<0.05)after taking Xuefu Zhuyu Decoction.(4)Some patients in the two groups had new cerebral infarction in other parts after operation,P>0.05 by independent sample t test,but the number of new cerebral infarction in the treatment group was fewer,only one of 30 patients had new cerebral infarction.(5)After treatment,the scores of neurological deficit(CSS)on the 14th and 28th day after operation in both groups were lower than those before treatment,P<0.05 was obtained by independent sample t test.There was significant difference in CSS score between the two groups 14 and 28 days after operation(P<0.05),and the CSS score of the patients taking Xuefu Zhuyu Decoction was lower than that of the patients taking Xuefu Zhuyu Decoction.(6)After treatment,the Barthel index of daily activity(ADL)on the 14th and 28th day after operation was higher than that before treatment in both groups,P<0.05 was obtained by independent sample t test.There was a significant difference in Barthel index between the two groups on the 14th and 28th day after operation(P<0.05),and the Barthel index was higher in the treatment group of traditional Chinese medicine at each observation time point.(7)In both the treatment group and the control group,some patients had abnormal liver and kidney function and electrolyte disturbance,P>0.05 by Chi-square test.There were no serious adverse events such as intracranial hemorrhage,severe cerebral hernia,multiple organ failure and death in the treatment group and the control group.ConclusionThe clinical effect of Xuefu Zhuyu Decoction combined with routine western medicine treatment on patients with hypercoagulable state in early stage after drilling and drainage of hypertensive intracerebral hemorrhage is defi.nite,which is obviously better than that of simple western medicine treatment.This prescription can ef.fectively reduce the early blood viscosity of patients with hypertensive intracerebral hemorrhage after operation,significantly improve the hemorheological parameters,and promote the absorption of edema around the hematoma,to a certain extent,reduce the incidence of new intracranial cerebral infarction.Xuefu Zhuyu Decoction can improve blood rheology,promote brain edema subsidence,increase blood supply and oxygen supply to brain tissue,promote neuron repair,improve neurological function and daily activity ability of patients after operation,and create conditions for good recovery after operation of hypertensive cerebral hemorrhage,which is worthy of clinical popularization and application. |
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