Analysis Of TCM Differentiation Of Patients With PVS And Clinical Study Of The Effect Of Yi Shen Qi Qiao Fang

Every year,millions of people in China sustain head and brain injuries.More than half are bad enough that people must go to the hospital.The worst injuries can lead to permanent brain damage or death.With the development of intensive care facilities and technologies that can artificially maintain blood flow and breathing,the term "vegetative state" has come to use.Persistent vegetative state(PVS) is a kind of special consciousness disturbance.The most common causes in both adults and children are head trauma and hypoxic ischemic encephalopathy.The condition may be transient,marking a stage in the recovery from severe acute or chronic brain damage,or permanent,as a consequence of the failure to recover from such injuries.The prognosis is poor and the recovery of consciousness from posttraumatic PVS is highly unlikely in an adult after 1 year.Most patients in PVS do not survive longer than 2 to 5 years.Death occurs from infection,generalized systemic failure, respiratory failure,and in some cases,sudden death of unknown etiology.Owing to the limitation of treatment reaction in modern medicine,it is necessary to find an effective Chinese-herb formula to promote the recovery of PVS.We report an analysis of the TCM differention in PVS and utilization of a Chinese medicine formula(Yi Shen Qi Qiao Fang) in treating PVS and try to to access the effect on the recovery of consciousness from PVS.Objective:To analyze the TCM differentiation of patients with PVS and evaluate the effect of the Chinese herb formula(Yi Shen Qi Qiao Fang) on the recovery of consciousness from the Patients with PVS.Methods:1.Patients with PVS,diagnosed pathologically with more than 3 months forecasted survival time in Nanjing Zi-Jin Hospital from 2006 to 2008 were selected.To establish a classification method and analysis for the disposition of TCM differentiation in patients with PVS and divide all the patients into two groups at random.2.One group is Chinese medicine group(group B,26 patients),the other is normal control group(group A,27 patients).Besides both groups were applied with the therapies for hyperbaric oxygen,cerebral metabolism drugs,electric stimulation,and other maintenance therapy as routine schedule,the patients of the Chinese medicine group were given the(Yi Shen Qi Qiao Fang) taken orally after meal,3 times per day for 2 months as one course.3.The quality of recovery of consciousness was evaluated with the PVS scoring before and after treatment.The PVS scores adopted to reflect the changes of consciousness of patients.As compared with those before treatment,the scores increased than after treatment as improved;decreased as aggravation.4.The evaluation was performed in two months for one course.And we give a PVS scoring when they enter the group,one month later and leaving the group.As compared with those before treatment,we observe the difference between the two groups to know whether the formula is good for the recovery of the PVS patients.Results:1.The majority of pathogenic factor of TCM differentiation in PVS are deficiency of both "Qi "and blood and phlegm with blood stasis locking the brain.The prevalence of the subtype in our samples is about 48.21%(27/56).2.Rudimentally or totally depart from the PVS;in group A,there were 2 cases rudimentally departed from the PVS,4 cases totally departed from the PVS.In group B, there were 6 cases rudimentally departed from PVS,4 cases totally departed from the PVS. Group B is better than group A,but they don't have significant difference(u=0.67,P＞0.05).3.PVS score;according to PVS scoring criteria,both two groups have no significant deviation(P＞0.05);after the treatment,group B is better than group A(P＞0.05).About the PVS score,during the treatment,the interclass comparison has no significant deviation (P＞0.05);after the treatment,group B is better than group A(F=4.452,P=0.043).About the interclass comparison,the scoring of the two groups during treatment is better than before treatment and has statistical significant(P＜0.05).Comparing after and during treatment, group A has no significant deviation(P＞0.05);group B has significant deviation(P＜0.05). Comparing after and before treatment,group A has extremely significant deviation (P＜0.005) but group B is more significant(P＜0.0005).Conclusions:The majority of pathogenic factor of TCM differentiation in PVS are deficiency of both "Qi "and blood,and phlegm with blood stasis locking the brain.Our findings indicate that the Chinese medicine(Yi Shen Qi Qiao Fang) combined with normal scheduled therapy can significantly improve the quality of life of patients with PVS,and it will have a better prospect for further studying.