Clinical Effect Observation On Treating Traumatic Brain Edema With Wuling San And Its Effect On The Two-way Adjustment

Objective:Using the traditional prescription Wuling San as an intervention drug,combined with conventional western medicine for the treatment of secondary cerebral edema after traumatic brain injury,observe its clinical effect;From the perspective of Na+,K+ and other electrolyte observe its two-way adjustment.Objective evaluation of its efficacy and safety for the treatment of secondary brain edema after cerebral trauma with traditional Chinese medicine provides new theoretical and clinical basis,the combination of Chinese and western medicine clinical treatment can get more extensive application in the field of neurosurgery.Methods:Choose between January 2016 and December at the general hospital neurosurgery inpatients in Lanzhou,Lanzhou Military Region,according to the inclusion criteria,exclusion criteria to choose 80 patients with traumatic craniocerebral injury,according to the classification standard screening mild cerebral edema and moderate cerebral edema,each type was randomly divided into two groups.Mild control group of 20 cases,intravenous infusion mannitol + other basic treatment;mild treatment group of 20 patients,taking modified Wuling San Decoction + other basic treatment;moderate treatment group and control group of 20 cases,were the same basis treatment(including intravenous infusion mannitol),the treatment group plus the above modified Wuling San Decoction.Treatment for 2 weeks,followed up for 1 month,observe the two groups before treatment and after treatment 1d,3d,7d and 14 d of the curative effect indicators,such as intracranial pressure,cranial pressure symptoms,cranial CT,state of consciousness,Glasgow coma scale(GCS),the degree of nerve function defect,C-reactive protein,liver and kidney function,electrolyte,disease "head internal injuries" diagnostic criteria of traditional Chinese medicine,Glasgow outcome scale(GOS)and so on.Do statistical analysis,draw the conclusion.Results:In patients with mild traumatic brain edema,after 7 days and 14 days:(1)two groups of patients in GCS,ICP,degree of clinical neural function defect score and serum CRP concentration such as observation indexes were improved markedly,no significant difference in two comparison(P>0.05);(2)in the control group patients serum Na+ concentration from the previous declined obviously,and lower than that of the treatment group,two groups compare the difference was statistically significant(P<0.05);(3)with 7 days after the group serum K+ concentration is lower than the treatment group but no significant difference(P > 0.05);14 days after treatment in the control group patients serum K+ concentration is significantly lower in treatment group,P<0.05,the tip is similar between the two groups was statistically significant;(4)7 days after treatment in the two groups on the clinical curative effect and efficacy of CT were no significant difference(P>0.05),14 days after the two groups in clinical curative effect of treatment,the curative effect of traditional Chinese medicine,CT curative effect were no significant statistical differences(P>0.05);(5)for 1 month after treatment,there was no significant difference between the two groups in GOS and CT(P > 0.05).In patients with moderate traumatic brain edema,after 7 days and 14 days:(1)two groups of patients in GCS,ICP,degree of clinical neural function defect score and serum CRP concentration such as observation indexes were improved markedly,GCS not seen in two two compared significant difference(P>0.05),ICP,degree of clinical neural function defect score,serum CRP concentration have significant difference(P<0.05);(2)in the control group patients serum Na+ concentration from the previous declined obviously,and lower than that of the treatment group,two groups compare the difference was statistically significant(P<0.05);(3)the control group patients serum K+ concentration is significantly lower in treatment group,comparing the two groups was statistically significant difference(P<0.05);(4)on the treatment for 7 days in the two groups in the CT no significant difference(P>0.05);On the clinical efficacy of the treatment group is significantly higher than the control group,the differences(P<0.05);5.14 days after two groups on the curative effect of TCM treatment no significant difference(P>0.05);Significant difference on clinical curative effect and CT curative effect(P<0.05),the treatment group is better than the control group;6.1 month after treatment,there was no significant difference between the two groups in GOS and CT(P>0.05).Conclusion:Modified Wuling San Decoction have promote wake,reduce intracranial pressure,promote the nerve functional recovery,reduce post-traumatic inflammatory response,improve headache symptoms,promote brain edema subsiding and other effects;And can maintain the patient's body Na+,K+ and other electrolyte balance,effective and safe.