Experience of modified Antelope horn and uncaria decoction combined with Angong Niuhuang pill in treating hypoxic ischemic encephalopathy after cardiopulmonary resuscitation
10.3969/j.issn.1008-9691.2023.06.006
- VernacularTitle:羚角钩藤汤加减联合安宫牛黄丸治疗心肺复苏后缺血缺氧性脑病的体会
- Author:
Xuanyu LU
1
;
Bo WANG
;
Yun LU
Author Information
1. 北京中医药大学,北京 100029
- Keywords:
Hypoxic ischemic encephalopathy;
Central high fever;
Grand mal seizure;
Antelope horn and uncaria decoction;
Angong Niuhuang pill
- From:
Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care
2023;30(6):668-672
- CountryChina
- Language:Chinese
-
Abstract:
Objective To observe the clinical efficacy of modified Antelope horn and uncaria decoction combined with Angong Niuhuang pill in the treatment of hypoxic-ischemic encephalopathy(HIE)after cardiopulmonary resuscitation(CPR).Methods Clinical data of 1 patient with HIE after CPR admitted to the intensive care unit(ICU)of West China Hospital of Sichuan University on December 18,2021 was retrospectively analyzed,to observe the influence of TCM on HIE.The patient was consulted by Professor Lu Yun.Results The patient,a 40-year-old male,developed coma,grand mal seizures,central high fever,and intracranial hypertension after CRP.Patient was previously healthy.The head CT scan revealed extensive brain edema.The patient was treated by invasive ventilator assisted ventilation,temperature control,pressure management,sedation,analgesia,anti-epilepsy medication,dehydration management,liver protection,maintenance of internal environment,and nutritional support.However,after 22 days of western medicine treatment,the patient's symptoms remained poorly controlled.The patient was requested for TCM consultation.Combined with the four diagnosis of the patient,including fainting,high fever,convulsions,obesity,yellow face,red lips,red tongue,white and greasy tongue coating,and weak pulse,the TCM dialectics was liver heat to cause wind,phlegm heat to close the heart.Modified Antelope horn and uncaria decoction combined with Angong Niuhuang pill,were utilized for treatment.The patient received one dose of Chinese medicine decoction per day,with Moschus and Saigae Tataricae Cornu powder administered three times via nasal feeding.One Angong Niuhuang pill was administered with Ginseng decoction via nasal feeding,twice daily.After 10 days of treatment,the patient exhibited alertness and was able to successfully carry out simple actions as ordered.He was removed from the ventilator.Notably,the patient presented with a red tongue,thin white tongue coating,and a weak and stringy pulse.The doctor made the following adjustments to the treatment plan:Alismatis Rhizoma,Rhei Radix Et Rhizoma,and Moschus were removed,and the dosage of Saigae Tataricae Cornu was increased to 3 g,and Paeoniae Radix Alba Was increased to 30 g.The dosage of Angong Niuhuang pill was reduced to 1 pill per day,following the same usage as before.Doctor stopped controlling body temperature,dehydration,analgesia,and liver protection treatment,while reducing the dosage of anti-epileptic drugs.Twenty days later,tmental state improved significantly,with relief from symptoms and a noticeable reduction in brain edema as confirmed by the head CT scan.He exhibited a red tongue,minimal tongue coating,and a weak pulse.Western medicine treatment involved administering valproic acid at a dosage of 1 600 mg every 12 hours through tube feeding for both antiepileptic and sedative purposes.After 40 days of follow-up,the patient was alert,able to respond to questions,and resumed normal activities.The sedation was discontinued.Subsequently,the patient was transferred out of the ICU and admitted to the neurology department for further rehabilitation.After a year of follow-up,the patient was able to resume a normal lifestyle,both in terms of living and work.Conclusion The effective intervention of TCM has a lot of space in brain resuscitation after CPR.The methods of reviving the brain,clearing the liver and relieving wind,and reducing turbidity can effectively reduce brain edema and control epileptic seizures.
