The subsidiary effect of Wenyang Yiqi method on patients with severe traumatic brain injury under mild hypothermia therapy
10.3969/j.issn.1008-9691.2015.05.001
- VernacularTitle:温阳益气法对重型颅脑损伤患者亚低温治疗期的辅助作用
- Author:
Guan WANG
;
Dechen CAO
;
Hongsheng SUN
;
Kun DONG
;
Xueyan WANG
- Publication Type:Journal Article
- Keywords:
Hypothermia;
Brain injury;
Intracranial pressure;
Wenyang Yiqi method;
Shenfu injection
- From:
Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care
2015;22(5):449-452
- CountryChina
- Language:Chinese
-
Abstract:
Objective To observe the neural protective subsidiary effect of Wenyang Yiqi method on patients with severe traumatic brain injury under mild hypothermia therapy.Methods A prospective study was conducted in which 53 patients with severe traumatic brain injury treated by mild hypothermia were randomly divided into control group (26 cases) and observation group (27 cases). All the patients in the two groups received conventional western treatment combined with mild hypothermia therapy. In the observation group, additionally was given the representative drug of Wenyang Yiqi method, Shenfu injection 100 mL mixed into 5% glucose 500 mL intravenous drip once a day. At the end of mild hypothermia, the Shenfu injection was stopped. After treatment, the changes of intracranial pressure (ICP) on 1 (the day the treatment began), 2, 3, 4, 5, 6 and 7 days and the indexes levels, including S-100B, lactate dehydrogenase (LDH) and creatinkinase (CK) in the cranial spinal fluid (CSF) before treatment and 2, 4, 6 days after treament (CSF) were observed. The Glasgow coma score (GCS) before treament and 3, 5, 7, 14, 28 days after treament, and Glasgow outcome scale (GOS) on 28 days and 3 months after treatment were recorded, and the incidences of complications were calculated at the end of therapy.Results After treatment with the prolongation of therapeutic time, the levels of ICP were gradually increased in two groups and reached the peak values on the 4th day, then beganto fall, and on the 5th day it was significantly lower in observation group than that in control group [ICP (mmHg, 1 mmHg = 0.133 kPa): 16.11±1.23 vs. 18.73±1.42], persisting the same situation to the 7th day (14.17±0.80 vs. 16.94±1.00,P < 0.05). The levels of S-100 B in the two groups were progressively decreased after the treatment, on the 2nd day it was significantly lower in observation group than that in control group (μg/L: 1.21±0.43 vs. 1.86±0.57, P < 0.05), also persisting to the 6th day (0.40±0.09 vs. 0.94±0.15,P < 0.05); the levels of LDH and CK reached the peak values on the 2nd day, then began to fall, they were significantly lower in the observation group than those in the control group on the 4th day [LDH (U/L): 63.43±12.21 vs. 80.11±14.34, CK (U/L): 52.41±14.14 vs. 88.37±12.21, bothP < 0.05], and on the 6th day still there were statistically significant differences between the two groups. The GCS before treatment showed no statistically significant difference between the two groups (P > 0.05); after treatment, the GCS score of the two groups was progressively improved, and on the 14th day the score in the observation group began significantly higher than that in the control group (11.74±1.24 vs. 9.41±2.11,P < 0.05), persisting the same situation to the 28th day (12.68±2.51 vs. 10.67±1.99,P < 0.05). On the 28th day after treatment, the GOS showed no statistically significant difference between the two groups (2.35±0.16 vs. 2.43±0.22,P > 0.05), but the score in the observation group was significantly higher than that in the control group after treatment for 3 months (4.11±0.38 vs. 3.72±0.41, P < 0.05). The incidences of complications in the observation group were significantly lower than those in the control group [respiratory failure: 25.9% (7/27) vs. 50.0% (13/26), shock: 18.5% (5/27) vs. 53.8% (14/26), acute pulmonary edema: 14.8% (4/27) vs. 30.8% (8/26), stress ulcer: 22.2% (6/27) vs. 57.7% (15/26), hypoproteinemia: 40.7% (11/27) vs. 73.1% (19/26), allP < 0.05].Conclusion Wenyang Yiqi method has the subsidiary neural protective effect on patients with severe traumatic brain injury treated by mild hypothermia, and can improve their outcome.
