天麻钩藤饮治疗轻型颅脑损伤患者的疗效研究

Effect of Tianma Gouteng Decoction on clinical efficacy in patients with mild traumatic brain injury

摘要:

目的 探讨天麻钩藤饮对轻型颅脑损伤患者临床疗效的影响。方法 前瞻性收集2016 年1 月- 2017 年1 月该院收治的轻型创伤性脑损伤（mTBI）患者36 例，分为观察组和对照组。观察组给予天麻钩藤 饮治疗和常规治疗，对照组仅给予常规治疗。观察两组患者第二代脑震荡估量评分表（SCAT-2）评分和基 于血氧饱和度的功能磁共振成像显像结果。结果 两组患者入院时定位能力、瞬时记忆、标准化脑震荡评分 量表（SAC）总分、SCAT-2 总分比较，差异无统计学意义（P >0.05）。治疗2 个月时与对照组比较，观察组 定位能力评分、瞬时记忆评分、SAC 总分和SCAT-2 总分提高（P <0.05）。2 个月后观察组患者低频振幅（ALFF） 值升高脑区主要位于双侧中央后回区域；观察组患者ALFF 值降低脑区主要位于上颞叶、下颞叶、旁海马区 和梭状回面孔区。在解剖自动贴标模版脑区层面，2 个月后观察组患者ALFF 值升高脑区主要位于右边额下回 盖部、三角部、右边中央沟盖、左脑岛、右边中扣带回、左中央后回、右楔前叶、左侧颞横回、左上颞叶区 域；观察组患者ALFF 值降低脑区主要位于左右嗅球、左右旁海马区、右杏仁核、左右距状回及右侧豆状核。 结论 天麻钩藤饮可以提高SCAT-2 评分，提升肢体协调和平衡能力，改善记忆力、头痛、眩晕及一些不稳 定的情绪。

Abstract:

Objective To investigate the effect of Tianma Gouteng Decoction on the clinical efficacy in patients with mild traumatic brain injury (mTBI). Methods From January 2016 to January 2017, 36 patients with mTBI were prospectively collected in our hospital. The patients were randomly divided into observation group and control group. The patients in both groups received conventional treatment, and the observation group was given Tianma Gouteng Decoction. The Sport Concussion Assessment Tool 2 (SCAT-2) score and BOLD-fMRI imaging of the two groups were observed. Results There was no significant difference in orientation ability, instant memory, SAC total score or SCAT-2 total score on admission between the two groups (P > 0.05). Two months after treatment, when compared with the control group, the patients in the observation group got higher scores of orientation ability and instant memory, SAC total score and SCAT-2 total score (P < 0.05). Two months after admission, the patients in the observation group got higher ALFF values in bilateral postcentral gyri; and lower ALFF in superior temporal lobe, inferior temporal lobe, parahippocampal gyrus, and fusiform gyrus. In the anatomical automatic labeling template brain region level, at two months after admission, the patients in the observation group had significantly higher ALFF in the operculum and pars triangularis of the right inferior frontal gyrus, operculum of the right central sulcus, left insula, right median- and para-cingulate gyrus, left postcentral gyrus, right precuneus, left Heschl’s gyrus, and left superior temporal lobe; while the decreased ALFF brain areas were located in olfactory bulbs, bilateral parahippocampal areas, right amygdala, bilateral calcarine gyri and right lenticular nucleus. Conclusions Tianma Gouteng Decoction can significantly increase SCAT-2 score, reduce stress, improve coordination and balance ability, and improve memory loss, headache, dizziness, and emotional instability in mTBI patients.