醒脑静注射液治疗成人化脓性脑膜炎疗效观察(1)
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【摘要】目的探讨醒脑静注射液在成人化脓性脑膜炎中的治疗作用。方法将21例成人化脓性脑膜炎感染患者随机分为治疗组11例及对照组10例，对照组常规给予抗生素、甘露醇、激素治疗，治疗组在常规治疗基础上辅以醒脑静注射液静脉滴注。两组疗程均为2周。观察患者退热时间，并记录比较治疗第3天及第14天的格拉斯评分情况和患者炎症指标变化全血白细胞数(B-WBC)及脑脊液白细胞数(CSF-WBC)及脑脊液生化指标变化。结果治疗组退热时间早，意识障碍明显缓解，B-WBC和CSF-WBC明显下降,与对照组比较，差异有统计学意义(P<0.01)。结论在治疗成人化脓性脑膜炎过程中，醒脑静注射液辅助治疗能及早缓解患者高热、意识障碍等症状，促进血和脑脊液中白细胞数下降至正常水平。
【关键词】化脓性脑膜炎；成人；中西医结合疗法； 醒脑静
Efficacy of Xingnaojing injection on purulent meningitis in adultLin Xin-jiang， DU Deng-qing, ZHUAN Wei-duan. Department of Neurology，The First Affiliated Hospital of medical college of Shantou University, Shantou 515000，China
【Abstract】ObjectiveTo explore the effects of Xingnaojing injection on purulent meningitis in adult. MethodsTwenty-one cases with purulent meningitis were randomly divided into two groups: the control(N =11) routine western medicine of antibiotics, mannitol and dexamethasone,and the treatment group(N=10) received intravenous drip of Xingnaojing injection based on the routine western medicine. The duration of fever was observed. To compare the Glasgow Coma Scale (GCS), WBC count in blood and cerebrospinal fluid were examined on the 3th and 14th day of treatment. ResultsThe time of fever of the treatment group WAs shorter than the control group obviously(P<0.05). The improvement of GCS and the decline of WBC count in blood and cerebrospinal fluid on 14th day was obviously in the treatment group (P<0.01). ConclusionXingnaojing injection is effective on relieving high fever and consciousness disorder in patients with purulent meningitis in adults, and on promoting the recovery of WBC count in blood and cerebrospinal fluid.
【Key words】Purulent meningitis；Adult; Integrated therapy of TCM and WM; Xingnaojing Injection
作者单位：515041汕头大学医学院第一附属医院神经内一科化脓性脑膜炎是细菌感染引起急性脑和脊髓软脑膜、蛛网膜及脑脊液的炎症，为严重的颅内感染之一。发生于成人脑膜炎常见病原为肺炎链球菌，起病多急，病情危重，易造成后遗症，危险因素包括急性或慢性鼻窦炎或中耳炎、酗酒、糖尿病、免疫力低下、伴有颅底骨折或脑脊液鼻瘘的脑外伤。文献报道，尽管抗生素治疗有效，病死率仍在20%左右[1]。本研究旨在化脓性脑膜炎的西医治疗基础上，辅以中成药醒脑静治疗，对缓解患者高热及意识障碍等有较好疗效。现报告如下。
1资料与方法
1.1一般资料2007年1月至2011年11月期间我科收治的成人化脓性脑膜炎病例21例，男14例，女7例；年龄17～71岁，平均(38±13)岁。其中中耳炎3例，外伤颅底骨折5例，伴脑脊液鼻瘘3例，鼻窦炎3例，脑室腹腔分流术后感染2例，颅脑手术后经硬膜下引流管感染1例，其他原因10例。主要表现为：头痛、高热、意识障碍，脑膜刺激征阳性，全血白细胞总数及中性分类增高，脑脊液白细胞数增高等 ......
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