【作者】 顾宁；

【导师】 周仲瑛；

【作者基本信息】 南京中医药大学 ， 中医内科学， 2001， 博士

【摘要】 根据中医学中风病理论及导师周仲瑛教授的学术观点，本文提出了瘀 热阻窍是脑出血急性期的核心病机，凉血通瘀法是脑出血急性期的主要治 疗大法，该法具有清热、凉血止血、活血祛瘀、通腑泻热等诸多作用。 通过临床研究，进一步探讨凉血通瘀法治疗急性脑出血的疗效。63例 患者被随机分为治疗组32例和对照组31例，治疗组在常规西医治疗基础 上合用凉血通瘀注射液，对照组仅予西医常规治疗，14天为一个疗程，观 察结果显示：凉血通瘀注射液能显著地改善患者的症状和体征，促进颅内 血肿的吸收、减轻继发性脑水肿，能降低死亡率和并发症的出现，能改善 血液流变学检测指标等等。治疗组患者临床总有效率为93．75％，显效率 46．88％，明显优于对照组的74．19％和16．13％（P＜0．05，P＜0．01）。 动物实验表明，凉血通瘀注射液能显著降低实验性脑水肿模型大鼠的 脑指数与脑组织含水量，能较好地调节伴随脑水肿出现的脑组织离子 （钾、钠、钙）含量改变，能升高大鼠脑组织SOD和 GSH－PX、降低 MDA水平，能降低大鼠血浆ET、升高CGRP与ANP水平，并有一定程度 保护模型大鼠血脑屏障（BBB）的作用。实验结果显示：凉血通瘀注射液 对实验性大鼠脑出血后脑水肿的治疗作用，优于清开灵注射液。更多还原

【Abstract】 Based on the theories about aPoplexy in talitional Chinesemedicine (TCM) and the views of Professor Zhou Zhong-ying,the author’s supervisor, it is put fOrward in this paPer that theblood StaSis and heat accumulated inside the btaln is the keypathOgenesis for acute ICH, and the main treAnent is tO begiven with CBCST, including many functions lilie c1earing awayheat, cooling the blood and stOPping bleeding, promOtng bloodcirculation to remove bloOd stasis, clearing Fu organs andpurging heat, etc.In order tO ddermine the curative effect of CBCST on acuteICH, 63 cases wer divided randomly into a trCatment group(32 cases ) receiving Liangxuetongu Injection and routinewestem theraPy and a contrOl group (3l cases ) treated onlywith rootine westem therapy, and l4 days constituted onetrCdrient course. The result showed that LiangxuetompInjection can haprove the patientS’ symPtoms and signSremarkably, Promote the reduction of inthecerebral hematoma andBE after ICH, reduce the mortality rate and complication, andimProve the indx of blood rheology in the measurement. Theclinical total and evident effective rates in the tr6aboeni grOupare suPerior to those of the contrOl grouP, 93.75% and 46.88%更多还原