An prospective observation on clinical therapeutic effect of Lund program combined with Angong Niuhuang pill for treatment of patients with severe traumatic craniocerebral injury / 中国中西医结合急救杂志

ABSTRACT

Objective To observe the therapeutic effect and prognosis of patients with severe traumatic craniocerebral injury treated by Lund program combined with Angong Niuhuang pill. Methods A prospective study was conducted. Forty-nine patients with severe traumatic craniocerebral injury were divided into two groupscombined treatment group (25 cases) and control group (24 cases). All the patients in the two groups received conventional therapy. Additionally, the combined treatment group was treated by the Lund program combined with Angong Niuhuang pill, the patients after admission into the intensive care unit (ICU), indwelling of gastric tube was immediately given (the tube inserted and retained through mouth in cases with cranial base bone fracture), one pill of Angong Niuhuang was fed nasally twice a day for consecutive 15 days. Before and after treatment, the intracranial pressure (ICP), cerebral perfusion pressure (CPP), Glasgow coma scale (GCS) score, the mean flow velocity of middle cerebral artery (MCA), and the incidence of complication, clinical efficacy and prognosis in the two groups were observed. Results There were no statistically significant differences in the levels of ICP, CPP, GCS score and the average flow velocity of MCA before treatment and the first day after treatment between the two groups. Beginning from 3 days after treatment, the degrees of improvement in the above indexes in the combination treatment group became much better than those in the control group [ICP (mmHg, 1 mmHg=0.133 kPa)16.78±4.50 vs. 18.80±5.67, CPP (mmHg)71.35±1.63 vs. 58.11±1.47, GCS score9.53±0.38 vs. 8.23±0.44, the mean blood flow velocity (cm/s)152.23±3.33 vs. 178.86±5.23, all P0.05). The rate of good therapeutic effect in combination treatment group was obviously higher than that of the control group [72.0% (18/25) vs. 33.3% (8/24), P < 0.05], while the mortality was markedly lowered [8.0% (2/25) vs. 33.3% (8/24), P < 0.05]. Conclusions The combination of Lund program and Angong Niuhuang pills for treatment of patients with severe traumatic craniocerebral injury can reduce the degree of increase of ICP at early stage, ameliorate cerebral edema and its development, elevate CPP and improve cerebral ischemia and hypoxia. In the aspects of controlling hyperpyrexia, decreasing limbs twitches and the incidence of hernia, elevating the quality of patients' life, reducing mortality and improving prognosis, the therapy has relatively good therapeutic effects.