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中国中医药治疗蛛网膜下腔出血的管理

Management of SAH with traditional Chinese medicine in China.

作者信息

Wang Chunxue, Zhao Xingquan, Mao Shujing, Wang Yongjun, Cui Xiangning, Pu Yuehua

机构信息

Department of Neurology, Beijing Tiantan Hospital, affiliated to the Capital University of Medical Sciences, Beijing, China.

出版信息

Neurol Res. 2006 Jun;28(4):436-44. doi: 10.1179/016164106X115044.

Abstract

China lacks large scale authorized epidemiological study results in allusion to subarachnoid hemorrhage (SAH) within recent 15 years since MONICA (multinational monitoring of trends and determinants in cardiovascular disease) study revealed SAH situation in China in 2000. The main cause of SAH in China is aneurysm which takes up 30-50%, while over 90% aneurysm locates at Willis circle. Early surgery for SAH after aneurysm rupture is the dominant procedure to deal with SAH in China. Moreover, calcium antagonists rank the absolute leading position for cerebral vascular spasm (CVS) among medication-based treatment options. However, traditional Chinese medicine such as Salvia miltiorrhiza, Acanthopanax senticosus, Ginkgo biloba, Pueraria lobata, Liguisticum chuanxiong, cow bezoar, Diospyros kaki and Gynostemma pentaphyllum have been proven beneficial in CVS prevention and treatment, while Salvia miltiorrhiza and TCM soup have unique effects on bleeding absorption. In addition, aescine and some TCM soup might relieve strong headache after SAH. In general, TCM integrated with western medicine have shown unique advantages in the current treatment of SAH in China. However, it is a pity that China still lacks larger scale randomized controlled trials and research on SAH treatment focusing on TCM and the related mechanism of TCM on SAH still need to be investigated further.

摘要

自2000年MONICA(心血管疾病趋势和决定因素多国监测)研究揭示中国蛛网膜下腔出血(SAH)情况以来,近15年中国缺乏针对SAH的大规模权威流行病学研究结果。中国SAH的主要病因是动脉瘤,占30%-50%,而90%以上的动脉瘤位于Willis环。动脉瘤破裂后SAH的早期手术是中国处理SAH的主要手段。此外,在基于药物的治疗选择中,钙拮抗剂在治疗脑血管痉挛(CVS)方面占据绝对领先地位。然而,丹参、刺五加、银杏叶、葛根、川芎、牛黄、柿蒂和绞股蓝等传统中药已被证明在预防和治疗CVS方面有益,而丹参和中药汤剂在出血吸收方面有独特作用。此外,七叶皂苷和一些中药汤剂可能缓解SAH后的剧烈头痛。总体而言,中西医结合在中国目前SAH治疗中已显示出独特优势。然而,遗憾的是,中国仍缺乏更大规模的随机对照试验以及针对SAH治疗的中医药研究,中医药对SAH的相关作用机制仍有待进一步研究。

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