持续性植物状态的中医证型分析与益神启窍方综合疗法的临床研究
|
摘要
颅脑外伤、脑血管急症是严重危害人类生命健康的常见急危重症。持续性植物状态(PVS)昏迷则是其最严重而复杂难治的后遗症。近年来我国的PVS呈持续增长趋势,为了进一步了解PVS的流行病学及中医证候情况,及为开展中西结合治疗该病提供参考信息,我们采用临床流行病学方法,调查了南京紫金医院2006-2008年间收治的56例PVS住院患者的临床资料,针对患者呈现不同的临床表现、发病诱因、及病理变化,通过中医体征舌脉等资料,经综合、归纳、分析以了解中医证型分布情况。
同时在美多芭、溴隐停及常规治疗的基础上,根据辨证施治,采用中药益神启窍方,观察中药对PVS患者促醒疗效的影响,以探明益神启窍方是否对患者醒脑、康复的影响,及可能的作用机理,为治疗PVS寻找新的有效方法。
研究目的:通过对56例PVS患者的流行病学资料及中医舌脉及临床资料的分析,了解PVS的流行态势与中医证型分布情况。并观察益神启窍方对PVS患者促醒疗效的影响。
研究方法:对患者进行中医辨证分型,并随机将患者分为常规组(简称A组),中药组(简称B组)与,两组均采用美多芭、嗅隐停、高压氧、其它脑代谢药物、电刺激、支持疗法等治疗,中药组在常规组的基础上加用益神启窍方,观察疗程2个月。分别在入组、1个月、出组时行PVS评分,评估中药对PVS患者促醒疗效的影响。
研究结果:
1.中医证型特征:
主要证型分布:分为气虚血瘀、心脾两虚、肾虚精亏、痰热蒙窍、筋急风动等5种中医证型。其中,以气虚血瘀型为主,占48.21%。
体征变化:以神呆不识,睁眼若视,肢窍失用肢躯拘急、如扳铅管,肌肉萎缩,手足肿胀,便溺不知为主,分别为占75%和48.2%。
舌象变化:舌质淡,苔白薄、占87.5%。舌淡红,、苔白腻、苔白厚或兼舌胖有齿痕占73.2%;舌紫暗兼瘀点、瘀斑占48.2%。
脉象变化:脉弦,细涩、共占62.5%;脉细数、沉、滑、尺弱无力、共占51.79%
2.初步脱离、脱离植物状态情况:
A组初步脱离植物状态2例,脱离植物状态4例,B组初步脱离植物状态6例,脱离植物状态4例,B组好于A组,但无显着性差异(u值=0.67,P＞0.05)。
3.PVS评分:
PVS疗效评分,组间比较,治疗“中”两组无显着差异(P＞0.05);治疗“后”B组优于A组(P＜0.05)。
PVS评分分值,组间比较,治疗“中”无显着差异(P＞0.05),治疗“后”B组优于A组(F=4.452,P=0.043)。组内比较,两组治疗“中”评分均比治疗“前”提高,有统计学意义(P＜0.05),治疗“后”与治疗“中”比较,A组无显着差异(P＞0.05),B组有显着差异(P＜0.05),治疗“后”与治疗“前”比较,A组有极显着差异(P＜0.005),B组差异更显着(P＜0.0005)。
结论:
PVS患者以气虚血瘀型为主,应用中药益神启窍方,达到活血化瘀、醒脑开窍、补肾益髓,对持续性植物状态患者有显着疗效。
Every year,millions of people in China sustain head and brain injuries.More than half are bad enough that people must go to the hospital.The worst injuries can lead to permanent brain damage or death.With the development of intensive care facilities and technologies that can artificially maintain blood flow and breathing,the term "vegetative state" has come to use.
Persistent vegetative state(PVS) is a kind of special consciousness disturbance.The most common causes in both adults and children are head trauma and hypoxic ischemic encephalopathy.The condition may be transient,marking a stage in the recovery from severe acute or chronic brain damage,or permanent,as a consequence of the failure to recover from such injuries.The prognosis is poor and the recovery of consciousness from posttraumatic PVS is highly unlikely in an adult after 1 year.Most patients in PVS do not survive longer than 2 to 5 years.Death occurs from infection,generalized systemic failure, respiratory failure,and in some cases,sudden death of unknown etiology.
Owing to the limitation of treatment reaction in modern medicine,it is necessary to find an effective Chinese-herb formula to promote the recovery of PVS.We report an analysis of the TCM differention in PVS and utilization of a Chinese medicine formula(Yi Shen Qi Qiao Fang) in treating PVS and try to to access the effect on the recovery of consciousness from PVS.
Objective:To analyze the TCM differentiation of patients with PVS and evaluate the effect of the Chinese herb formula(Yi Shen Qi Qiao Fang) on the recovery of consciousness from the Patients with PVS.
Methods:
1.Patients with PVS,diagnosed pathologically with more than 3 months forecasted survival time in Nanjing Zi-Jin Hospital from 2006 to 2008 were selected.To establish a classification method and analysis for the disposition of TCM differentiation in patients with PVS and divide all the patients into two groups at random.
2.One group is Chinese medicine group(group B、26 patients),the other is normal control group(group A、27 patients).Besides both groups were applied with the therapies for hyperbaric oxygen,cerebral metabolism drugs,electric stimulation,and other maintenance therapy as routine schedule,the patients of the Chinese medicine group were given the(Yi Shen Qi Qiao Fang) taken orally after meal,3 times per day for 2 months as one course.
3.The quality of recovery of consciousness was evaluated with the PVS scoring before and after treatment.The PVS scores adopted to reflect the changes of consciousness of patients.As compared with those before treatment,the scores increased than after treatment as improved;decreased as aggravation.
4.The evaluation was performed in two months for one course.And we give a PVS scoring when they enter the group,one month later and leaving the group.As compared with those before treatment,we observe the difference between the two groups to know whether the formula is good for the recovery of the PVS patients.
Results:
1.The majority of pathogenic factor of TCM differentiation in PVS are deficiency of both "Qi "and blood and phlegm with blood stasis locking the brain.The prevalence of the subtype in our samples is about 48.21%(27/56).
2.Rudimentally or totally depart from the PVS;in group A,there were 2 cases rudimentally departed from the PVS,4 cases totally departed from the PVS.In group B, there were 6 cases rudimentally departed from PVS,4 cases totally departed from the PVS. Group B is better than group A,but they don't have significant difference(u=0.67,P＞0.05).
3.PVS score;according to PVS scoring criteria,both two groups have no significant deviation(P＞0.05);after the treatment,group B is better than group A(P＞0.05).About the PVS score,during the treatment,the interclass comparison has no significant deviation (P＞0.05);after the treatment,group B is better than group A(F=4.452,P=0.043).About the interclass comparison,the scoring of the two groups during treatment is better than before treatment and has statistical significant(P＜0.05).Comparing after and during treatment, group A has no significant deviation(P＞0.05);group B has significant deviation(P＜0.05). Comparing after and before treatment,group A has extremely significant deviation (P＜0.005) but group B is more significant(P＜0.0005).
Conclusions:
The majority of pathogenic factor of TCM differentiation in PVS are deficiency of both "Qi "and blood,and phlegm with blood stasis locking the brain.Our findings indicate that the Chinese medicine(Yi Shen Qi Qiao Fang) combined with normal scheduled therapy can significantly improve the quality of life of patients with PVS,and it will have a better prospect for further studying.
同时在美多芭、溴隐停及常规治疗的基础上,根据辨证施治,采用中药益神启窍方,观察中药对PVS患者促醒疗效的影响,以探明益神启窍方是否对患者醒脑、康复的影响,及可能的作用机理,为治疗PVS寻找新的有效方法。
研究目的:通过对56例PVS患者的流行病学资料及中医舌脉及临床资料的分析,了解PVS的流行态势与中医证型分布情况。并观察益神启窍方对PVS患者促醒疗效的影响。
研究方法:对患者进行中医辨证分型,并随机将患者分为常规组(简称A组),中药组(简称B组)与,两组均采用美多芭、嗅隐停、高压氧、其它脑代谢药物、电刺激、支持疗法等治疗,中药组在常规组的基础上加用益神启窍方,观察疗程2个月。分别在入组、1个月、出组时行PVS评分,评估中药对PVS患者促醒疗效的影响。
研究结果:
1.中医证型特征:
主要证型分布:分为气虚血瘀、心脾两虚、肾虚精亏、痰热蒙窍、筋急风动等5种中医证型。其中,以气虚血瘀型为主,占48.21%。
体征变化:以神呆不识,睁眼若视,肢窍失用肢躯拘急、如扳铅管,肌肉萎缩,手足肿胀,便溺不知为主,分别为占75%和48.2%。
舌象变化:舌质淡,苔白薄、占87.5%。舌淡红,、苔白腻、苔白厚或兼舌胖有齿痕占73.2%;舌紫暗兼瘀点、瘀斑占48.2%。
脉象变化:脉弦,细涩、共占62.5%;脉细数、沉、滑、尺弱无力、共占51.79%
2.初步脱离、脱离植物状态情况:
A组初步脱离植物状态2例,脱离植物状态4例,B组初步脱离植物状态6例,脱离植物状态4例,B组好于A组,但无显着性差异(u值=0.67,P＞0.05)。
3.PVS评分:
PVS疗效评分,组间比较,治疗“中”两组无显着差异(P＞0.05);治疗“后”B组优于A组(P＜0.05)。
PVS评分分值,组间比较,治疗“中”无显着差异(P＞0.05),治疗“后”B组优于A组(F=4.452,P=0.043)。组内比较,两组治疗“中”评分均比治疗“前”提高,有统计学意义(P＜0.05),治疗“后”与治疗“中”比较,A组无显着差异(P＞0.05),B组有显着差异(P＜0.05),治疗“后”与治疗“前”比较,A组有极显着差异(P＜0.005),B组差异更显着(P＜0.0005)。
结论:
PVS患者以气虚血瘀型为主,应用中药益神启窍方,达到活血化瘀、醒脑开窍、补肾益髓,对持续性植物状态患者有显着疗效。
Every year,millions of people in China sustain head and brain injuries.More than half are bad enough that people must go to the hospital.The worst injuries can lead to permanent brain damage or death.With the development of intensive care facilities and technologies that can artificially maintain blood flow and breathing,the term "vegetative state" has come to use.
Persistent vegetative state(PVS) is a kind of special consciousness disturbance.The most common causes in both adults and children are head trauma and hypoxic ischemic encephalopathy.The condition may be transient,marking a stage in the recovery from severe acute or chronic brain damage,or permanent,as a consequence of the failure to recover from such injuries.The prognosis is poor and the recovery of consciousness from posttraumatic PVS is highly unlikely in an adult after 1 year.Most patients in PVS do not survive longer than 2 to 5 years.Death occurs from infection,generalized systemic failure, respiratory failure,and in some cases,sudden death of unknown etiology.
Owing to the limitation of treatment reaction in modern medicine,it is necessary to find an effective Chinese-herb formula to promote the recovery of PVS.We report an analysis of the TCM differention in PVS and utilization of a Chinese medicine formula(Yi Shen Qi Qiao Fang) in treating PVS and try to to access the effect on the recovery of consciousness from PVS.
Objective:To analyze the TCM differentiation of patients with PVS and evaluate the effect of the Chinese herb formula(Yi Shen Qi Qiao Fang) on the recovery of consciousness from the Patients with PVS.
Methods:
1.Patients with PVS,diagnosed pathologically with more than 3 months forecasted survival time in Nanjing Zi-Jin Hospital from 2006 to 2008 were selected.To establish a classification method and analysis for the disposition of TCM differentiation in patients with PVS and divide all the patients into two groups at random.
2.One group is Chinese medicine group(group B、26 patients),the other is normal control group(group A、27 patients).Besides both groups were applied with the therapies for hyperbaric oxygen,cerebral metabolism drugs,electric stimulation,and other maintenance therapy as routine schedule,the patients of the Chinese medicine group were given the(Yi Shen Qi Qiao Fang) taken orally after meal,3 times per day for 2 months as one course.
3.The quality of recovery of consciousness was evaluated with the PVS scoring before and after treatment.The PVS scores adopted to reflect the changes of consciousness of patients.As compared with those before treatment,the scores increased than after treatment as improved;decreased as aggravation.
4.The evaluation was performed in two months for one course.And we give a PVS scoring when they enter the group,one month later and leaving the group.As compared with those before treatment,we observe the difference between the two groups to know whether the formula is good for the recovery of the PVS patients.
Results:
1.The majority of pathogenic factor of TCM differentiation in PVS are deficiency of both "Qi "and blood and phlegm with blood stasis locking the brain.The prevalence of the subtype in our samples is about 48.21%(27/56).
2.Rudimentally or totally depart from the PVS;in group A,there were 2 cases rudimentally departed from the PVS,4 cases totally departed from the PVS.In group B, there were 6 cases rudimentally departed from PVS,4 cases totally departed from the PVS. Group B is better than group A,but they don't have significant difference(u=0.67,P＞0.05).
3.PVS score;according to PVS scoring criteria,both two groups have no significant deviation(P＞0.05);after the treatment,group B is better than group A(P＞0.05).About the PVS score,during the treatment,the interclass comparison has no significant deviation (P＞0.05);after the treatment,group B is better than group A(F=4.452,P=0.043).About the interclass comparison,the scoring of the two groups during treatment is better than before treatment and has statistical significant(P＜0.05).Comparing after and during treatment, group A has no significant deviation(P＞0.05);group B has significant deviation(P＜0.05). Comparing after and before treatment,group A has extremely significant deviation (P＜0.005) but group B is more significant(P＜0.0005).
Conclusions:
The majority of pathogenic factor of TCM differentiation in PVS are deficiency of both "Qi "and blood,and phlegm with blood stasis locking the brain.Our findings indicate that the Chinese medicine(Yi Shen Qi Qiao Fang) combined with normal scheduled therapy can significantly improve the quality of life of patients with PVS,and it will have a better prospect for further studying.
引文
[1]张国谨,主编.持续性植物状态[M].南京:南京出版社,1998:148
[2]奚肇庆,丰广魁,刘涛,等.持续性植物状态的中医辩证论治研究[J].江苏中医药.2006,27(8):21-23.
[3]ANA Committee on Ethical Affairs.Persistent vegetative state:report of the American Neurological Association Committee on Ethical Affairs[J].Ann Neurol.1994,33:386-390
[4]The Multi-Society Task Force on PVS.Medical aspects of the persistent vegetative[J].N Engl J Med,1994,330:1499-1508
[5]The Multi-Society Task Force on PVS.Medical aspects of the persistent vegetative[J].N Engl J Med,1994,330:1499-1508,1572-1579
[6]Jennett B,Plum F.Persistent vegetative state after brain damage.A syndrome in search of a name[J].Lancet,1972,1:734-737
[7]奚肇庆,丰广魁,林福军,刘涛,王培东,等 益神启窍方及综合疗法对持续性植物状态患者血清氨基酸含量的影响 中国中医急症 2007,16(11):1305-1307.
[8]Bates D.The prognosis of medical coma.J Neurol Neurosurg Psychiatry.2001,71(1):120-123
[9]Matsuda W,Komatsu Y,Yanaka K,Matsumura A.Levodopa treatment for patients in persistent state or minimally conscious states:Meuropsychol Rehabil.2005;15(3-4):
[10]会议纪要.《关于修订我国持续性植物状态(PVS)诊断和疗效标准专家会议纪要》[J].中华急诊医学杂志,2002,11(4):241
[11]Rothstein TL.The role of evoked potentials in anoxic-ischemic coma and severe trauma.J Clin Neurophysiol,2001,17(5):486-497
[12]Li SW,Wei J,Guo DH,Persistent vegetative state clinical and electrophysiologic observation of 5 cases[J].Chin Med Sci J,1993,8:101-106
[13]甘永梅,奚肇庆,王培东,马虎龙 创伤性脑损伤机理及治疗研究进展 中华实用中西医杂志 2005 18(2):173-175.
[14]李瑛,王华,阎小燕,等中西医结合脑血管病诊疗学.第1版,北京:中国中医药出版社 2007,8.
[15]Kinney HC Sanuels MA.Neuropathology of the persistent vegetative state.A review.J Neuropath/exp Neurol,1994,53:548-558
[16]李金彩,肖华,耿明亮.持续性植物状态患者脑脊液和血中多巴氨含量的变化[J].中华航海医学杂志,2000,7(2):110
[17]杨洪杰,肖华.持续性植物状态患者脑脊液中多巴氨含量的变化的临床研究[J].中国现代医学杂志,2002,12(10):58-59
[18]朱文锋.略论脑当另立为脏[J].湖南中医学院学报,1990,10(3):113-115
[19]丰广魁,奚肇庆,林福军,刘涛,王培东 论脑的生理功用 辽宁中医杂志 2007,34(1-1):1535-1536.
[20]阎孝诚,主编.实用中医脑病学[M].北京:学苑出版社,1993,3
[21]丰广魁,林福军,姜亚军,奚肇庆,刘涛,王培东 试论脑病的病理 陕西中医 2007,28(6):700-702.
[22]任继学,脑髓述要[J].中国中医基础医学杂志,2003,9(3):161-164
[23]刘明锋,主编.实用颅脑损伤学[M]北京:人民军医出版社,1992:96
[24]王廷岚.补阳还五汤加减主治“植物人”10例临床分析[J].实用中医药杂志,1996,(1):3-5
[25]刘宏丽,徐金秀.中医综合疗法治疗持续性植物状态20例[J]中医杂志,2005,46(11):841
[26]奚肇庆,丰广魁,刘涛等.持续性植物状态的中医辨证论治研究[J]江苏中医药杂志,2006,27(8):21-23
[27]陈大舜,李定祥.论脑属脏—为五脏之主[J].中国中医基础医学杂志,2002,8(6):401-402
[28]张思超,王涛.从脑的位置探析脑病病因病机及其证治特点[J].中医药学刊,2004,22(2):23
[29]沈绍功,韩学杰 中医急诊学和证候学的关联与互动 中国中医急症 200716(9):1033-1035.
[30]苏德模 略论中医痰瘀学说与脑血栓的关系 中国中医急症 2007,16(6):746.
[31]周岁锋,郭应军,汤双齐 毒邪学说在危重症患者中的应用 中国中医急症 2007,16(4):437-438.
[32]潘向荣,周凯,韦敏强.中医药为主治疗脑外伤后持续性植物状态2例[J]四川中医,2003,21(4):39-40
[33]耿明亮,李蜂,田凯.中西医结合治疗持续性植物状态疗效观察[J].现代康复,2000,4(3):382-383 414-27
[34]郭志勇,李金彩,肖华.中西医结合治疗持续性植物状态疗效优势[J].中国临床康复,2003,(20):2854-2855
[35]卜文良,徐妙娣,张厚秦.中西医结合治疗脑外伤后持续性植物状态[J].浙江中西医结合杂志,2001,11(1):33-34
[36]王晓燕,吴淑君,醒脑开窍针法用于颅脑损伤后持续性植物状态临床研究[J].中国康复医学杂志,2006,21(6)547-548
[37]丰广魁,奚肇庆,刘涛,林福军,王培东,等 益神启窍方合并综合疗法对持续性植物状态PVS患者疗效评分的影响 中医杂志 2007,48(11):999-1000.
[38]中华本草编委会,中华本草[M].上海:上海科学技术出版社,1998:814-833;1314-1353;2503-2513;738-744;2194-2200;1329-1335
[39]黄厚聘,等.黄芪的药理、毒理研究[J].药学通报,1986,11(9):559
[40]李淑云,宋久存.黄芪和川芎对小鼠中毒保护作用研究[J].中西医结合脑血管 杂志,2005,3(3):238-239
[41]柯庆,邓常春.黄芪对沙土鼠脑缺血再灌注损伤的影响[J].中国中西医结合急救杂志,2001,8(2):105-108
[42]潘思源,等.黄芪和川芎对小鼠中毒保护作用研究[J].中西医结合脑血管杂志,2005,3(3):238-239
[43]云秦川.中药黄芪的药理研究进展[J].内蒙古中医药,2004,(6):33-34
[44]樊红汕,等.绵毛黄芪总苷的抗氧化作用[J].中国药理通讯,1989,6(2):54
[45]秦震,孙国华,张福林等.黄芪干预大鼠实验性脑梗塞的研究[J].中国神经精神疾病杂志,1990,16:367
[46]柴耀辉,秦震,姚国莉.黄芪治疗急性脑梗塞的前瞻性研究[J].临床神经病学杂志,1994,7:216
[47]曹仁存,郑彩梅.自由基与兴奋性氨基酸在反复性脑缺血神经元损害中的作用[J].解放军医学杂志,1995,20:92.
[48]陈可冀,等.血瘀证与活血化瘀研究[M].第一版,上海:上海科技出版社,1990:551
[49]徐理纳.当归对麻醉犬外周血管的扩张作用[J].中华医学杂志,1980,60(2):80.
[50]徐理纳.阿魏酸钠抗血小板聚集作用机理研究对TXA2—PGI2平衡的影响[J].中国医学科学院学报,1984,6(6):414.
[51]尹锺洙.阿魏酸钠抗大鼠血小板丙二醛生成的影响[J].中国药理学报,1986,7(4):336.
[52]徐理纳.阿魏酸钠和阿斯匹林联用对大鼠血小板聚集作用的影响及对PGI2—TXA2平衡的调节[J].药学学报,1985,20(1):5.
[53]吴建新.黄芪、当归及其配伍对大鼠血小板聚集和血小板中cAMP、cGMP的影响[J].中药药理与临床,1992,(1):16.
[54]毛腾敏.丹蓼、当归对老年大鼠血瘀的影响[J].中西医结合杂志,1988,(10):835.
[55]王玉升.当归注射液对急性脑缺血大鼠治疗作用机理的实验研究[J].中国中药杂志,1993,(1):48.
[56]徐理纳.治疗偏头痛新药当归素的研究[J].中国医学科学院学报,1987,(4):276.
[57]马兰芳.当归多糖对造血细胞生成影响的实验研究中华血液学杂志,1988,(3):148
[58]王亚平.当归多糖对小鼠红系细胞增殖的影响[J].中华血液学杂志,1993,14(12):650
[59]李仪奎.黄芪、当归药对配伍的药理研究[J].中国药理与临床,1992,(2):1.
[60]董万超,越伟刚,刘春华.麝香研究进展[J].特产研究,2001,(2):48-58
[61]曹婉如,林素青,越蔚君,等.麝香与麝香酮缩短大鼠戊巴比妥钠睡眠时间的探 讨[J].中草药,1980,11(7):309-312
[62]Siddiqui H H.Indian J Pharm,1965,27(3):80
[63]王树荣.麝香对中枢系统的影响[J].山东中医学院学报,1983,增刊:76
[64]叶启智,唐光风.麝香对兔的唤醒作用及对清醒兔脑电图和行为的影响[J].广西中医药,1986,9(3):131-133
[65]郝吉福,程怡.麝香的药理学研究概况[J].时珍国医国药,2004,15(4):248-2491
[66]李仪奎,胡月娟,等.麝香对中枢耐缺氧能力的影响[J].中草药,1985,16(3):19-21
[67]蒋振亚,李常度,等[J].麝香对大鼠实验性脑缺血神经元损伤的保护作用[J].中国中医药科技,2001,8(2):96-99.
[68]黄丽萍,黄敬耀.麝香酮对D—半乳糖所致拟痴呆小鼠抗痴呆作用的研究[J].江西中医学院学报,2002,14(1):35-37
[69]李保英.麝香对小鼠脑损伤的影响[J].国外医学.中医中药分册,1996,18(5):33
[70]周金黄,等.中药药理学[M]第一版.上海:上海科学技术出版社,1986:201
[71]刘汕辉,等.光桃仁和山桃仁的药理研究[J].中药药理与临床,1989,5(2):46
[72]越润芝,等.桃仁药理作用的研究[J].上海中医药与临床,1985,(创刊号):10
[73]中国医学科学院药物研究所药理室.药用菖蒲研究进展[J].新医药杂志,1977,(6):46
[74]方永奇,吴启端,等.石菖蒲对中枢神经系统兴奋—镇静作用研究[J].广西中医药,2001,24(1):49
[75]蒋红兰,匡忠生,等.石菖蒲冰片对神经细胞缺氧性损伤的保护作用[J].广州中医药大学学报,2003,20(1):63-65
[76]张家俊,陈文为.中药酸枣仁、龙齿、石菖蒲对小鼠脑组织单氨类神经递质及其代谢物的影响[J].北京中医药大学学报,1995,18(6):64
[77]杨晓燕,陈发奎,等.石菖蒲对抗抑郁药理作用的研究[J].海军军事医学,1999,20(2):16
[78]胡锦官,顾健,等.石菖蒲及其有效成份对中枢神经系统作用的实验研究[J].中药药理与临床,1999,15(3):19
[79]周大兴,包祖晓,吴雄生,等.石菖蒲醇提物的抗惊厥作用[J].中国现代应用药学,1999,16(2):19
[80]张信岳,郑高利,寿燕,等.石菖蒲的益智和抗惊厥作用研究[J].浙江中医学院学报,1999,23(2):46
[81]吴启端,方永奇,李翎,等.石菖蒲对中枢神经系统兴奋性的有效部位研究[J].医药报导,2002,21(7):399
[82]周大兴.石菖蒲的促进小鼠学习记忆和提高耐缺氧力作用[J].现代应用药学,1993,10(4):4
[83]周大兴.石菖蒲对小鼠学习记忆的促进作用[J].中草药,1992,23(8):417
[84]钱曾年.α—细辛醚对中枢神经系统的影响[J].苏州医学院学报,1986,3(4):47
[85]胡锦官,顾健,王志旺,等.石菖蒲及其有效成份对学习记忆的实验研究[J].中药材,1999,22(11):584
[86]匡忠生,谢宇晖,李翎,等.石菖蒲提取液对脑缺血—再灌注诱导的神经细胞凋亡保护作用[J].广东医学,2002,23(5):459
[87]方永奇,李翎,吴启端,等.β—细辛醚和冰片对大鼠缺血再灌注脑损伤的保护作用[J].现代老年医学与保健,2002,11(2):15
[88]方永奇,李翎,邹衍衍,等.石菖蒲对缺血再灌注脑损伤大鼠脑电图和脑水肿的影响[J].中国中医急症,2003,12(1):5
[89]方永奇,匡忠生,谢宇晖,等.石菖蒲组分对缺血再灌注脑损伤大鼠神经细胞凋亡的影响[J].现代中西医结合杂志,2002,11(17):1645
[90]李翎,吴启端,邹衍衍,等.石菖蒲系列提取物对大鼠脑缺血再灌注脑损伤的影响[J].中医药学刊,2003,21(2):212
[91]吴启端,方永奇,李翎,等.石菖蒲醒脑开窍的有效部位筛选[J].时珍国医国药,2002,13(5):260
[92]李宏宇,等.不同商品白芷的药理研究[J].中国中药志,1991,16(9):560
[93]周继铭,等.白芷的研究—Ⅲ.制剂的质量控制及毒性试验[J].中国医院药学杂志,1988,8(11):505
[94]夙良元,等.五种不同产地白芷药理作用的比较研究[J].安徽中医学院学报,1990,9(2):56.
[95]刘计,等.当归补血汤的药理研究[J].中药药理与临床,1987,3(3):7.
[96]江苏新医学院.中药大辞典(缩印本)[M].上海:上海科学技术出版社,1993:613-614
[97]田茸,慕宝龙.石菖蒲对中枢神经系统作用的研究现状[J].中国中医药信息杂志,2006,13(3):101-103
[98]赖真,王沙燕,耿小茵,等.补阳还五汤和黄芪对沙土鼠脑缺血再灌注后脑组织的兴奋性氨基酸的影响[J].北京中医药大学学报,2002,25(3):33-35.
[99]刘亚敏,张锡安,等.麝香、冰片对全脑缺血再灌注大鼠脑组织氨基酸类神经递质的影响[J].中药新药与临床药理,2002,12(4):231-233
[100]唐洪梅,席萍,吴敏,等.石菖蒲对小鼠脑组织氨基酸类神经递质的影响[J].中药新药与临床药理,2004,15(5):310-311
[101]邱小鹰,梅元武,王何,等.脑温改变对大鼠脑缺血再灌注组织兴奋性氨基酸的影响[J].中国临床康复,2003,7(19):2662-3
[102]李强,潘莉莉.反相高效液相色谱法测定脑梗塞患者血浆氨基酸[J].辽宁医 学杂志,1999,13(3):140-141
[103]Baker AJ.Moulton RJ.MacMillan VH,et al.Exciatory amino acids in cerebrospinal fluid following traumatic brain injury in J Neurosurg 1993,79(3):369-373
[104]Castillo J,Davaloa A,Naveiro J,et al.Neuroexcitatory amino acids and their relation to infarct size and neurological deficit in ischemic stroke.Stroke.1996,27(6):1060-1065.
[105]张中兴,卢江,张萍,等.脑梗死后血、脑脊液中兴奋性氨基酸变化与神经功能缺失的关系[J].中国临床康复,2003,7(25:3422-3
[106]郭燕舞.周媛,张世忠,等.持续性植物状态患者意识状态与氨基酸类神经递质水平的关系[J].中国临床康复,2004,8(4):629-631.
[107]胡学芳,张锡然,王培东,等.持续性植物状态患者血浆、脑脊液中氨基酸水平的变化[J].中国应用生理学杂志,2003,19(3):248-249
[108]李金彩,肖华,耿明亮.持续性植物状态患者脑脊液和血中多巴氨含量的变化[J].中华航海医学杂志,2000,7(2):110
[109]杨洪杰,肖华.持续性植物状态患者脑脊液中多巴氨含量的变化的临床研究[J].中国现代医学杂志,2002,12(10):58-59
[110]肖华,徐如祥,李金彩,等.持续性植物状态猫体内多巴氨变化的实验研究[J].中华神经医学杂志,2006,5(5):531-532
[111]李茂林,王祝峰,刘鑫,等.外伤性、持续性植物状态患者血清及脑脊液中多巴氨含量监测的临床分析[J].实用医学杂志,2003,19(8):943-944.
[112]徐仁宝,卢建,蒋左蔗.受体的基础与临床[M].上海:上海科学技术出版社,2001:145-151
[113]Humbert C.A clinical and pathological study of akinetic mutisum.Neurology,1959,11-21
[114]肖华,邹春芽,徐如祥.中枢多巴氨受体与脑损害[J].(国外医学)创伤与外科基本问题分册,1996,17(3):135-138
[115]肖华,徐如祥,李金彩.脑损伤早期脑皮质神经细胞膜D1受体活性变化的实验研究[J].解放军医学杂志,1998,23(5):443-444
[116]Milhad D,et al.Treatment of akinetic mutisum with bromocriptine(letter).Presse Med,1993,22(14):688
[117]张宏,王清华,徐如祥,等.嗅隐停和美多巴对重型颅脑损伤迁延性昏迷的催醒治疗30例临床分析[J].第一军医大学学报,2001,21(7):548
[1]张国谨,主编.持续性植物状态[M]南京:南京出版社,1988:148
[2]会议纪要.《关于修订我国持续性植物状态(PVS)诊断和疗效标准专家会议纪要》[J].中华急诊医学杂志,2002,11(4):241
[3]郭燕舞.持续性植物状态临床研究进展[J].国外医学神经病学神经外科学分册,2002,29(2):187-190
[4]刘明锋,主编.实用颅脑损伤学[M].北京:人民军医出版社,1992:82
[5]Gutling E,Landis T,Lleihes P.Akinetic mutism in bilateral necrotizing leucoen-cephalopathy after radiation and chemotherapy:electrophysiological and autopsy findings.J Neurol,1992,239:125-128
[6]Tabeuehi A.Excitatory amino acid transmitters:past,present,and fu.Tule.In:Kanazawal,ed Neurotransmitters focus on excitatory amino acids.Tokyo:Exeerpta,1998,395
[7]Kinney HC Sanuels MA.Neuropathology of the persistent vegetative state.A review.J Neuropath/exp Neurol,1994,53:548-558
[8]Kostic KV,Przedborski S,Jackson Le-Wis-V,et al.Effect of unilateral perinatal-hypoxic-ischemic brain injury on striatal dopamine uptake sites and D1 and D2 receptors in adult rates[Published erratum appears in Neurosic lett 1991 Dec16,134(1):151].Neurosic Lett 1991,129(2):197-200
[9]郭志勇,李金彩,肖华.中西医结合治疗持续性植物状态疗效优势[J].中国临床康复,2003,(20):2854-2855
[10]Heindl UT,laub MC.Outcome of persistent vegetative state following hypoxic or traumatic brain injury in children and adolescents,Neuropediatrics 1996,27(2):94-100
[11]王传民,张国谨,王培东,等.高压氧综合治疗持续性植物状态疗效观察[J].中华航海医学杂志,1995,2(1):20
[12]王德生,王晓丹,吕英.国内持续性植物状态研究现状[J].中国康复医学杂志,2004,19(10):795-798
[13]王维治,主编.神经病学第5版[M].北京:人民卫生出版社,2004,7:4
[14]卢明,黄培新,杜宝新,黄燕,刘茂才.中风病中西结合研究思路之探讨.中国中医急症 2007,16(6):684-685.
[15]李向荣,吴清明,刘未艾,等.中西医结合卒中单元对急性脑卒中患者的影响初步研究 中国中医急症 2007 16(4):381-383
[16]尤可,孔立 论解毒法在中风病中的应用 中国中医急症 2007,16(9):1086-1089.
[17]何刚,冯子驹,卢静,等。中风病证候分布及动态变化研究及探讨 中国中医急症 2007,16(6):686-687
[18]林福军,奚肇庆,丰广魁 102例住院持续性植物状态患者的流行病学调查 山 东医药 2007,47(34)104-105.
[19]印会河,主编.中医基础理论[M].上海:上海科学技术出版社,1984:30
[20]杜伟国,徐成贺.《内经》对脑髓学说的认识[J].中医药研究,2001,17(4):3-4
[21]方药中,等主编.实用中医内科学[M].上海:上海科学技术出版社,1985:355
[22]陈佑邦,王永炎主编.中医急诊医学[M].福建:福建科学技术出版社,1995:88
[23]张琴珠.植物人研究中的一些神经心理学问题[J].心理科学,1996,19(2):97-100
[24]郭燕舞,周媛,张世忠,等.持续性植物状态患者意识状态与氨基酸类神经递质水平的关系[J].中国临床康复,2004,8(4):629-631
[25]胡学芳,张锡然,王培东,等.持续性植物状态患者血浆、脑脊液中氨基酸水平的变化[J].中国应用生理学杂志,2003,19(3):248-249
[26]Lechevalier B,Bertran F,Busson P,et al.Akinetic mutism with right hemiplegia caused by infarction in the territory of the left anterior cerebral artery.Rev Neurol Paris,1996,152(3):181-189
[27]Krimchansky BZ,Keren O,Sazbon L,Groswasser Z Differential time and related appearance of signs,indicating improvement in the state of consciousness in vegetative state traumatic brain injury(VS-TBI) patients after initiation of dopamine treatment;Brain Inj.2004;18(11):1099-105
[28]Kmietowicz Z.New technique helps to assess vegetative state.BMJ.2000,321(7255):196-200
[29]王德生,王晓丹,吕英.国内持续性植物状态研究现状[J].中国康复医学杂志,2004,19(10):795-798
[30]中国社会科学院语言研究所词典编辑室.现代汉语词典[M]北京:商务印书馆,1997:239,167
[31]乔德才,张琴珠,封茂滋.神经病病人持续性植物状态发临床诊断标准的探讨[J].中华医学杂志,1988,78(3):167
[32]张微微,持续性植物状态的治疗进展[J].内科急危重症杂志,2003,9(3):157-167
[33]Wade DT,Johnston C.The permanent vegeative state:practical quide on diagnosis and management.BMJ.1999,319(7213):841-844
[34]越普学,许自强,等.胎脑移植治疗“植物人”6例报告[J].铁道医学,1991,19(2):96-97
[1]周岁锋,郭应军,汤双齐 毒邪学说在危重症患者中的应用 中国中医急症 2007,16(4):437-438.
[2]丰广魁,林福军,姜亚军,奚肇庆,刘涛,王培东 试论脑病的病理 陕西中医 2007,28(6):700-702.
[3]奚肇庆,丰广魁,刘涛,等.持续性植物状态的中医辩证论治研究[J].江苏中医药.2006,27(8):21-23.
[4]李瑛,王华,阎小燕,等中西医结合脑血管病诊疗学.第1版,北京:中国中医药出版社 2007,8
[5]尤可,孔立 论解毒法在中风病中的应用 中国中医急症 2007,16(9):1086-1089.
[6]甘永梅,奚肇庆,王培东,马虎龙 创伤性脑损伤机理及治疗研究进展 中华实用中西医杂志 2005 18(2):173-175.
[7]何刚,冯子驹,卢静,等。中风病证候分布及动态变化研究及探讨 中国中医急症 2007,16(6):686-687
[8]丰广魁,奚肇庆,刘涛,林福军,王培东,等 益神启窍方合并综合疗法对持续性植物状态PVS患者疗效评分的影响 中医杂志 2007,48(11):999-1000.
[9]苏德模 略论中医痰瘀学说与脑血栓的关系 中国中医急症 2007,16(6):746.
[10]沈绍功,韩学杰 中医急诊学和证候学的关联与互动 中国中医急症 200716(9):1033-1035.
[11]卢明,黄培新,杜宝新,黄燕,刘茂才.中风病中西结合研究思路之探讨.中国中医急症 2007,16(6):684-685.
[12]李向荣,吴清明,刘未艾,等.中西医结合卒中单元对急性脑卒中患者的影响初步研究 中国中医急症 2007 16(4):381-383
[2]奚肇庆,丰广魁,刘涛,等.持续性植物状态的中医辩证论治研究[J].江苏中医药.2006,27(8):21-23.
[3]ANA Committee on Ethical Affairs.Persistent vegetative state:report of the American Neurological Association Committee on Ethical Affairs[J].Ann Neurol.1994,33:386-390
[4]The Multi-Society Task Force on PVS.Medical aspects of the persistent vegetative[J].N Engl J Med,1994,330:1499-1508
[5]The Multi-Society Task Force on PVS.Medical aspects of the persistent vegetative[J].N Engl J Med,1994,330:1499-1508,1572-1579
[6]Jennett B,Plum F.Persistent vegetative state after brain damage.A syndrome in search of a name[J].Lancet,1972,1:734-737
[7]奚肇庆,丰广魁,林福军,刘涛,王培东,等 益神启窍方及综合疗法对持续性植物状态患者血清氨基酸含量的影响 中国中医急症 2007,16(11):1305-1307.
[8]Bates D.The prognosis of medical coma.J Neurol Neurosurg Psychiatry.2001,71(1):120-123
[9]Matsuda W,Komatsu Y,Yanaka K,Matsumura A.Levodopa treatment for patients in persistent state or minimally conscious states:Meuropsychol Rehabil.2005;15(3-4):
[10]会议纪要.《关于修订我国持续性植物状态(PVS)诊断和疗效标准专家会议纪要》[J].中华急诊医学杂志,2002,11(4):241
[11]Rothstein TL.The role of evoked potentials in anoxic-ischemic coma and severe trauma.J Clin Neurophysiol,2001,17(5):486-497
[12]Li SW,Wei J,Guo DH,Persistent vegetative state clinical and electrophysiologic observation of 5 cases[J].Chin Med Sci J,1993,8:101-106
[13]甘永梅,奚肇庆,王培东,马虎龙 创伤性脑损伤机理及治疗研究进展 中华实用中西医杂志 2005 18(2):173-175.
[14]李瑛,王华,阎小燕,等中西医结合脑血管病诊疗学.第1版,北京:中国中医药出版社 2007,8.
[15]Kinney HC Sanuels MA.Neuropathology of the persistent vegetative state.A review.J Neuropath/exp Neurol,1994,53:548-558
[16]李金彩,肖华,耿明亮.持续性植物状态患者脑脊液和血中多巴氨含量的变化[J].中华航海医学杂志,2000,7(2):110
[17]杨洪杰,肖华.持续性植物状态患者脑脊液中多巴氨含量的变化的临床研究[J].中国现代医学杂志,2002,12(10):58-59
[18]朱文锋.略论脑当另立为脏[J].湖南中医学院学报,1990,10(3):113-115
[19]丰广魁,奚肇庆,林福军,刘涛,王培东 论脑的生理功用 辽宁中医杂志 2007,34(1-1):1535-1536.
[20]阎孝诚,主编.实用中医脑病学[M].北京:学苑出版社,1993,3
[21]丰广魁,林福军,姜亚军,奚肇庆,刘涛,王培东 试论脑病的病理 陕西中医 2007,28(6):700-702.
[22]任继学,脑髓述要[J].中国中医基础医学杂志,2003,9(3):161-164
[23]刘明锋,主编.实用颅脑损伤学[M]北京:人民军医出版社,1992:96
[24]王廷岚.补阳还五汤加减主治“植物人”10例临床分析[J].实用中医药杂志,1996,(1):3-5
[25]刘宏丽,徐金秀.中医综合疗法治疗持续性植物状态20例[J]中医杂志,2005,46(11):841
[26]奚肇庆,丰广魁,刘涛等.持续性植物状态的中医辨证论治研究[J]江苏中医药杂志,2006,27(8):21-23
[27]陈大舜,李定祥.论脑属脏—为五脏之主[J].中国中医基础医学杂志,2002,8(6):401-402
[28]张思超,王涛.从脑的位置探析脑病病因病机及其证治特点[J].中医药学刊,2004,22(2):23
[29]沈绍功,韩学杰 中医急诊学和证候学的关联与互动 中国中医急症 200716(9):1033-1035.
[30]苏德模 略论中医痰瘀学说与脑血栓的关系 中国中医急症 2007,16(6):746.
[31]周岁锋,郭应军,汤双齐 毒邪学说在危重症患者中的应用 中国中医急症 2007,16(4):437-438.
[32]潘向荣,周凯,韦敏强.中医药为主治疗脑外伤后持续性植物状态2例[J]四川中医,2003,21(4):39-40
[33]耿明亮,李蜂,田凯.中西医结合治疗持续性植物状态疗效观察[J].现代康复,2000,4(3):382-383 414-27
[34]郭志勇,李金彩,肖华.中西医结合治疗持续性植物状态疗效优势[J].中国临床康复,2003,(20):2854-2855
[35]卜文良,徐妙娣,张厚秦.中西医结合治疗脑外伤后持续性植物状态[J].浙江中西医结合杂志,2001,11(1):33-34
[36]王晓燕,吴淑君,醒脑开窍针法用于颅脑损伤后持续性植物状态临床研究[J].中国康复医学杂志,2006,21(6)547-548
[37]丰广魁,奚肇庆,刘涛,林福军,王培东,等 益神启窍方合并综合疗法对持续性植物状态PVS患者疗效评分的影响 中医杂志 2007,48(11):999-1000.
[38]中华本草编委会,中华本草[M].上海:上海科学技术出版社,1998:814-833;1314-1353;2503-2513;738-744;2194-2200;1329-1335
[39]黄厚聘,等.黄芪的药理、毒理研究[J].药学通报,1986,11(9):559
[40]李淑云,宋久存.黄芪和川芎对小鼠中毒保护作用研究[J].中西医结合脑血管 杂志,2005,3(3):238-239
[41]柯庆,邓常春.黄芪对沙土鼠脑缺血再灌注损伤的影响[J].中国中西医结合急救杂志,2001,8(2):105-108
[42]潘思源,等.黄芪和川芎对小鼠中毒保护作用研究[J].中西医结合脑血管杂志,2005,3(3):238-239
[43]云秦川.中药黄芪的药理研究进展[J].内蒙古中医药,2004,(6):33-34
[44]樊红汕,等.绵毛黄芪总苷的抗氧化作用[J].中国药理通讯,1989,6(2):54
[45]秦震,孙国华,张福林等.黄芪干预大鼠实验性脑梗塞的研究[J].中国神经精神疾病杂志,1990,16:367
[46]柴耀辉,秦震,姚国莉.黄芪治疗急性脑梗塞的前瞻性研究[J].临床神经病学杂志,1994,7:216
[47]曹仁存,郑彩梅.自由基与兴奋性氨基酸在反复性脑缺血神经元损害中的作用[J].解放军医学杂志,1995,20:92.
[48]陈可冀,等.血瘀证与活血化瘀研究[M].第一版,上海:上海科技出版社,1990:551
[49]徐理纳.当归对麻醉犬外周血管的扩张作用[J].中华医学杂志,1980,60(2):80.
[50]徐理纳.阿魏酸钠抗血小板聚集作用机理研究对TXA2—PGI2平衡的影响[J].中国医学科学院学报,1984,6(6):414.
[51]尹锺洙.阿魏酸钠抗大鼠血小板丙二醛生成的影响[J].中国药理学报,1986,7(4):336.
[52]徐理纳.阿魏酸钠和阿斯匹林联用对大鼠血小板聚集作用的影响及对PGI2—TXA2平衡的调节[J].药学学报,1985,20(1):5.
[53]吴建新.黄芪、当归及其配伍对大鼠血小板聚集和血小板中cAMP、cGMP的影响[J].中药药理与临床,1992,(1):16.
[54]毛腾敏.丹蓼、当归对老年大鼠血瘀的影响[J].中西医结合杂志,1988,(10):835.
[55]王玉升.当归注射液对急性脑缺血大鼠治疗作用机理的实验研究[J].中国中药杂志,1993,(1):48.
[56]徐理纳.治疗偏头痛新药当归素的研究[J].中国医学科学院学报,1987,(4):276.
[57]马兰芳.当归多糖对造血细胞生成影响的实验研究中华血液学杂志,1988,(3):148
[58]王亚平.当归多糖对小鼠红系细胞增殖的影响[J].中华血液学杂志,1993,14(12):650
[59]李仪奎.黄芪、当归药对配伍的药理研究[J].中国药理与临床,1992,(2):1.
[60]董万超,越伟刚,刘春华.麝香研究进展[J].特产研究,2001,(2):48-58
[61]曹婉如,林素青,越蔚君,等.麝香与麝香酮缩短大鼠戊巴比妥钠睡眠时间的探 讨[J].中草药,1980,11(7):309-312
[62]Siddiqui H H.Indian J Pharm,1965,27(3):80
[63]王树荣.麝香对中枢系统的影响[J].山东中医学院学报,1983,增刊:76
[64]叶启智,唐光风.麝香对兔的唤醒作用及对清醒兔脑电图和行为的影响[J].广西中医药,1986,9(3):131-133
[65]郝吉福,程怡.麝香的药理学研究概况[J].时珍国医国药,2004,15(4):248-2491
[66]李仪奎,胡月娟,等.麝香对中枢耐缺氧能力的影响[J].中草药,1985,16(3):19-21
[67]蒋振亚,李常度,等[J].麝香对大鼠实验性脑缺血神经元损伤的保护作用[J].中国中医药科技,2001,8(2):96-99.
[68]黄丽萍,黄敬耀.麝香酮对D—半乳糖所致拟痴呆小鼠抗痴呆作用的研究[J].江西中医学院学报,2002,14(1):35-37
[69]李保英.麝香对小鼠脑损伤的影响[J].国外医学.中医中药分册,1996,18(5):33
[70]周金黄,等.中药药理学[M]第一版.上海:上海科学技术出版社,1986:201
[71]刘汕辉,等.光桃仁和山桃仁的药理研究[J].中药药理与临床,1989,5(2):46
[72]越润芝,等.桃仁药理作用的研究[J].上海中医药与临床,1985,(创刊号):10
[73]中国医学科学院药物研究所药理室.药用菖蒲研究进展[J].新医药杂志,1977,(6):46
[74]方永奇,吴启端,等.石菖蒲对中枢神经系统兴奋—镇静作用研究[J].广西中医药,2001,24(1):49
[75]蒋红兰,匡忠生,等.石菖蒲冰片对神经细胞缺氧性损伤的保护作用[J].广州中医药大学学报,2003,20(1):63-65
[76]张家俊,陈文为.中药酸枣仁、龙齿、石菖蒲对小鼠脑组织单氨类神经递质及其代谢物的影响[J].北京中医药大学学报,1995,18(6):64
[77]杨晓燕,陈发奎,等.石菖蒲对抗抑郁药理作用的研究[J].海军军事医学,1999,20(2):16
[78]胡锦官,顾健,等.石菖蒲及其有效成份对中枢神经系统作用的实验研究[J].中药药理与临床,1999,15(3):19
[79]周大兴,包祖晓,吴雄生,等.石菖蒲醇提物的抗惊厥作用[J].中国现代应用药学,1999,16(2):19
[80]张信岳,郑高利,寿燕,等.石菖蒲的益智和抗惊厥作用研究[J].浙江中医学院学报,1999,23(2):46
[81]吴启端,方永奇,李翎,等.石菖蒲对中枢神经系统兴奋性的有效部位研究[J].医药报导,2002,21(7):399
[82]周大兴.石菖蒲的促进小鼠学习记忆和提高耐缺氧力作用[J].现代应用药学,1993,10(4):4
[83]周大兴.石菖蒲对小鼠学习记忆的促进作用[J].中草药,1992,23(8):417
[84]钱曾年.α—细辛醚对中枢神经系统的影响[J].苏州医学院学报,1986,3(4):47
[85]胡锦官,顾健,王志旺,等.石菖蒲及其有效成份对学习记忆的实验研究[J].中药材,1999,22(11):584
[86]匡忠生,谢宇晖,李翎,等.石菖蒲提取液对脑缺血—再灌注诱导的神经细胞凋亡保护作用[J].广东医学,2002,23(5):459
[87]方永奇,李翎,吴启端,等.β—细辛醚和冰片对大鼠缺血再灌注脑损伤的保护作用[J].现代老年医学与保健,2002,11(2):15
[88]方永奇,李翎,邹衍衍,等.石菖蒲对缺血再灌注脑损伤大鼠脑电图和脑水肿的影响[J].中国中医急症,2003,12(1):5
[89]方永奇,匡忠生,谢宇晖,等.石菖蒲组分对缺血再灌注脑损伤大鼠神经细胞凋亡的影响[J].现代中西医结合杂志,2002,11(17):1645
[90]李翎,吴启端,邹衍衍,等.石菖蒲系列提取物对大鼠脑缺血再灌注脑损伤的影响[J].中医药学刊,2003,21(2):212
[91]吴启端,方永奇,李翎,等.石菖蒲醒脑开窍的有效部位筛选[J].时珍国医国药,2002,13(5):260
[92]李宏宇,等.不同商品白芷的药理研究[J].中国中药志,1991,16(9):560
[93]周继铭,等.白芷的研究—Ⅲ.制剂的质量控制及毒性试验[J].中国医院药学杂志,1988,8(11):505
[94]夙良元,等.五种不同产地白芷药理作用的比较研究[J].安徽中医学院学报,1990,9(2):56.
[95]刘计,等.当归补血汤的药理研究[J].中药药理与临床,1987,3(3):7.
[96]江苏新医学院.中药大辞典(缩印本)[M].上海:上海科学技术出版社,1993:613-614
[97]田茸,慕宝龙.石菖蒲对中枢神经系统作用的研究现状[J].中国中医药信息杂志,2006,13(3):101-103
[98]赖真,王沙燕,耿小茵,等.补阳还五汤和黄芪对沙土鼠脑缺血再灌注后脑组织的兴奋性氨基酸的影响[J].北京中医药大学学报,2002,25(3):33-35.
[99]刘亚敏,张锡安,等.麝香、冰片对全脑缺血再灌注大鼠脑组织氨基酸类神经递质的影响[J].中药新药与临床药理,2002,12(4):231-233
[100]唐洪梅,席萍,吴敏,等.石菖蒲对小鼠脑组织氨基酸类神经递质的影响[J].中药新药与临床药理,2004,15(5):310-311
[101]邱小鹰,梅元武,王何,等.脑温改变对大鼠脑缺血再灌注组织兴奋性氨基酸的影响[J].中国临床康复,2003,7(19):2662-3
[102]李强,潘莉莉.反相高效液相色谱法测定脑梗塞患者血浆氨基酸[J].辽宁医 学杂志,1999,13(3):140-141
[103]Baker AJ.Moulton RJ.MacMillan VH,et al.Exciatory amino acids in cerebrospinal fluid following traumatic brain injury in J Neurosurg 1993,79(3):369-373
[104]Castillo J,Davaloa A,Naveiro J,et al.Neuroexcitatory amino acids and their relation to infarct size and neurological deficit in ischemic stroke.Stroke.1996,27(6):1060-1065.
[105]张中兴,卢江,张萍,等.脑梗死后血、脑脊液中兴奋性氨基酸变化与神经功能缺失的关系[J].中国临床康复,2003,7(25:3422-3
[106]郭燕舞.周媛,张世忠,等.持续性植物状态患者意识状态与氨基酸类神经递质水平的关系[J].中国临床康复,2004,8(4):629-631.
[107]胡学芳,张锡然,王培东,等.持续性植物状态患者血浆、脑脊液中氨基酸水平的变化[J].中国应用生理学杂志,2003,19(3):248-249
[108]李金彩,肖华,耿明亮.持续性植物状态患者脑脊液和血中多巴氨含量的变化[J].中华航海医学杂志,2000,7(2):110
[109]杨洪杰,肖华.持续性植物状态患者脑脊液中多巴氨含量的变化的临床研究[J].中国现代医学杂志,2002,12(10):58-59
[110]肖华,徐如祥,李金彩,等.持续性植物状态猫体内多巴氨变化的实验研究[J].中华神经医学杂志,2006,5(5):531-532
[111]李茂林,王祝峰,刘鑫,等.外伤性、持续性植物状态患者血清及脑脊液中多巴氨含量监测的临床分析[J].实用医学杂志,2003,19(8):943-944.
[112]徐仁宝,卢建,蒋左蔗.受体的基础与临床[M].上海:上海科学技术出版社,2001:145-151
[113]Humbert C.A clinical and pathological study of akinetic mutisum.Neurology,1959,11-21
[114]肖华,邹春芽,徐如祥.中枢多巴氨受体与脑损害[J].(国外医学)创伤与外科基本问题分册,1996,17(3):135-138
[115]肖华,徐如祥,李金彩.脑损伤早期脑皮质神经细胞膜D1受体活性变化的实验研究[J].解放军医学杂志,1998,23(5):443-444
[116]Milhad D,et al.Treatment of akinetic mutisum with bromocriptine(letter).Presse Med,1993,22(14):688
[117]张宏,王清华,徐如祥,等.嗅隐停和美多巴对重型颅脑损伤迁延性昏迷的催醒治疗30例临床分析[J].第一军医大学学报,2001,21(7):548
[1]张国谨,主编.持续性植物状态[M]南京:南京出版社,1988:148
[2]会议纪要.《关于修订我国持续性植物状态(PVS)诊断和疗效标准专家会议纪要》[J].中华急诊医学杂志,2002,11(4):241
[3]郭燕舞.持续性植物状态临床研究进展[J].国外医学神经病学神经外科学分册,2002,29(2):187-190
[4]刘明锋,主编.实用颅脑损伤学[M].北京:人民军医出版社,1992:82
[5]Gutling E,Landis T,Lleihes P.Akinetic mutism in bilateral necrotizing leucoen-cephalopathy after radiation and chemotherapy:electrophysiological and autopsy findings.J Neurol,1992,239:125-128
[6]Tabeuehi A.Excitatory amino acid transmitters:past,present,and fu.Tule.In:Kanazawal,ed Neurotransmitters focus on excitatory amino acids.Tokyo:Exeerpta,1998,395
[7]Kinney HC Sanuels MA.Neuropathology of the persistent vegetative state.A review.J Neuropath/exp Neurol,1994,53:548-558
[8]Kostic KV,Przedborski S,Jackson Le-Wis-V,et al.Effect of unilateral perinatal-hypoxic-ischemic brain injury on striatal dopamine uptake sites and D1 and D2 receptors in adult rates[Published erratum appears in Neurosic lett 1991 Dec16,134(1):151].Neurosic Lett 1991,129(2):197-200
[9]郭志勇,李金彩,肖华.中西医结合治疗持续性植物状态疗效优势[J].中国临床康复,2003,(20):2854-2855
[10]Heindl UT,laub MC.Outcome of persistent vegetative state following hypoxic or traumatic brain injury in children and adolescents,Neuropediatrics 1996,27(2):94-100
[11]王传民,张国谨,王培东,等.高压氧综合治疗持续性植物状态疗效观察[J].中华航海医学杂志,1995,2(1):20
[12]王德生,王晓丹,吕英.国内持续性植物状态研究现状[J].中国康复医学杂志,2004,19(10):795-798
[13]王维治,主编.神经病学第5版[M].北京:人民卫生出版社,2004,7:4
[14]卢明,黄培新,杜宝新,黄燕,刘茂才.中风病中西结合研究思路之探讨.中国中医急症 2007,16(6):684-685.
[15]李向荣,吴清明,刘未艾,等.中西医结合卒中单元对急性脑卒中患者的影响初步研究 中国中医急症 2007 16(4):381-383
[16]尤可,孔立 论解毒法在中风病中的应用 中国中医急症 2007,16(9):1086-1089.
[17]何刚,冯子驹,卢静,等。中风病证候分布及动态变化研究及探讨 中国中医急症 2007,16(6):686-687
[18]林福军,奚肇庆,丰广魁 102例住院持续性植物状态患者的流行病学调查 山 东医药 2007,47(34)104-105.
[19]印会河,主编.中医基础理论[M].上海:上海科学技术出版社,1984:30
[20]杜伟国,徐成贺.《内经》对脑髓学说的认识[J].中医药研究,2001,17(4):3-4
[21]方药中,等主编.实用中医内科学[M].上海:上海科学技术出版社,1985:355
[22]陈佑邦,王永炎主编.中医急诊医学[M].福建:福建科学技术出版社,1995:88
[23]张琴珠.植物人研究中的一些神经心理学问题[J].心理科学,1996,19(2):97-100
[24]郭燕舞,周媛,张世忠,等.持续性植物状态患者意识状态与氨基酸类神经递质水平的关系[J].中国临床康复,2004,8(4):629-631
[25]胡学芳,张锡然,王培东,等.持续性植物状态患者血浆、脑脊液中氨基酸水平的变化[J].中国应用生理学杂志,2003,19(3):248-249
[26]Lechevalier B,Bertran F,Busson P,et al.Akinetic mutism with right hemiplegia caused by infarction in the territory of the left anterior cerebral artery.Rev Neurol Paris,1996,152(3):181-189
[27]Krimchansky BZ,Keren O,Sazbon L,Groswasser Z Differential time and related appearance of signs,indicating improvement in the state of consciousness in vegetative state traumatic brain injury(VS-TBI) patients after initiation of dopamine treatment;Brain Inj.2004;18(11):1099-105
[28]Kmietowicz Z.New technique helps to assess vegetative state.BMJ.2000,321(7255):196-200
[29]王德生,王晓丹,吕英.国内持续性植物状态研究现状[J].中国康复医学杂志,2004,19(10):795-798
[30]中国社会科学院语言研究所词典编辑室.现代汉语词典[M]北京:商务印书馆,1997:239,167
[31]乔德才,张琴珠,封茂滋.神经病病人持续性植物状态发临床诊断标准的探讨[J].中华医学杂志,1988,78(3):167
[32]张微微,持续性植物状态的治疗进展[J].内科急危重症杂志,2003,9(3):157-167
[33]Wade DT,Johnston C.The permanent vegeative state:practical quide on diagnosis and management.BMJ.1999,319(7213):841-844
[34]越普学,许自强,等.胎脑移植治疗“植物人”6例报告[J].铁道医学,1991,19(2):96-97
[1]周岁锋,郭应军,汤双齐 毒邪学说在危重症患者中的应用 中国中医急症 2007,16(4):437-438.
[2]丰广魁,林福军,姜亚军,奚肇庆,刘涛,王培东 试论脑病的病理 陕西中医 2007,28(6):700-702.
[3]奚肇庆,丰广魁,刘涛,等.持续性植物状态的中医辩证论治研究[J].江苏中医药.2006,27(8):21-23.
[4]李瑛,王华,阎小燕,等中西医结合脑血管病诊疗学.第1版,北京:中国中医药出版社 2007,8
[5]尤可,孔立 论解毒法在中风病中的应用 中国中医急症 2007,16(9):1086-1089.
[6]甘永梅,奚肇庆,王培东,马虎龙 创伤性脑损伤机理及治疗研究进展 中华实用中西医杂志 2005 18(2):173-175.
[7]何刚,冯子驹,卢静,等。中风病证候分布及动态变化研究及探讨 中国中医急症 2007,16(6):686-687
[8]丰广魁,奚肇庆,刘涛,林福军,王培东,等 益神启窍方合并综合疗法对持续性植物状态PVS患者疗效评分的影响 中医杂志 2007,48(11):999-1000.
[9]苏德模 略论中医痰瘀学说与脑血栓的关系 中国中医急症 2007,16(6):746.
[10]沈绍功,韩学杰 中医急诊学和证候学的关联与互动 中国中医急症 200716(9):1033-1035.
[11]卢明,黄培新,杜宝新,黄燕,刘茂才.中风病中西结合研究思路之探讨.中国中医急症 2007,16(6):684-685.
[12]李向荣,吴清明,刘未艾,等.中西医结合卒中单元对急性脑卒中患者的影响初步研究 中国中医急症 2007 16(4):381-383