中医治疗蛛网膜下腔出血后脑血管痉挛 临床研究进展

Clinical Research Progress of Traditional Chinese Medicine in the Treatment of Cerebral Vasospasm Following Subarachnoid Hemorrhage

摘要: 蛛网膜下腔出血是临床较为凶险的急性脑血管病症，致残与致死概率均居高不下，对患者的生命安全与后续康复均会产生显著影响。中医药在干预此类病症时具备特有优势，能够从多个层面、多个路径发挥调控作用，在减轻临床症状、降低并发症发生率、推动神经功能修复等方面均具备可观价值。本文针对中医对该病的病机认知、临床辨证思路及方剂用药等相关内容进行系统整理与综述。目前相关研究仍有不少短板：中医证型划分缺少统一标准，临床诊疗随意性较大；高水准临床研究数量有限，大样本、多中心、随机对照研究偏少；中药具体作用靶点与分子机制研究不够深入，使其进一步推广受到制约。文章在梳理现有研究的基础上，期望为后续中医理论深化与临床规范化开展提供参考，从而提升本病的中医诊疗实效。

Abstract: Subarachnoid hemorrhage is an acute cerebrovascular disease with high clinical severity, accompanied by high disability and mortality rates, which exerts a significant impact on patients’ life safety and subsequent rehabilitation. Traditional Chinese medicine (TCM) has unique advantages in the intervention of this disease, exerting regulatory effects through multiple levels and pathways, and shows considerable value in alleviating clinical symptoms, reducing the incidence of complications, and promoting neurological function recovery. This paper systematically summarizes and reviews the TCM understanding of pathogenesis, clinical syndrome differentiation ideas, and herbal prescriptions for this disease. At present, there are still many shortcomings in relevant studies: the classification of TCM syndromes lacks unified standards, leading to strong subjectivity in clinical diagnosis and treatment; high-quality clinical research is limited, with few large-sample, multicenter, randomized controlled trials; research on the specific targets and molecular mechanisms of TCM is insufficient, which restricts its further application. Based on the review of existing studies, this paper aims to provide references for the subsequent improvement of TCM theory and standardized clinical practice, so as to enhance the actual effect of TCM in the diagnosis and treatment of this disease.