Heavy craniocerebral injury is a common critical illness in the field of neurosurgery and trauma surgery, its condition changes quickly, high mortality, many sequelae, and the early intervention of Chinese medicine in the prevention and treatment of complications, symptom improvement and other aspects have a very positive significance, the author on the recent treatment of nearly 50 cases in the selection of three typical cases to talk about treatment experience. 1, case information Case 1: Chen, female, 23 years old, heavy craniocerebral injury caused by car accident, craniotomy treatment, sometimes high fever and convulsions, by Western medicine symptomatic treatment, the symptoms do not improve significantly, so asked the Chinese medicine consultation, the patient was in a deep coma, high fever does not subside, is performing ice caps and ice bags and other physical cooling, tracheotomy, phlegm in the throat, convulsions, daily solution of dilute stool three or four times, moss greasy, smooth pulse, consider stasis of blood and phlegm water obstruction. The treatment is to calm the liver and quench the wind, resolve phlegm and stop spasms. The formula is based on the combination of Antelope Horns and Hooked Vine Drink and Antelope Horns and Hooked Vine Soup, plus and minus: Antelope Horns (decoction) 5g, Hooked Vine (later) 20g, Tian Ma 15g, Bile South Star 15g, Tian Zhu Huang 10g, Guang Di Long 15g, Roasted Silkworm 15g, Centipede 2, Whole Scorpion (decoction) 5g, Fu Shen 10g, Che Qian Zi (package) 10g, Licorice 5g, three doses, decoction. Take the juice intranasal feeding, one dose a day; the second diagnosis has been removed from the ice cap, heat down convulsions stop, the medicine is effective, not to change the formula, continue into the three doses; the third diagnosis of fever, convulsions did not make, the formula to the whole scorpion, centipede, with the evidence of conditioning for several months and peace. Case 2: Mo, male, 18 years old, heavy craniocerebral injury caused by car accident, craniotomy treatment, the patient was confused, phlegm sound in the throat, both lungs full of croup, dry stools such as pills, ask the Chinese medicine consultation, view his tongue red coating yellow thick, diagnose his pulse sliding number powerful, consider the phlegm does not dissolve, obscuring the heart orifice, lung Qi does not descend, large intestine conduction failure, treatment is intended to clean phlegm and open the orifice, laxative to drain the turbidity as the key, Bile South Star 15 grams Fa The treatment is to cleanse the phlegm and open the orifice, to open the stool and drain the turbidity. The patient was discharged from the hospital after half a month of conditioning. Case 3: Wang, male, 45 years old, heavy cranial injury caused by a fall from a height, craniotomy treatment, postoperative coma and persistent hyperthermia has been 8 days, body temperature between 38.5 ℃-40 ℃, snoring like thunder, red face, shortness of breath, stool has not been resolved, red tongue and less fluid, pulse string slippery, consider the lack of yin and fluid, hyperactivity of liver and Yang, brain lobe injury, treatment is intended to nourish the liver and kidney yin, calm the hyperactivity of Yang, clear drainage The treatment is to nourish the yin of the liver and kidney, calm the hyperactive yang, and clear the Yang-ming dry heat. Antelope horn (separately decocted) 5g Hooked vine (later) 30g Hang chrysanthemum 10g Xia Ku Cao 30g Sheng Di Huang 30g White peony 20g Zhe Bei 10g Stiff silkworm 15g Sheng Long Mu (first decocted) 30g Sheng Jun (later) 8g Bamboo leaf 5g Three doses, one dose per day, divided into nasal feedings. At the second consultation, the stool has been cleared, the patient’s maximum body temperature is 38.3℃, the medicine has been bull’s-eye, so we have to observe the disease mechanism and continue to take three doses. The third diagnosis: the body temperature was between 36.5-37.5, and the patient’s mind was slightly clearer, so the front was removed from Shengjun, and XuanShen, Citrus aurantium, and ZhuRu were added. 2, discussion The above cases were treated by conventional Western medicine, including surgery, prevention and control of infection, correction and maintenance of water-electrolyte balance, nutritional drugs, dehydrating agents, based on the use of blood circulation, blood stasis, internal organs to drain heat, open the orifice and awaken the mind, the purpose is to correct the rebellious Qi and blood, so that the turbid evil can not disturb the mind. According to Chinese medicine, “the brain is the house of the genitals”, after heavy cranio-cerebral trauma, the blood overflows outside the veins, the brain marrow is damaged, the qi is disturbed, the functions of the internal organs are dysfunctional, the phlegm and water drinks are generated quickly, and the heat is turned into heat, thus forming a situation of stagnation of blood, phlegm and water drinks, resulting in the occlusion of the brain, the genitals are trapped, the five viscera are not unified, the qi of the six internal organs is closed, and the symptoms are numerous, which can be seen as Coma, phlegm and saliva congestion, abdominal distension and vomiting blood, high fever that does not subside, inability to pass stool, thick yellow tongue coating, slippery pulse, etc. In the Nei Jing, it is said that “if there is a fall, the bad blood stays inside.” Blood stasis is the pathological basis of heavy craniocerebral injury, even if the surgery removed the intracranial hematoma (tangible blood stasis), but Chinese medicine believes that this does not solve all the problems, that is, including the invisible blood stasis and a series of pathological changes caused by phlegm and hot water and drink have not been corrected, so the blood is an important part of the treatment of heavy craniocerebral injury, although the injury or early postoperative period should not be used to break the blood and eliminate stasis, but we believe that peach kernel Although it is not advisable to use blood-breaking and blood-stasis expelling drugs in the early stage of injury or postoperative period, we think that the use of peach kernel, salvia, dizhong, amber and panax ginseng is still desirable. Amber and Panax ginseng are especially important. Amber is sweet and mild, and is calm in nature. It can calm the five viscera, clear the heart and lungs, fix the soul, subdue epilepsy, kill evil spirits and spirits, eliminate blood stasis and phlegm, detoxify compulsions, break Y knots, pass through five lunges, facilitate urination, brighten the eyes and shade, and stop bleeding and produce muscle (Jing Yue Quan Shu). And panax pseudoginseng, both good at transforming blood, but also good at stopping bleeding, such as the “medicine in the heart of the ginseng Xilu” cloud broken wound bleeding, with panax pseudoginseng end rubbed then its blood immediately stop, is able to stop bleeding; its broken place has flowed this blood, with panax pseudoginseng are transformed into yellow water, is able to transform blood. Therefore, these two medicines are very suitable for the pathogenesis of heavy cranial trauma. Ming medical miscellaneous writings” in the cloud: “one of the body, qi and blood is clear and smooth, the flow of fluid, what phlegm. Only the turbidity of blood and qi reverse, the fluid is unclear, fumigation into a collection and become phlegm.” The manifestation of phlegm in patients with severe craniocerebral trauma varies, both the tangible phlegm blocking the airway and the invisible phlegm blocking the meridians and clear orifices, etc. We choose Ming Tian Ma, Bile South Star, Fuxian Xia, Shi Calamus, Tian Zhu Huang, Stiff Silkworm, Citrus Aurantium, Bamboo Roo, Yuan Zhi, etc., and we often use White Mustard Seed, Lycopodium, Bamboo Roo, Smallpox Powder, Guadua, Xiang Bei, etc. to resolve phlegm and calm asthma, especially It has a laxative power, which is effective in reducing phlegm and resolving phlegm, and has the ability to push down walls and walls. High fever and convulsions is one of the common clinical manifestations of patients with heavy craniocerebral injury. Antelope horn is cold in nature, strong in clearing heat, has a good effect of clearing liver heat, resting liver wind, is the treatment of liver wind, convulsions of epilepsy, we commonly use 4-5 grams, the central hyperthermia caused by brainstem hemorrhage also has a more significant effect, combined with convulsions often add scorpion 5 grams, centipede 2-3, stiff silkworm 15 grams. Constipation is also one of the common clinical manifestations of heavy craniocerebral injury patients, the method of venting heat from the internal organs in the early treatment of heavy craniocerebral injury patients in Chinese medicine occupies an extremely important position, and sometimes can receive unexpected results, especially the Chinese medicine rhubarb on heavy craniocerebral injury has a multi-target therapeutic effect, rhubarb tapping down the body to redistribute fluid, can synergistically reduce intracranial pressure, reduce cerebral edema; rhubarb blood to dispel blood stasis, improve cerebral circulation and blood flow degeneration. Improve cerebral circulation and blood rheology, increase cerebral blood flow and reduce brain damage; rhubarb removes stagnation in the gastrointestinal tract, reducing the continuous damage to the gastric mucosa by gastric juice and harmful metabolites, rhubarb diuresis and detoxification makes the body avoid secondary injury strikes secondary to the primary injury.