菖蒲郁金汤辅助治疗重症病毒性脑炎对神经功能、S100B、NSE的影响
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摘要
目的:分析菖蒲郁金汤辅助治疗重症病毒性脑炎患儿对神经功能、S100B蛋白、神经元特异性烯醇化酶(NSE)的影响。方法:选取重症病毒性脑炎患者66例,根据治疗方法不同分为对照组和观察组。对照组患者采用常规对症治疗,观察组患者加用菖蒲郁金汤进行辅助治疗,分析两组患者治疗后的临床效果。结果:观察组患者头晕目眩、神识昏蒙、四肢懈怠及身热不退等中医症候消失时间短于对照组,差异有统计学意义(P<0.05)。治疗前,两组患者S100B、NSE、β-EP水平比较,差异无统计学意义(P>0.05)。治疗3、10 d后,观察组患者S100B、NSE、β-EP水平低于对照组,差异有统计学意义(P<0.05)。治疗前,两组患者MMSE评分比较,差异无统计学意义(P>0.05)。治疗后,观察组患者MMSE评分高于对照组,差异有统计学意义(P<0.05)。结论:菖蒲郁金汤辅助治疗重症病毒性脑炎可促进患者神经功能的恢复,降低S100B、NSE、β-EP水平,加快临床症状的消失。
Objective:To analyze the effect of Changpu Yujin Decoction on neurologic function,S100 B protein and neuron specific enolase(NSE) in children with severe viral encephalitis.Methods:Sixty-six patients with severe viral encephalitis were divided into control group and observation group according to different treatment methods. The patients in the control group were treated with routine symptomatic therapy, and those in the observation group were treated with Changpu Yujin Decoction. The clinical effects of the two groups were analyzed.Results:The time of disappearance of TCM symptoms in the observation group was shorter than that in the control group(P<0.05). Before treatment, there was no significant difference in NSE or β-EP levels between the two groups(P>0.05). After 3 days treatment, the levels of S100 B,NSE and β-EP in the observation group were significantly lower than those in the control group(P<0.05). Before treatment, there was no significant difference in MMSE score between the two groups(P>0.05). After treatment, the MMSE scores of the patients in the observation group were higher than those in the control group. The difference was statistically significant(P<0.05). Conclusion:The adjuvant treatment of severe viral encephalitis with Changpu Yujin Decoction can promote the recovery of nervous function, decrease the levels of NSE and β-EP and accelerate the disappearance of clinical symptoms in patients with severe viral encephalitis.
Objective:To analyze the effect of Changpu Yujin Decoction on neurologic function,S100 B protein and neuron specific enolase(NSE) in children with severe viral encephalitis.Methods:Sixty-six patients with severe viral encephalitis were divided into control group and observation group according to different treatment methods. The patients in the control group were treated with routine symptomatic therapy, and those in the observation group were treated with Changpu Yujin Decoction. The clinical effects of the two groups were analyzed.Results:The time of disappearance of TCM symptoms in the observation group was shorter than that in the control group(P<0.05). Before treatment, there was no significant difference in NSE or β-EP levels between the two groups(P>0.05). After 3 days treatment, the levels of S100 B,NSE and β-EP in the observation group were significantly lower than those in the control group(P<0.05). Before treatment, there was no significant difference in MMSE score between the two groups(P>0.05). After treatment, the MMSE scores of the patients in the observation group were higher than those in the control group. The difference was statistically significant(P<0.05). Conclusion:The adjuvant treatment of severe viral encephalitis with Changpu Yujin Decoction can promote the recovery of nervous function, decrease the levels of NSE and β-EP and accelerate the disappearance of clinical symptoms in patients with severe viral encephalitis.
引文
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[19] 王凯萍,曾雪飞,何颖慧,等.白虎汤加味联合氢溴酸东莨菪碱治疗重症手足口病并发病毒性脑炎[J].中医药学报,2016,44(3):108-110.
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[2] 赵传丽.神经节苷脂联合更昔洛韦对病毒性脑炎患者血清及脑脊液指标影响的研究[J].神经损伤与功能重建,2017,12(2):159-160.
[3] 潘可达,方慧,郑默,等.大剂量丙种球蛋白对病毒性脑炎患者脑脊液中血清神经功能指标及相关炎症因子表达水平的影响[J].中华医院感染学杂志,2017,27(9):1929-1932.
[4] 吴蕾.连续性血液净化技术在重症病毒性脑炎中的应用研究[J].中国血液净化,2017,16(3):176-178.
[5] 郝丹丹.醒脑静注射液联合胎盘多肽治疗小儿病毒性脑炎临床观察[J].河北医药,2017,39(12):1802-1804.
[6] 程率芳,崔应麟,杨小红,等.六味地黄丸在病毒性脑炎患儿治疗中的应用效果观察[J].山东医药,2017,57(18):63-65.
[7] 韩彤立,徐曼婷,陈春红,等.生酮饮食添加治疗儿童癫痫性痉挛临床和随访研究[J].中国小儿急救医学,2016,23(6):401-404.
[8] 尉娜,王建平,王家勤,等.病毒性脑炎患儿脑脊液水通道蛋白4、基质金属蛋白酶-9及神经元特异性烯醇化酶水平变化[J].中华实用儿科临床杂志,2016,31(5):388-389.
[9] 邓衍圣.热毒宁联合丙种球蛋白治疗小儿重症病毒性脑炎临床分析[J].安徽医药,2017,18(4):653-655.
[10] 张会敏,卢艳,张艳格,等.重组人干扰素α1b注射液对儿童病毒性脑炎细胞免疫功能的影响[J].脑与神经疾病杂志,2017,25(10):598-601.
[11] 尹子铭,石建军,续秋艳,等.DWI联合MRS对病毒性脑炎和脑低级别胶质瘤的诊断价值[J].中国CT和MRI杂志,2018(1):15-18.
[12] 康莺歌,常晶,王洁翡.纳洛酮辅助治疗小儿病毒性脑炎的疗效观察[J].中国实用神经疾病杂志,2017,20(8):113-114.
[13] 刘煜,陈历赛,段颖晖,等.儿童早期预警评分在PICU病毒性脑炎患儿病情转归中的预测价值[J].护理学杂志,2017,32(5):24-26.
[14] 曹玉红,张立毅,张光运,等.病毒性脑炎患儿脑脊液和血清胶质纤维酸性蛋白的检测及其临床意义[J].西部医学,2018(1):95-97.
[15] 王燕,黄慧洁,李斌.脑脊液中TNF-α、NSE水平对儿童病毒性脑炎影响的Meta分析[J].重庆医学,2017,46(24):3366-3369.
[16] 何双龙,许健健.亚低温联合咪达唑仑对重症病毒性脑炎患儿血清β-EP、NSE水平的影响[J].中国妇幼保健,2016,31(5):1065-1068.
[17] 梁爱红.地塞米松与甲基强的松龙治疗儿童重症病毒性脑炎的临床对照[J].河北医药,2017,39(9):1400-1402.
[18] 孙恒斌,余天浩,张宙.连续性血液净化治疗在重症病毒性脑炎伴发癫痫持续状态患者的疗效观察[J].临床神经病学杂志,2016,29(5):363-365.
[19] 王凯萍,曾雪飞,何颖慧,等.白虎汤加味联合氢溴酸东莨菪碱治疗重症手足口病并发病毒性脑炎[J].中医药学报,2016,44(3):108-110.
[20] 胡梅,周宏斌.甲泼尼龙联合人血白蛋白治疗重症病毒性脑炎的有效性及安全性研究[J].实用心脑肺血管病杂志,2016,24(5):115-117.
[21] 张伟,胡玉莲,袁征.菖蒲郁金汤联合大剂量丙种球蛋白治疗小儿重症病毒性脑炎临床研究[J].中医学报,2017,32(7):1305-1308.