清脑益元汤治疗缺血性中风临床疗效及对NSE、S100B表达的影响
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摘要
目的:观察清脑益元汤对缺血性中风急性期的治疗效果,探讨其对血清NSE、S100B表达的影响。方法:采取随机原则,选取广西中医药大学第一附属医院脑病科从2016年4月至12月住院患者60例,随机分为两组:对照组(30例)予以单纯西医常规治疗,治疗组(30例)在对照组基础上加用清脑益元汤。采用酶联免疫吸附法(ELISA)检测两组治疗前及治疗后第3、7、14天血清NSE、S100B表达水平,评估两组患者神经功能缺损程度(NIHSS评分)、中医证候积分、生活能力状态及临床疗效。结果:治疗后,两组患者NIHSS评分、中医临床证候积分及血清NSE、S100B表达水平比较均较前下降,且治疗组下降更明显(P<0.05,P<0.01);生活能力状态较治疗前得到显著改善(P<0.01),且治疗组改善更显著(P<0.05);治疗组临床总有效率(90.0%)显著高于对照组(76.7%)(P<0.05)。结论:清脑益元汤能明显减轻缺血性中风患者急性期神经功能缺损程度,提高临床疗效,其机制可能与下调血清NSE、S100B表达水平有关。
Objective: To observe the effects of Qingnao Yiyuan Decotion in treating acute ischemic stroke, and the influence on serum neuronal specific enolase(NSE) and S100 calcium-binding protein B(S100 B). Methods: A total of 60 hospitalized patients from Department of Encephalopathy in The First Affiliated Hospital of Guangxi University of Chinese Medicine during April 2016 to December 2016 were randomly divided into treatment group and control group, 30 cases in each group. Control group was given western routine therapy, while treatment group was given Qingnao Yiyuan Decoction on the basis of western routine therapy. Enzyme linked immunosorbent assay(ELISA) was used to detect the serum levels of NSE and S100 B of two groups before treatment and 3 days, 7 days, 14 days after treatment, respectively, NIHSS score, TCM syndrome integral, the capability state of life, and the clinical curative effect were evaluated. Results: After treatment, NIHSS score, Chinese clinical syndrome integral, and serum level of NSE and S100 B in the treatment group and control group decreased, and the treatment group decreased more significantly(P<0.05, P<0.01). The capability state of life improved significantly in both groups(P<0.01), the treatment group improved more significantly(P<0.05). Clinical total effective rate in treatment group was significantly higher than that in the control group, clinical total effective rate of two groups were 90.0% and 76.7%, respectively, the difference was statistically significant(P<0.05). Conclusion: Qingnao Yiyuan Decoction can reduce the degree of neurologic impairment of ischemic stroke patients and improve clinical efficacy, the mechanism of which is related to down-regulating serum NSE and S100 B levels.
Objective: To observe the effects of Qingnao Yiyuan Decotion in treating acute ischemic stroke, and the influence on serum neuronal specific enolase(NSE) and S100 calcium-binding protein B(S100 B). Methods: A total of 60 hospitalized patients from Department of Encephalopathy in The First Affiliated Hospital of Guangxi University of Chinese Medicine during April 2016 to December 2016 were randomly divided into treatment group and control group, 30 cases in each group. Control group was given western routine therapy, while treatment group was given Qingnao Yiyuan Decoction on the basis of western routine therapy. Enzyme linked immunosorbent assay(ELISA) was used to detect the serum levels of NSE and S100 B of two groups before treatment and 3 days, 7 days, 14 days after treatment, respectively, NIHSS score, TCM syndrome integral, the capability state of life, and the clinical curative effect were evaluated. Results: After treatment, NIHSS score, Chinese clinical syndrome integral, and serum level of NSE and S100 B in the treatment group and control group decreased, and the treatment group decreased more significantly(P<0.05, P<0.01). The capability state of life improved significantly in both groups(P<0.01), the treatment group improved more significantly(P<0.05). Clinical total effective rate in treatment group was significantly higher than that in the control group, clinical total effective rate of two groups were 90.0% and 76.7%, respectively, the difference was statistically significant(P<0.05). Conclusion: Qingnao Yiyuan Decoction can reduce the degree of neurologic impairment of ischemic stroke patients and improve clinical efficacy, the mechanism of which is related to down-regulating serum NSE and S100 B levels.
引文
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[5]金艳,张春和.S100B蛋白、NSE与急性缺血性脑卒中的相关性研究.中国卫生检验杂志,2012,22(2):249-251
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[8]Singh H V,Pandey A,Shrivastava A K,et al.Prognostic value of neuron specific enolase and IL-10 in ischemic stroke and its Correlation with degree of neurological deficit.Clin Chim Acta,2013,118(6):1298-1303
[9]陈景红,李娜,高俊淑,等.老年急性脑梗死患者血清血管内皮生长因子和S100-β蛋白水平动态变化的临床评价.中国老年学杂志,2013,33(4):903-904
[10]汤菲,安黎云,贾志然.动态观察急性脑梗死患者血清S100B蛋白的表达与神经功能缺损程度的关系.检验医学与临床,2014,11(16):2216-2217
[11]Li K,Jia J,Wang Z,et al.Elevated serum levels of NSE and S-100B correlate with increased risk of acute cerebral infarction in Asian popilations.Med Sci Monit,2015,30(21):1879-1888
[12]杜文秀,李艳艳,史路遥,等.阿托伐他汀钙对急性脑梗死患者血浆S100B和高迁移率族蛋白1水平的影响.中华老年心脑血管病杂志,2016,18(9):938-942
[13]Donato R,Cannon B R,Sorci G,et al.Function of S100 pronteins.Curr Mol Med,2013,13(1):24-57
[14]祝美珍,朱爱,刘泰,等.清热化瘀Ⅱ号方对大鼠脑缺血再灌注损伤IL-6及IL-8表达的影响.中华中医药杂志,2017,32(7):3136-3139
[15]祝美珍,齐玉洁,刘泰,等.清热化瘀Ⅱ号方对大鼠脑缺血再灌注损伤TLR4、TRIF mRNA表达的影响.中华中医药杂志,2017,32(2):529-532
[16]刘抒雯,刘敬霞,虎喜成,等.水蛭治疗缺血性脑卒中作用机制研究进展.新中医,2015,47(6):284-286
[17]张明发,沈雅琴.红景天苷的神经保护作用及作用机制研究进展.药物评价研究,2017,40(7):1019-1028
[18]李恩,陈伟,张立田,等.何首乌神经保护作用研究现状.亚太传统医药,2012,8(10):196-198
[19]陆小华,马骁,王建,等.赤芍的化学成分和药理作用研究进展.中草药,2015,46(4):595-602
[20]刘抒雯,刘敬霞,虎喜成,等.三七总皂苷治疗缺血性脑卒中研究进展.中国实验方剂学杂志,2015,21(15):217-220
[21]曾克武,廖理曦,万彦军,等.基于靶点“钩钓”策略的肉苁蓉苯乙醇苷药理靶点鉴定及功效解析.中草药,2018,49(1):173-178
[2]中华医学会神经病学分会脑血管病学组急性缺血性脑卒中诊治指南撰写组.中国急性缺血性脑卒中诊治指南2010.中国全科医学,2011,14(35):4013-4017
[3]CFDA.中药新药临床研究指导原则(试行).北京:中国医药科技出版社,2002:99-103
[4]中华医学会全国第四届脑血管疾病学术会议.各类脑血管疾病诊断要点.中华神经科杂志,1996,29(6):381-383
[5]金艳,张春和.S100B蛋白、NSE与急性缺血性脑卒中的相关性研究.中国卫生检验杂志,2012,22(2):249-251
[6]Kimura T,Nishikawa T.A biomarker panel:an additional resource in acute stroke evaluation.Minerva Anestesiol,2013,79(7):711-712
[7]Zhang H,Kang T,Li L,et al.Electroacupuncture reduces Hemiplegia following acute middle cerebral artery infarction with alteration of serum NSE,S-100B and endothelin.Curr Neurovasc Res,2013,10(3):216-221
[8]Singh H V,Pandey A,Shrivastava A K,et al.Prognostic value of neuron specific enolase and IL-10 in ischemic stroke and its Correlation with degree of neurological deficit.Clin Chim Acta,2013,118(6):1298-1303
[9]陈景红,李娜,高俊淑,等.老年急性脑梗死患者血清血管内皮生长因子和S100-β蛋白水平动态变化的临床评价.中国老年学杂志,2013,33(4):903-904
[10]汤菲,安黎云,贾志然.动态观察急性脑梗死患者血清S100B蛋白的表达与神经功能缺损程度的关系.检验医学与临床,2014,11(16):2216-2217
[11]Li K,Jia J,Wang Z,et al.Elevated serum levels of NSE and S-100B correlate with increased risk of acute cerebral infarction in Asian popilations.Med Sci Monit,2015,30(21):1879-1888
[12]杜文秀,李艳艳,史路遥,等.阿托伐他汀钙对急性脑梗死患者血浆S100B和高迁移率族蛋白1水平的影响.中华老年心脑血管病杂志,2016,18(9):938-942
[13]Donato R,Cannon B R,Sorci G,et al.Function of S100 pronteins.Curr Mol Med,2013,13(1):24-57
[14]祝美珍,朱爱,刘泰,等.清热化瘀Ⅱ号方对大鼠脑缺血再灌注损伤IL-6及IL-8表达的影响.中华中医药杂志,2017,32(7):3136-3139
[15]祝美珍,齐玉洁,刘泰,等.清热化瘀Ⅱ号方对大鼠脑缺血再灌注损伤TLR4、TRIF mRNA表达的影响.中华中医药杂志,2017,32(2):529-532
[16]刘抒雯,刘敬霞,虎喜成,等.水蛭治疗缺血性脑卒中作用机制研究进展.新中医,2015,47(6):284-286
[17]张明发,沈雅琴.红景天苷的神经保护作用及作用机制研究进展.药物评价研究,2017,40(7):1019-1028
[18]李恩,陈伟,张立田,等.何首乌神经保护作用研究现状.亚太传统医药,2012,8(10):196-198
[19]陆小华,马骁,王建,等.赤芍的化学成分和药理作用研究进展.中草药,2015,46(4):595-602
[20]刘抒雯,刘敬霞,虎喜成,等.三七总皂苷治疗缺血性脑卒中研究进展.中国实验方剂学杂志,2015,21(15):217-220
[21]曾克武,廖理曦,万彦军,等.基于靶点“钩钓”策略的肉苁蓉苯乙醇苷药理靶点鉴定及功效解析.中草药,2018,49(1):173-178