醒脑静注射液联合纳洛酮治疗脑出血后昏迷疗效观察及对血浆Leptin、GnRH水平的影响
|
摘要
目的:探讨醒脑静注射液联合纳洛酮治疗脑出血后昏迷的疗效及对血浆瘦素(Leptin)和促性腺激素释放激素(GnRH)水平的影响。方法:将脑出血患者72例按随机数字表法分成治疗组(36例)和对照组(36例),对照组采取纳洛酮静脉滴注,治疗组在对照组的基础上采取醒脑静注射液静脉滴注,疗程均为2周;比较2组格拉斯哥昏迷量表(GCS)和神经功能缺损评分、昏迷持续时间及临床疗效,检测2组血浆Leptin和GnRH水平。结果:总有效率治疗组为94.44%,对照组为72.22%,2组比较,差异有统计学意义(P <0.05)。治疗后,2组患者GCS评分明显增加(P <0.05),NIHSS评分明显减少(P <0.05);且治疗组GCS评分高于对照组(P <0.05),NIHSS评分低于对照组(P <0.05)。治疗组患者昏迷持续时间短于对照组,差异有统计学意义(P <0.05)。治疗后,2组血浆Leptin、GnRH水平均较治疗前明显降低(P <0.05);且治疗组血浆Leptin、GnRH水平明显低于对照组(P <0.05)。结论:醒脑静注射液联合纳洛酮治疗脑出血后昏迷可提高临床疗效,改善血浆Leptin、GnRH水平,促进脑出血后昏迷康复。
Objective: To discuss the curative effect of Xingnaojing injection combined with naloxone on coma after cerebral hemorrhage and its effects on plasma leptin and gonadotropin releasing hormone(GnRH)levels. Methods:Divided 72 cases of patients with cerebral hemorrhage into the treatment group(36 cases)and the control group(36 cases)according to random number table. The control group received an intravenous infusion of naloxone, while the treatment group was additionally treated with Xingnaojing injection by intravenous infusion. Both groups were treated for 2 weeks. Compared the Glasgow coma scale(GCS), neurological deficit scores, duration of coma, and the curative effect between the two groups. Detected plasma Leptin and GnRH levels in the two groups.Results: The total effective rate was 94.44% in the treatment group and 72.22% in the control group, compared the two groups,difference being significant(P < 0.05). After treatment, the GCS scores of patients in the two groups were significantly increased(P <0.05);the NIHSS scores were obviously decreased(P < 0.05);the GCS scores in the treatment group were higher than those in the control group(P < 0.05), and the NIHSS scores were lower than those in the control group(P < 0.05). The duration time of coma in the treatment group was shorter than that in the control group, difference being significant(P < 0.05). After treatment, the plasma Leptin and GnRH levels in the two groups were significantly lower than those before treatment(P < 0.05);the plasma Leptin and GnRH levels in the treatment group were evidently lower than those in the control group(P < 0.05). Conclusion: The application of Xingnaojing injection combined with naloxone for coma after cerebral hemorrhage can increase the clinical effect, improve plasma Leptin and GnRH levels, and promote coma recovery after cerebral hemorrhage
Objective: To discuss the curative effect of Xingnaojing injection combined with naloxone on coma after cerebral hemorrhage and its effects on plasma leptin and gonadotropin releasing hormone(GnRH)levels. Methods:Divided 72 cases of patients with cerebral hemorrhage into the treatment group(36 cases)and the control group(36 cases)according to random number table. The control group received an intravenous infusion of naloxone, while the treatment group was additionally treated with Xingnaojing injection by intravenous infusion. Both groups were treated for 2 weeks. Compared the Glasgow coma scale(GCS), neurological deficit scores, duration of coma, and the curative effect between the two groups. Detected plasma Leptin and GnRH levels in the two groups.Results: The total effective rate was 94.44% in the treatment group and 72.22% in the control group, compared the two groups,difference being significant(P < 0.05). After treatment, the GCS scores of patients in the two groups were significantly increased(P <0.05);the NIHSS scores were obviously decreased(P < 0.05);the GCS scores in the treatment group were higher than those in the control group(P < 0.05), and the NIHSS scores were lower than those in the control group(P < 0.05). The duration time of coma in the treatment group was shorter than that in the control group, difference being significant(P < 0.05). After treatment, the plasma Leptin and GnRH levels in the two groups were significantly lower than those before treatment(P < 0.05);the plasma Leptin and GnRH levels in the treatment group were evidently lower than those in the control group(P < 0.05). Conclusion: The application of Xingnaojing injection combined with naloxone for coma after cerebral hemorrhage can increase the clinical effect, improve plasma Leptin and GnRH levels, and promote coma recovery after cerebral hemorrhage
引文
[1]黎志迪,魏建功,王士强,等.盐酸纳洛酮联合正中神经电刺激对脑出血昏迷患者脑血流及电生理变化的影响[J].中国临床药理学杂志,2016,32(17):1549-1552.
[2]傅国萍,鲁国建,董芬.醒脑静与盐酸纳洛酮治疗处于昏迷状态的脑出血患者的临床效果对比[J].中华中医药学刊,2015,33(6):1387-1389.
[3]中华医学会神经病学分会,中华医学会神经病学分会脑血管病学组.中国脑出血诊治指南(2014)[J].中华神经科杂志,2015,48(6):435-444.
[4]王忠诚.神经外科学[M].武汉:湖北科学技术出版社,1998:284-286.
[5]王拥军.神经病学临床评定量表[M].北京:中国友谊出版社,2005:283.
[6]王维治.神经病学[M].北京:人民卫生出版社,2006:221-222.
[7]王晨,毛新龙,邹军辉.醒脑静与盐酸纳洛酮治疗昏迷脑出血的临床观察[J].中国药房,2016,27(11):1510-1512.
[8]张丽敏,梁增坤.醒脑静联合盐酸纳洛酮治疗脑出血后昏迷55例疗效观察[J].湖南中医杂志,2017,33(8):48-49.
[9]马征,孙雅菲,康玲伶,等.醒脑静注射液治疗急性脑出血患者临床疗效及对血清炎症因子、氧化应激的影响[J].中国实验方剂学杂志,2017,23(19):186-190.
[10]乔潜林,白新学,刘海玉,等.醒脑静注射液对脑出血合并肺部感染患者神经功能与凝血功能和炎性指标的影响[J].中华医院感染学杂志, 2017, 27(17):3878-3881.
[11]朱廷芳.免疫营养对脑出血患者血清瘦素水平及预后影响的研究[J].实用临床护理学杂志,2016,1(7):26-27.
[12]孙永,姚凯华,李志锋,等.急性脑出血患者血浆、脑脊液β-内啡肽、GnRH水平变化对脑损伤程度及预后的影响[J].山东医药,2017,57(29):26-29.
[2]傅国萍,鲁国建,董芬.醒脑静与盐酸纳洛酮治疗处于昏迷状态的脑出血患者的临床效果对比[J].中华中医药学刊,2015,33(6):1387-1389.
[3]中华医学会神经病学分会,中华医学会神经病学分会脑血管病学组.中国脑出血诊治指南(2014)[J].中华神经科杂志,2015,48(6):435-444.
[4]王忠诚.神经外科学[M].武汉:湖北科学技术出版社,1998:284-286.
[5]王拥军.神经病学临床评定量表[M].北京:中国友谊出版社,2005:283.
[6]王维治.神经病学[M].北京:人民卫生出版社,2006:221-222.
[7]王晨,毛新龙,邹军辉.醒脑静与盐酸纳洛酮治疗昏迷脑出血的临床观察[J].中国药房,2016,27(11):1510-1512.
[8]张丽敏,梁增坤.醒脑静联合盐酸纳洛酮治疗脑出血后昏迷55例疗效观察[J].湖南中医杂志,2017,33(8):48-49.
[9]马征,孙雅菲,康玲伶,等.醒脑静注射液治疗急性脑出血患者临床疗效及对血清炎症因子、氧化应激的影响[J].中国实验方剂学杂志,2017,23(19):186-190.
[10]乔潜林,白新学,刘海玉,等.醒脑静注射液对脑出血合并肺部感染患者神经功能与凝血功能和炎性指标的影响[J].中华医院感染学杂志, 2017, 27(17):3878-3881.
[11]朱廷芳.免疫营养对脑出血患者血清瘦素水平及预后影响的研究[J].实用临床护理学杂志,2016,1(7):26-27.
[12]孙永,姚凯华,李志锋,等.急性脑出血患者血浆、脑脊液β-内啡肽、GnRH水平变化对脑损伤程度及预后的影响[J].山东医药,2017,57(29):26-29.