醒脑静注射液对外伤性颅脑损伤疗效的研究
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摘要
目的探讨醒脑静注射液对外伤性颅脑损伤疗效的研究。方法选取北京朝阳中西医结合出诊抢救中心2013年12月至2015年7月收治符合纳入标准的外伤性颅脑损伤患者72例。其中对照组36例,予以营养脑细胞、脑保护治疗及早期功能康复训练;研究组36例,在对照组治疗方案基础上予以醒脑静注射液治疗,共治疗14 d。比较治疗前后GCS、MoCA、NIHSS评分及治疗后GOS评分,治疗前后采血测定炎症介质,神经损伤蛋白及离子水平,对比临床疗效及不良反应。结果与治疗前比较,两组治疗后GCS、MoCA评分升高,NIHSS评分降低(P<0.05);与对照组比较,研究组治疗后GCS、GOS、MoCA评分较高,NIHSS评分较低(P<0.05)。与治疗前比较,两组治疗后血清hs-CRP、TNF-α、IL-6以及IL-18含量降低(P<0.05);与对照组比较,研究组治疗后血清hs-CRP、TNF-α、IL-6以及IL-18含量较低(P<0.05)。与治疗前比较,两组治疗后血清GFAP、MBP、NSE以及S100β含量降低(P<0.05);与对照组比较,研究组治疗后血清GFAP、MBP、NSE以及S100β含量较低(P<0.05)。与治疗前比较,两组治疗后血清Ca~(2+)、Zn~(2+)以及Mg~(2+)含量升高(P<0.05);与对照组比较,研究组治疗后血清Ca~(2+)、Zn~(2+)以及Mg~(2+)含量较高(P<0.05)。对照组有效率69.44%,与研究组有效率88.89%对比,差异有统计学意义(P<0.05)。对照组不良反应发生率13.89%,研究组不良反应发生率16.67%,两组间无明显差异(P>0.05)。结论醒脑静注射液对外伤性颅脑损伤具有良好疗效,可降低神经损伤及炎症指标,提高离子水平,值得推广。
Objective To study the clinical effect of Xingnaojing Injection in traumatic brain injury. Methods Seventy-two patients with traumatic head injury admitted from December 2013 to July 2015 were randomly divided into control group and study group(n = 36). The control group received nourishment Brain cells and brain protection,the study group received Xingnaojing Injection in addition to nutrition brain cells and brain protection. Both groups were treated for 14 days. Blood samples were taken for the measurement of levels of inflammatory mediators,nerve injury and ion,levels of GCS,GOS,MoCA and NIHSS scores. The clinical efficacy and adverse reactions were compared. Results Compared to those before treatment,serum levels of GCS,MoCA,NIHSS,hs-CRP,TNF-α,IL-6 and IL-18 in the two groups significantly decreased,levels of GFAP,MBP,NSE and S100β decreased,and levels of Ca~(2+),Zn~(2+)and Mg~(2+)in serum increased(P < 0. 05). Compared to the control group,the scores of GCS,GOS and MoCA in the study group were higher,the NIHSS score was lower,the serum levels of hs-CRP,TNF-α,IL-6 and IL-18 were lower,levels of GFAP,MBP,NSE and levels of Ca~(2+),Zn~(2+)and Mg~(2+)in serum were higher(P < 0. 05). The effective rate in the control group(69. 44%) was lower than the study group(88. 89%),P < 0. 05. There was no significant difference between the two groups(P > 0. 05). Conclusion Xingnaojing injection is effective for traumatic brain injury,reducing the nerve injury and inflammation index and improving the ion level,and is worth popularized.
Objective To study the clinical effect of Xingnaojing Injection in traumatic brain injury. Methods Seventy-two patients with traumatic head injury admitted from December 2013 to July 2015 were randomly divided into control group and study group(n = 36). The control group received nourishment Brain cells and brain protection,the study group received Xingnaojing Injection in addition to nutrition brain cells and brain protection. Both groups were treated for 14 days. Blood samples were taken for the measurement of levels of inflammatory mediators,nerve injury and ion,levels of GCS,GOS,MoCA and NIHSS scores. The clinical efficacy and adverse reactions were compared. Results Compared to those before treatment,serum levels of GCS,MoCA,NIHSS,hs-CRP,TNF-α,IL-6 and IL-18 in the two groups significantly decreased,levels of GFAP,MBP,NSE and S100β decreased,and levels of Ca~(2+),Zn~(2+)and Mg~(2+)in serum increased(P < 0. 05). Compared to the control group,the scores of GCS,GOS and MoCA in the study group were higher,the NIHSS score was lower,the serum levels of hs-CRP,TNF-α,IL-6 and IL-18 were lower,levels of GFAP,MBP,NSE and levels of Ca~(2+),Zn~(2+)and Mg~(2+)in serum were higher(P < 0. 05). The effective rate in the control group(69. 44%) was lower than the study group(88. 89%),P < 0. 05. There was no significant difference between the two groups(P > 0. 05). Conclusion Xingnaojing injection is effective for traumatic brain injury,reducing the nerve injury and inflammation index and improving the ion level,and is worth popularized.
引文
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[14]徐元虎.醒脑静注射液的药理药效学研究与临床应用现状[J].现代中西医结合杂志,2010,19(4):507-510.
[15]李勇,陈之力.创伤性颅脑损伤患者血清、脑脊液中IL-18含量动态变化的临床意义及与预后的关系[J].中国农村卫生事业管理,2016,36(2):269-270.
[16]张垣,黄建平,陈炳,等.小牛血去蛋白提取物联合高压氧对重型颅脑损伤患者hs-CRP、TNA-α、IL-6的影响及其临床疗效[J].中国生化药物杂志,2016,36(4):170-172.
[17]黄川峰.醒脑静注射液对脑缺再灌注损伤小鼠血清IL-6和TNF-α水平影响[J].中国实用医药,2012,7(35):244-245.
[18]李庆禄,李宁,王文智,等.GFAP、MBP在早期脑挫裂伤诊断中的价值[J].国际检验医学杂志,2014,35(20):2756-2757.
[19]韩潇,王莹洁,朱昌来,等.醒脑静注射液在体外循环家兔的脑保护作用[J].江苏医药,2014,40(3):258-260.
[20]李建伟,张赛.镁离子对创伤性颅脑损伤的脑保护作用的研究进展[J].武警后勤学院学报(医学版),2006,15(6):617-619.
[21]于荣三,李凤英,孙龙,等.血清钠钾钙镁锌五种离子检查在颅脑损伤中的临床意义[J].中国误诊学杂志,2011,11(12):2883-2884.
[22]顾丽君.醒脑静注射液的药理药效分析及其临床应用研究[J].亚太传统医药,2013,9(1):153-154.
[2]张小年,张皓.创伤性颅脑损伤国内研究进展[J].中国康复理论与实践,2008,14(2):101-104.
[3]范成普,杜杭根,田勇.醒脑静注射液在创伤性脑损伤应用研究进展[J].浙江中西医结合杂志,2015,25(1):96-99.
[4]史玉虎,焦常新,赵标,等.醒脑静注射液治疗重度颅脑损伤疗效观察[J].中医药临床杂志,2012,24(6):518-519.
[5]中华医学会.临床诊疗指南,神经外科学分册[M].人民卫生出版社,2013:25-27.
[6]中国医师协会神经外科医师分会.中国颅脑创伤病人脑保护药物治疗指南[J].中华神经外科杂志,2008,24(10):723-724.
[7]曾实,王昊,许民辉,等.颅脑冲击伤临床诊疗规范(建议)[J].中华创伤杂志,2014,30(11):1067-1069.
[8]中国康复医学会康复护理专业委员会.颅脑创伤临床康复护理策略专家共识[J].护理学杂志,2016,31(18):1-6.
[9]Healey C,Osler TM,Rogers FB,et al.Improving the Glasgow Coma Scale score:motor score alone is a better predictor[J].J Tramua,2003,54(4):671-678.
[10]Wright J.Glasgow Outcome Scale[J].Encyclopedia Clin Neuropsychol,2011:1150-1152.
[11]Nasreddine ZS,Phillips NA,Bédirian V,et al.The Montreal Cognitive Assessment,Mo CA:a brief screening tool for mild cognitive impairment[J].J Am Geriatr Soc,2005,53(4):695-699.
[12]Dunning K.National Institutes of Health Stroke Scale[J].Encyclopedia Clin Neuropsychol,2011,9(1):1714-1715.
[13]苏敏,徐鹏.血必净注射液对重型颅脑损伤患者血清TNF-α、IL-6水平的影响[J].山东医药,2012,52(9):53-54.
[14]徐元虎.醒脑静注射液的药理药效学研究与临床应用现状[J].现代中西医结合杂志,2010,19(4):507-510.
[15]李勇,陈之力.创伤性颅脑损伤患者血清、脑脊液中IL-18含量动态变化的临床意义及与预后的关系[J].中国农村卫生事业管理,2016,36(2):269-270.
[16]张垣,黄建平,陈炳,等.小牛血去蛋白提取物联合高压氧对重型颅脑损伤患者hs-CRP、TNA-α、IL-6的影响及其临床疗效[J].中国生化药物杂志,2016,36(4):170-172.
[17]黄川峰.醒脑静注射液对脑缺再灌注损伤小鼠血清IL-6和TNF-α水平影响[J].中国实用医药,2012,7(35):244-245.
[18]李庆禄,李宁,王文智,等.GFAP、MBP在早期脑挫裂伤诊断中的价值[J].国际检验医学杂志,2014,35(20):2756-2757.
[19]韩潇,王莹洁,朱昌来,等.醒脑静注射液在体外循环家兔的脑保护作用[J].江苏医药,2014,40(3):258-260.
[20]李建伟,张赛.镁离子对创伤性颅脑损伤的脑保护作用的研究进展[J].武警后勤学院学报(医学版),2006,15(6):617-619.
[21]于荣三,李凤英,孙龙,等.血清钠钾钙镁锌五种离子检查在颅脑损伤中的临床意义[J].中国误诊学杂志,2011,11(12):2883-2884.
[22]顾丽君.醒脑静注射液的药理药效分析及其临床应用研究[J].亚太传统医药,2013,9(1):153-154.