逐瘀安脑丸对高血压性脑出血患者临床疗效及炎症因子影响
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摘要
目的:观察逐瘀安脑丸对高血压性脑出血患者临床疗效及炎症因子的影响。方法:将2015年5月—2017年10月我院收治的84例出血量在15～40 mL的高血压脑出血患者,随机分为治疗组和对照组,最后完成本研究的有治疗组39例,对照组41例。对照组给予常规西药治疗,治疗组加用逐瘀安脑丸,运用双抗体夹心ELISA法分别检测治疗前后两组患者空腹的血清IL-6、IL-1β、TNF-α水平,并记录两组治疗前、治疗后7 d、治疗后28 d的NIHSS评分。结果:治疗组总有效率达92.3%,优于对照组的68.3%(P<0.05);两组患者治疗后NIHSS评分明显降低,治疗组显著优于对照组,差异具有统计学意义(P<0.05);治疗7、14 d后两组患者的血清IL-6、IL-1β、TNF-α浓度均较治疗前下降,治疗组显著低于对照组,差异具有统计学意义(P<0.05)。结论:逐瘀安脑丸结合常规西药与单纯西药治疗高血压性脑出血相比,其对改善患者的神经功能、降低炎症因子水平和提高临床疗效作用更显著。
Objective:To observe the effect of Zhuyu Annao Pill on the clinical efficacy and inflammatory factors in patients with hypertensive intracerebral hemorrhage. Methods:84 cases of hypertensive intracerebral hemorrhage from 15 to 40 mL in our hospital from May 2015 to October 2017 were randomly divided into the treatment group and the control group. At last,39 cases were treated in the treatment group and 41 cases in the control group. The control group was treated with conventional Western medicine,and the treatment group was added with Zhuyu Annao pill,and the serum IL-6,IL-1β and TNF-α levels of the two groups were measured by double antibody sandwich ELISA,and the NIHSS scores of 7 d and 28 d were recorded before and after treatment in two groups. Results:The total effective rate of the treatment group was 92.3%,superior to 68.3% in the control group(P<0.05). The NIHSS scores of the two groups were significantly lower after treatment,and the treatment group was significantly better than the control group(P<0.05). The serum levels of IL-6,IL-1β and TNF-α in the two groups after 7 and 14 d were lower than those before the treatment,and the treatment group was significantly lower than those in the treatment group. The difference between the control group and the control group was statistically significant(P<0.05). Conclusion:Compared with Western medicine,Zhuyu Annao Pill combined with conventional Western medicine is more significant in improving the neurologic function,reducing the level of inflammatory factors and improving the clinical effect.
Objective:To observe the effect of Zhuyu Annao Pill on the clinical efficacy and inflammatory factors in patients with hypertensive intracerebral hemorrhage. Methods:84 cases of hypertensive intracerebral hemorrhage from 15 to 40 mL in our hospital from May 2015 to October 2017 were randomly divided into the treatment group and the control group. At last,39 cases were treated in the treatment group and 41 cases in the control group. The control group was treated with conventional Western medicine,and the treatment group was added with Zhuyu Annao pill,and the serum IL-6,IL-1β and TNF-α levels of the two groups were measured by double antibody sandwich ELISA,and the NIHSS scores of 7 d and 28 d were recorded before and after treatment in two groups. Results:The total effective rate of the treatment group was 92.3%,superior to 68.3% in the control group(P<0.05). The NIHSS scores of the two groups were significantly lower after treatment,and the treatment group was significantly better than the control group(P<0.05). The serum levels of IL-6,IL-1β and TNF-α in the two groups after 7 and 14 d were lower than those before the treatment,and the treatment group was significantly lower than those in the treatment group. The difference between the control group and the control group was statistically significant(P<0.05). Conclusion:Compared with Western medicine,Zhuyu Annao Pill combined with conventional Western medicine is more significant in improving the neurologic function,reducing the level of inflammatory factors and improving the clinical effect.
引文
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[9]秦锐,费夕,熊晓雯,等.益气活血通络汤对气虚血瘀型脑出血患者运动功能的影响[J].辽宁中医杂志,2017,44(2):331-333.
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[11]金凡,侯博儒,任海军,等.肿瘤坏死因子与脑出血后继发性脑损伤[J].中国临床神经外科杂志,2010,15(9):569-572.
[12]HUA Y,WU J,Keep RF,et al. Tumor necrosis factor-alpha increases in the brain after intracerebral hemorrhage and thrombin stimulation[J].Neurosurgery,2006,58(3):542-550.
[13]黄承红,蔡志友,曾令琼,等.依达拉奉对脑出血患者血清IL-1β、TNF-α影响的研究[J].重庆医学,2008,37(7):778-729.
[14]张明伟,彭俊,刘阳,等.高血压脑出血患者血清和颅内血肿液中IL-1β、IL-6、TNF-α的含量研究[J].中华神经外科疾病研究杂志,2010,9(2):138-141.
[15]吴林,李文娅,张其瑞,等.逐瘀安脑丸对大鼠实验性脑出血后水通道蛋白4、铁离子表达及脑水肿的作用研究[J].时珍国医国药,2010,21(2):383-385.
[16]郑福奎,吴林,陈炜,等.逐瘀安脑方治疗急性期脑出血临床研究[J].中国中医急症,2011,7(10):1555-1556.
[17]CHEN Wei,HU Yueqiang,JIANG Lingfei,et al. Mechanism of action of Zhuyu Annao pill in mice with cerebral intrahemorrhage based on TLR4[J].Asian Pac J Trop Med,2016,9(11):1095-1100.
[18]张玥.脑出血早期运用活血化瘀法对其预后的影响[J].辽宁中医杂志,2004,31(6):478.
[19]ZHAO X,ZHANG Y,Strong R,et al. Distinct patterns of intrace rebral hemorrhage-induced alerations in NF-kappaBsubunit,NOS,and COX-2 expression[J]. J Neur Ochem,2007,101(3):652.
[2]程昭昭,王国平,任明山.急性脑出血的血肿扩大与血清总胆固醇和低密度脂蛋白胆固醇的关系[J].中华老年心脑血管病杂志,2013,15(6):611-613.
[3]刘晓静,张拥波,李继梅.炎症与脑出血的靶向治疗[J].中国卒中杂志,2013,8(4):272.
[4]WassermanJK,ZhuX,SchlichterLC.Evolutionofthe inflammatory response in the brain following intracerebra lhemor rhage and effects of delayed minocy cline treatment[J].Brain Res,2007,1180:140.
[5]陈清棠.脑卒中患者神经功能缺损评分标准[J].中华神经科杂志,1996,29(6):381.
[6]张健,陈干涛.急性脑出血患者IL-6和TNF-α水平与预后的关系[J].实用癌症杂志,2012,27(6):652-657.
[7]海兴华,李华南,张玮,等.针灸治疗脑出血急性期累积Meta分析[J].辽宁中医杂志,2017,44(12):2613-2616.
[8]闻梓钧,董明,耿煜,等.脑心通胶囊治疗高血压脑出血的临床观察[J].辽宁中医杂志,2016,43(4):791-792.
[9]秦锐,费夕,熊晓雯,等.益气活血通络汤对气虚血瘀型脑出血患者运动功能的影响[J].辽宁中医杂志,2017,44(2):331-333.
[10]刘泰,高玉广,武丽,等.脑出血急性期病因病机变化规律之管见[J].辽宁中医杂志,2015,42(6):1221-1222.
[11]金凡,侯博儒,任海军,等.肿瘤坏死因子与脑出血后继发性脑损伤[J].中国临床神经外科杂志,2010,15(9):569-572.
[12]HUA Y,WU J,Keep RF,et al. Tumor necrosis factor-alpha increases in the brain after intracerebral hemorrhage and thrombin stimulation[J].Neurosurgery,2006,58(3):542-550.
[13]黄承红,蔡志友,曾令琼,等.依达拉奉对脑出血患者血清IL-1β、TNF-α影响的研究[J].重庆医学,2008,37(7):778-729.
[14]张明伟,彭俊,刘阳,等.高血压脑出血患者血清和颅内血肿液中IL-1β、IL-6、TNF-α的含量研究[J].中华神经外科疾病研究杂志,2010,9(2):138-141.
[15]吴林,李文娅,张其瑞,等.逐瘀安脑丸对大鼠实验性脑出血后水通道蛋白4、铁离子表达及脑水肿的作用研究[J].时珍国医国药,2010,21(2):383-385.
[16]郑福奎,吴林,陈炜,等.逐瘀安脑方治疗急性期脑出血临床研究[J].中国中医急症,2011,7(10):1555-1556.
[17]CHEN Wei,HU Yueqiang,JIANG Lingfei,et al. Mechanism of action of Zhuyu Annao pill in mice with cerebral intrahemorrhage based on TLR4[J].Asian Pac J Trop Med,2016,9(11):1095-1100.
[18]张玥.脑出血早期运用活血化瘀法对其预后的影响[J].辽宁中医杂志,2004,31(6):478.
[19]ZHAO X,ZHANG Y,Strong R,et al. Distinct patterns of intrace rebral hemorrhage-induced alerations in NF-kappaBsubunit,NOS,and COX-2 expression[J]. J Neur Ochem,2007,101(3):652.