世界中医药

目的：观察谷红注射液对脑缺血再灌注损伤的临床疗效,及对肿瘤坏死因子(TNF-α)的影响。方法:随机选取2011年2月至2016年6月,于我院神经科住院部就诊的脑缺血再灌注损伤患者60例,以就诊先后顺序编号,单盲随机数字表法分为观察组和对照组,每组30例。观察组患者中女19例,男11例;年龄41~74岁,平均年龄(56.04±9.41)岁。对照组患者中女17例,男13例;年龄42~73岁,平均年龄(53.82±8.26)岁。2组性别、年龄差异无统计学意义(P>0.05)。运动功能评定:治疗前后采用Fugl-Mayer评估量表(FMA)评估患者的偏瘫肢体运动功能;治疗前后采用改良Barthel指数(mBI)评估患者日常生活活动能力(ADL)包括独立生活的能力和技巧熟练程度。采用酶联免疫吸附试验(ELISA)检测肿瘤坏死因子-α(TNF-α)。结果:2组治疗后FMA评分均高于治疗前(P<0.05);与对照组相比,观察组治疗后FMA评分均较高(P<0.05)。治疗后,观察组mBI量表评分明显提高,与治疗前和对照组治疗后比较,差异均有统计学意义(P<0.01)治疗后,2组TNF-α表达水平明显下降,观察组治疗后与观察组治疗前、对照组治疗后比较,差异均有统计学意义(P<0.01)。将脑缺血再灌注患者FMA、mBI和TNF-α进行相关性分析,结果显示,与FMA相比,r=-0.971,P=0.000<0.05;与mBI相比,r=-0.969,P=0.000<0.05,两者均呈负相关。结论:谷红注射液能有效改善脑缺血再灌注损伤患者的肢体运动功能障碍,同时下调TNF-α表达水平,其疗效机制可能与下调TNF-α表达水平有关。

English Summary:

To observe the clinical effect of Guhong Injection on cerebral ischemia reperfusion injury and its effect on the tumor necrosis factor (TNF-α). Methods:A total of 60 cerebral ischemia reperfusion injury cases during February 2011 to June 2016 in the Department of Neurology in our hospital were randomly selected by the visiting sequence numbers, and single blind randomized digital table method was used to divide them into observation group and control group, each group with 30 cases. The observation group had 19 female and 11 male patients, aged 41-74, average age (56.04±9.41). Control group, 17 cases female, 13 male cases; age 42-73, average age (53.82±8.26). There were no significant differences in gender and age between the two groups (P>0.05). Motor function was evaluated before and after treatment with Fugl-Mayer assessment table in patients with hemiplegia limb motor function assessment (FMA). Activities of daily living (ADL) of patients was evaluated before and after treatment with Modified Barthel Index (MBI) assessment, including independent living skills proficiency. Tumor necrosis factor alpha (TNF-α) was detected by enzyme linked immunosorbent assay (ELISA). Results:After treatment, the FMA scores of the two groups were higher than before the treatment (P<0.05); the FMA scores of the observation group were significantly higher (P<0.05) than the control group. After treatment, observation group’s MBI questionnaire score improved significantly compared with before treatment and the control treatment group (P<0.01) after treatment, two groups’TNF-α expression levels decreased significantly. The observation group had a significant decrease compared with both observation group’s results before the treatment, and control group after treatment, (P<0.01). As for the correlation analysis between FMA, mBI and TNF-αin patients with cerebral ischemia reperfusion, the results showed that compared with r=-0.971, FMA, P=0.000<0.05, and mBI compared with r=-0.969, P=0.000<0.05, both were negatively correlated. Conclusion:Guhong injection can effectively improve the limb motor dysfunction in patients with cerebral ischemia reperfusion injury, and help decrease the expression level of TNF-α. Its therapeutic mechanism may be related to the down-regulation of TNF-α expression level.

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