醒脑静注射液在急性脑出血治疗中的临床疗效和安全性

doi:10.3969/j.issn.1673-7202.2019.03.027

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醒脑静注射液在急性脑出血治疗中的临床疗效和安全性
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                        10.3969/j.issn.1673-7202.2019.03.027
                    
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基金项目:国家自然科学基金项目（81300956）

Observation on the Safety and Efficacy of Xingnaojing Injection for the Treatment of Acute Cerebral Hemorrhage

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目的：探讨醒脑静注射液应用于急性脑出血患者治疗的临床疗效和安全性。方法：选取2016年5月至2017年5月盘锦市人民医院收治的急性脑出血患者103例作为研究对象，按照用药方案不同随机分为对照组(n=49)和观察组(n=54)。对照组在常规对症治疗基础上，应用依达拉奉治疗；观察组基于对照组，增加醒脑静注射液治疗，比较2组治疗前和治疗14 d后的脑血流指标、神经细胞因子、炎性反应递质变化情况，统计治疗14 d期间的有效率和不良反应率。结果：观察组脑源性神经营养因子(BDNF)(63.24±3.07)ng/L、血管内皮生长因子(VEGF)(503.38±16.28)ng/L显著高于对照组，神经胶质纤维酸性蛋白(GFAP)(0.76±0.27)ng/L、神经元特异性烯醇化酶(NSE)(7.38±1.24)μg/L、S100B蛋白(S-100B)(0.33±0.10)μg/L、髓鞘碱性蛋白(MBP)(1.29±0.36)μg/L、D-二聚体(208.59±8.16)μg/L、内皮素-1(ET-1)(6.24±0.59)ng/L显著低于对照组(P<0.05)；观察组纤维蛋白原(FN)(2.76±0.27)G/L显著高于对照组，白细胞介素-6(IL-6)(10.33±2.10)pg/mL、高迁移率族蛋白B1(HMGB1)(1.29±0.36)μg/L、降钙素原(PCT)(0.44±0.16)μg/L、IL-1β(87.38±7.24)pg/mL、α1-抗胰蛋白酶(α1-AT)(1.59±0.36)U/L、C反应蛋白(CRP)(7.38±1.28)mg/L、正水通道蛋白-4(AQP-4)(33.24±3.65)μg/mL显著低于对照组(P<0.05)；观察组血管搏动指数(PI)(0.96±1.28)、舒张压末期血流速度(EDV)(38.19±1.15)cm/s、收缩期峰值流速(PSV)(93.45±1.56)cm/s、血流速度(Vm)(56.43±2.58)cm/s高于对照组，阻力指数(RI)(0.47±0.22)低于对照组(P<0.05)；观察组在治疗14 d后的治疗有效率(94.44%)高于对照组(83.67%)(P<0.05)；不良反应率观察组(7.41%)和对照组(14.29%)差异有统计学意义(P<0.05)。结论：对于急性脑出血，临床上可在常规对症治疗、西医依达拉奉治疗基础上，增加中药醒脑静注射液，能有效提高治疗有效率，改善患者神经细胞因子、炎性反应递质含量，促进脑血流的恢复，药物安全性高。

Abstract:

To explore the clinical efficacy and safety of Xingnaojing Injection for the treatment of acute cerebral hemorrhage. Methods:From May 2016 to May 2017，103 cases of patients with acute cerebral were selected in People's Hospital of Panjin. According to the different treatment regimen，they were randomly divided into the control group(49 cases)and the study group(54 cases). Edaravone was used in the control group which based on conventional symptomatic treatment. For the study group，based on the control group，Xingnaojing injection was added. The cerebral blood flow index，nerve cell factor，inflammatory factor changes were compared between the 2 groups before treatment and 14 days after the treatment. The efficiency rate and adverse reaction rate were compared. Results:In study group，BDNF(63.24±3.07)ng/L，VEGF(503.38±16.28)ng/L were significant higher than the control group. GFAP(0.76±0.27)ng/L，NSE(7.38±1.24)μg/L，S-100B(0.33±0.10)μg/L，MBP(1.29±0.36)μg/L，D-dimer(208.59±8.16)μg/L，ET-1(6.24±0.59)ng/L were significant lower than the control group(P<0.05). In the study group，FN(2.76±0.27)G/L was significant higher than the control group. IL-6(10.33±2.10)pg/mL，HMGB1(1.29±0.36)μg/L，PCT(0.44±0.16)μg/L，IL-1β(87.38±7.24)pg/mL，α1-AT(1.59±0.36)U/L，CRP(7.38±1.28)mg/L，AQP-4(33.24±3.65)μg/mL were significant lower than the control group(P<0.05). In the study group，PI(0.96±1.28)，EDV(38.19±1.15)cm/s，PSV(93.45±1.56)cm/s，Vm(56.43±2.58)cm/s were significant higher than the control group. RI(0.47±0.22)was significant lower than the control group(P<0.05). The effective rate in the study group(94.44%)after the treatment for 14 days was significant higher than the control group(83.67%)(P<0.05). The adverse reaction rate of the study group(7.41%)was significant different from the control group(14.29%)(P>0.05). Conclusion:For the treatment of acute cerebral hemorrhage，on the basis of routine edaravone treatment，Chinese medicine Xingnaojing injection can effectively improve the treatment efficiency，the factor of nerve cells and inflammatory cytokines and promote the recovery of cerebral blood flow. The safety is higher.

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李震,陈磊,肖明,许峰.醒脑静注射液在急性脑出血治疗中的临床疗效和安全性[J].世界中医药,2019,(03).

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收稿日期:2018-10-31
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在线发布日期: 2019-04-01
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