世界中医药

目的:探讨安宫牛黄丸配合西药尼莫地平对高血压脑出血(HICH)患者临床效果的影响。方法:选取2016年4月至2017年4月沈阳市第二中医院收治的HICH患者92例作为研究对象,按照用药方案不同,分为观察组(n=47)和对照组(n=45)。观察组以安宫牛黄丸结合尼莫地平治疗,对照组单纯使用西药尼莫地平治疗。检测2组治疗前、治疗7 d后血清神经递质,治疗3个月后的日常生活活动Barthel指数、应激激素指标变化,记录治疗7 d内的不良反应。结果:1)观察组在用药后,血清神经递质指标NTF(5.64±0.91)ng/mL、GABA(9.14±1.15)μmol/L、NGF(87.92±3.64)pg/mL显著高于对照组,Glu(70.89±3.04)μmol/L、NPY(169.46±7.32)μg/L、NSE(12.58±1.08)μg/L、Gly(227.52±17.63)μmol/L、Asp(27.23±1.58)U/L显著低于对照组(P<0.05);2)观察组在用药后,血清应激激素指标AD(0.50±0.16)ng/mL、Cor(275.12±10.25)nmol/L显著高于对照组,CRH(7.54±1.26)pmol/L、NE(322.13±10.62)ng/L、Ang-Ⅱ(41.62±3.01)ng/L、ACTH(6.54±0.75)pmol/L、MDA(3.22±0.46)nmol/mL、AVP(2.18±0.67)ng/L显著低于对照组(P<0.05);3)观察组在用药后日常生活活动Barthel指数总分(81.15±4.62)分显著高于对照组(64.48±3.78)分(P<0.05);4)观察组不良反应率(14.89%)和对照组(17.78%)差异无统计学意义(P>0.05)。结论:对于HICH患者,在西药尼莫地平治疗基础上,增加中药安宫牛黄丸治疗能够有效改善患者神经递质、应激激素表达水平,提高患者日常生活能力,不良反应较低。

English Summary:

To investigate the clinical effects of Angong Niuhuang Pills combined with nimodipine for the treatment of hypertensive intracerebral hemorrhage(HICH). Methods:From April 2016 to April 2017，92 patients with HICH were selected in Second Traditional Chinese Medicine Hospital of Shenyang. According to the different medication schemes，they were divided into the observation group(47 cases)and the control group(45 cases). The observation group was treated with Angong Niuhuang Pills combined with nimodipine，and the control group was treated with nimodipine alone. The serum neurotransmitters were detected before and after 7 days of the treatment in both groups. After 3 months of treatment，the changes of Barthelindex，stress hormone index were detected and the side effects were recorded within 7 days during the treatment. Results:1)In the study group after medication，the serum neurotransmitters NTF(5.64±0.91)ng/mL，GABA(9.14±1.15)μmol/L，NGF(87.92±3.64)pg/mL were significantly higher than those of the control group. Glu(70.89±3.04)μmol/L，NPY(169.46±7.32)μg/L，NSE(12.58±1.08)μg/L，Gly(227.52±17.63)μmol/L，Asp(27.23±1.58)U/L were significantly lower than those of the control group(P<0.05). 2)In the study group，the serum stress hormone index AD(0.50±0.16)ng/mL，Cor(275.12±10.25)nmol/L were significantly higher than that of the control group. CRH(7.54±1.26)pmol/L，NE(322.13±10.62)ng/L，Ang-Ⅱ(41.62±3.01)ng/L，ACTH(6.54±0.75)pmol/L，MDA(3.22±0.46)nmol/mL，AVP(2.18±0.67)ng/L were significantly lower than that of the control group(P<0.05). 3)The total Barthel index score of the study group(81.15±4.62)was significantly higher than that of the control group(64.48±3.78)(P<0.05). 4)There was no significant difference in the adverse reaction rate between the study group(14.89%)and the control group(17.78%)(P<0.05). Conclusion:For the patients with HICH，on the basis of the western medicine nimodipine，the addition of Angong Niuhuang Pills can effectively improve the neurotransmitter，stress hormone expression and improve the ability of daily life for patients，and the side effects are less.

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