清热解毒法治疗大、中等面积急性脑梗死及对CD_(62)P、TNF-α、IL-6活性的影响

The Effect of Clearing Heat and Toxin Therapy on Activities of CD_(62)P,TNF-α,IL-6 in Patients with Extensive and Medium Acute Cerebral infarction

目的观察清热解毒法治疗大、中等面积急性脑梗死(ACI)的疗效。方法将65例大、中等面积ACI患者随机分为两组,治疗组33例采用西医常规治疗加清热解毒中药和醒脑静注射液,对照组32例给予西医常治疗加胞二磷胆碱注射液;测定两组治疗前后血小板CD62P阳性表达率与TNF-α、IL-6水平,并与30例健康人组作对照相关分析,同时观察临床疗效及神经功能缺损评分情况。结果ACI患者CD62P表达与TNF-α、IL-6均显著高于健康人组,ACI患者CD62P表达与TNF-α、IL-6水平呈正相关;实热证患者CD62P与TNF-α、IL-6水平明显高于非实热证患者;治疗组治疗后CD62P与TNF-α、IL-6水平的降低较对照组显著,总有效率亦明显高于对照组。结论清热解毒法对大、中等面积ACI的作用机制与其抑制血小板活化增强、减轻细胞因子介导的中枢神经系统免疫应答及炎症损伤等有关。

Objective:To observe the effect of Clearing Heat and Relieving Toxin Therapy for extensive and mediun acute cerebral infarction (ACI).Method:65 cases with extensive and medium acute cerebral infarction were divided into two groups, the treatment group (33 cases) were given Clearing Heat and Toxin drug and Xingnaojing Injection,the control group were given CDPC Injcetion in addition toconventional treatment. The level of CD62P, TNF- α , IL- 6 before and after treatment were measured by flow cytometer and ECL method,and compared with that of 30 healthy people. Meanwhile the clinical curative effect and the neurological impairment scale were observed.Results:The level of CD62P, TNF- α , IL- 6 in ACI group were higher than that in healthy group. There was direct associated between the expression of CD62P and the level of TNF- α , IL- 6. The level of CD62P, TNF- α , IL- 6 in patients with Excess- Heat Syndrome were higher than patients with Deficiency- Heat Syndrome. After treatment the level of CD62P, TNF- α , IL- 6 in treatment group were much lower than that in control group. The total clinical effective rate of the treatment group was much higher than that of control group. Results: The mechanism of Clearing Heat and Toxin Therapy for extensivre and medium ACI were related to depress platelet activation, relieve immune responses and inflammatory damage mediated by cell factors in CNS.