通腑化瘀导痰汤对重型颅脑损伤血清S-100β、NSE及预后的影响

The Effect of Tongfu Huayu Daotan Decoction on Concentrations of Serum S-100β, NSE and Prognosis in Patients with Severe Craniocerebral Injury

目的探讨通腑化瘀导痰汤对重型颅脑损伤血清S-100β蛋白及血清神经元特异性烯醇化酶（NSE）浓度变化及预后的影响。方法将60例重型颅脑损伤患者随机分为对照组和治疗组，对照组采用西医综合治疗，治疗组予通腑化瘀导痰汤加西医综合治疗。两组患者分别于入院时，治疗后24h、36h、72h、5d及7d抽血进行血清S-100β蛋白及血清神经元特异性烯醇化酶（NSE）浓度检测，并于伤后第2周及第4周用GOS预后分级方法及神经功能缺损评分评定临床疗效，将所得数据进行统计学分析。结果入院时、治疗后24h及36h两组血清NSE、S-100β蛋白含量无显著性差异（P〉0.05）；治疗后．72h，5d，7d，治疗组血清NSE、S-100β蛋白含量明显降低（P〈0.01）；治疗后治疗组GOS预后分级评分及神经功能缺损评分明显优于对照组（P〈0.01）。结论通腑化瘀导痰汤能降低重型颅脑损伤患者血清S-100β蛋白及血清神经元特异性烯醇化酶（NSE）含量，结合西医综合治疗能提高重型颅脑损伤GOS预后分级、神经功能缺损评分和临床疗效。

Objective To explore the effects of Tongfu Huayu Daotan Decoction （通腑化瘀导痰汤）on the serum concentration of S-1001~ protein, neuron-specific enolase（NSE） and Prognosis in patients with severe craniocerebral injury. Methods Sixty patients with severe craniocerebral injury were randomly divided into a treatment group and a control group. The treated group was treated with Tongfu Huayu Daotan Decoction plus conventional treatments including dehydration, antibiotics, organ functional support, nerve nutrition, prevention of complication, etc.; the control group was treated with conventional treatments alone. The concentration of serum S-100β protein and neuron-specific enolase（NSE） in plasma at admission and at24, 36, 72huors, and 5, 7 days after treatment were determined respectively; the Glasgow outcome scale （CA）S） and neurological deficits scoring at 2weeks and 4weeks after hospitalization were compared to observe the efficacy of the patients. Results The concentration of serum S-100β protein and neuron-specific enolase （NSE） in plasma at previous treatment and at 24, 36 hours after the treatment had no statistical difference in the two groups（P〉0.05 ）. The concentration of serum S-100β protein and neuron-specific enolase （NSE） in plasma at 72huors, 5 and 7 days after the treatment in the Tongfu Huayu Daotan Decoction group were lower than those in the control group, the differences being significant （P〈0.01）. The Glasgow outcome scale （GOS） and neurological deficits scoring at 2weeks and 4weeks after the treatment in the Tongfu Huayu Daotan Decoction group were significantly higher than those in the control group, the differences being significant （P 〈0.01） .Conclusion Tongfu Huayu Daotan Decoction can alleviate the plasma concentrations of S-100β protein and neuron-specific enolase （NSE） in patients with severe craniocerebral injury and markedly improve the clinical therapeutic effects. Combined Tongfu Huayu Daotan Decoction and western medicine can significantly reduce mortality and improve the Glasgow outcome scale （GOS）, neurological deficits scoring and therapeutic effect.