川芎嗪对重度脑损害脑功能保护的量化研究

Tetramethylpyrazine protects brain function from severe brain injury in patients： quantitativeresearch

目的利用数字化实时脑功能监测仪及临床指标探讨早期应用川芎嗪对重度脑损害昏迷患者脑功能保护的作用疗效。方法随机对照分析2006年1月至2012年5月深圳市人民医院神经外科和急诊中心急性重度脑损害、Glasgow-Pittsburgh昏迷评分7～20分、发病24h内就诊且存活2周以上的患者共364例，随机（随机数字法）分成川芎嗪干预组186例和对照组178例，两组间除应用川芎嗪外其他治疗均相同。利用数字化脑状态监测仪（cerebralstatemonitor，CSM）获取患者治疗前和治疗后3d、7d及14d时的量化脑功能指标：脑状态指数（cerebralstateindex，CSI），同时记录临床指标（Glasgow—Pittsburgh评分）．两组病例治疗前后各指标统计学处理采用重复测量设计的方差分析。结果经重复测量设计的方差分析证实，在治疗后的第3、7和14天内川芎嗪干预组比对照组的脑功能指标（CSI）及临床指标（Glasgow—Pittsburgh评分）随时间变化更快、改善幅度更大，且差异有统计学意义（P=0．024）。结论早期应用川芎嗪能够保护重度脑损害昏迷患者的脑功能。

Objective To investigate the effect of Tetramethylpyrazine （extracted from Chinese herbal medicine Ligusticum wallichii） employed in the early stage of severe brain injury on the restoration of brain function in coma patients monitored with digitized cerebral state monitor and clinical signs. Methods A total of 364 patients were referred to us from Emergency Department and Neurosurgery Department, Shenzhen People＇s Hospital from January 2006 through May 2012. The scores of patients＇Glasgow- Pittsburgh coma scales were between 7 - 20 as brain injury happened within 24 h and survived more than two weeks. All patients were randomly （random number） divided into two groups： Tetramethylpyrazine group （n = 186） and control group （n---178）. The patients of control group received routine treatment, and the patients of Tetramethylpyrazine group were treated with Tetramethylpyrazine in addition to routine treatment in early stage. The patients of two groups were assessed with cerebral state indexes （CSI） and Glasgow- Pittsburgh coma scales before treatment and 3, 7, 14 days after treatment. Statistical comparisons between groups were analyzed by using repeated measure design analysis of variance. Results A repeated measures design analysis of variance indicated that the CSI and clinical signs （ Glasgow-Pittsburgh coma scale） were improved significantly in Tetramethylpyrazine group than those in the control group at 3, 7, 14 days after treatment （P = 0. 024）. Conclusions Tetramethylpyrazine can protect brain function and improve clinicalsigns in patients with severe brain injury in the early stage.