醒脑静对自发性脑出血患者血清基质金属蛋白酶-9及神经功能的影响

Effects of Xingnaojing on expression of matrix metalloprotei-nase-9 and neurological function in patients with intracerebral hemorrhage

目的 观察醒脑静对自发性脑出血患者血清基质金属蛋白酶-9（MMP-9）及神经功能的影响.方法 将2010年3月～2013年6月在桐乡市中医医院住院的自发性脑出血患者随机分为观察组和对照组,各50例,对照组按指南给予常规治疗,观察组在常规治疗基础上加用醒脑静治疗,疗程14 d,观察两组患者治疗前后血清MMP-9水平及神经功能变化,第28天评价总体疗效.结果 脑出血后血清MMP-9在病程第3天达高峰,观察组为（15129±29.64）ng/mL,对照组为（159.07±31.02）ng/mL,差异无统计学意义（P＞0.05）,后逐步下降,观察组与对照组第5天[（131.22±26.59） ng/mL比（142.42±25.04） ng/mL]差异有统计学意义（P＜0.05）,第7天[（85.26±15.20）ng/mL比（108.66±19.65）ng/mL）]差异有高度统计学意义（P＜0.01）,第14天均下降至基本正常水平.第14天观察组NIHSS评分[（7.38±2.44）分]低于对照组[（8.46±3.41）分],但差异无统计学意义（P＞0.05）,第28天观察组NIHSS评分为（5.52±2.48）分,明显低于对照组[（6.88±3.07）分],差异有统计学意义（P＜0.05）.观察组总体疗效为84.00％,优于对照组（74.00％）（P＜0.05）.结论 醒脑静可改善自发性脑出血患者神经功能,提高临床疗效,其治疗机制可能与降低血清MMP-9水平有关.

Objective To observe the effects of Xingnaojing Injection on expression of matrix metalloproteinase-9 （MMP-9） and neurological function in patients with intraeerebral hemorrhage （ICH）. Methods 100 cases in Tongxiang Traditional Chinese Medicine Hospital from March 2010 to June 2013 were randomly divided into control group and observation group, each of 50 patients, control group was treated with conventional method according to the guideline, and observation group was treated with the methods above-mentioned and Xingnaojing Injection. Course of treatment was 14 days. Before and after treatment, MMP-9 level and neurological function changes were noted. Results After cerebral hemorrhage, MMP-9 peaked on day 3, which was （151.29±29.64） ng/mL in observation group and （159.07± 31.02） ng/mL in control group, there was no statistical significance （P 〉 0.05）, then gradually declined, on day 5, there was statistical significance between observation group and control group [（131.22±26.59） ng/mL vs （142.42±25.04） ng/mL] （P 〈 0.05）; on day 7, there was notable statistical significance between the two groups [（85.26±15.20） ng/mL vs （108.66±19.65） ng/mL] （P 〈 0.01）, on day 14, MMP-9 level of two groups were decreased to normal. On day 14, the NIHSS scores of observation group [（7.38±2.44） points] were lower than the control group [（8.46±3.41） points], there was no sta- tistical significance （P 〉 0.05）, but on day 28, the NIHSS scores of observation group [（5.52±2.48） points] were reduced much more than the control group [（6.88±3.07） points], there was statistical significance （P 〈 0.05）. Also, the overall ef- ficacy of observation group was 84.00%, better than the control group （74.00%） （P 〈 0.05）. Conclusion Xingnaojing In- jection can improve neurological function of the patients with ICH, enhance clinical efficacy, the mechanization maybe related to declining the serum MMP-9.