安脑平冲片对脑出血微创术后患者神经功能恢复及脑水肿和水通道蛋白的影响

Effects of Annao Pingchong pill on recovery of neural nerve function, cerebral edema and aquaporin after minimally invasive surgery for intracerebral hemorrhage

目的观察安脑平冲片对基底核区脑出血微创术后神经功能恢复的疗效。方法选取基底核脑出血患者84例，按随机数字表法分为对照组和观察组，每组42例。两组患者均在cT引导下行微创碎吸术，对照组患者术后给予脱水降颅压、控制血压、防治感染、营养神经等西医基础治疗；观察组患者术后在西医治疗基础上加用安脑平冲片，每次4片，每日3次；两组患者疗程均为2周。治疗后观察两组临床疗效，于治疗前及治疗后1周和2周各进行1次中国脑卒中临床神经功能缺损程度评分（CSS）、格拉斯哥昏迷评分（GCS）测定；并观察两组患者脑水肿体积、血清水通道蛋白4（AQP4）水平。采用Pearson直线相关分析法分析血清AQP4与CSS评分和脑水肿体积的相关性。结果治疗后观察组总有效率明显高于对照组[90．5％（38／42）比73．8％（31／42），P〈0．01]；两组患者CSS、GCS评分均较治疗前有所改善，且观察组2周时优于对照组[CSS（分）：11．24±5．60比15．90±6．49，GCS（分）：13．57±1．68比11．98±2．04，均P〈0．05]；观察组治疗后各时间点脑水肿体积、AQP4水平均低于对照组，以治疗2周时最为明显，两组比较差异有统计学意义[脑水肿体积（mL）：4．05±1．20比7．67±2．43，AQP4（A值）：0．055±0．032比0．116±0．046，均P〈0．01]。结论安脑平冲片能明显减少基底核区脑出血微创术后患者的脑水肿，改善神经缺损功能，促进患者神经功能的恢复。

Objective To observe the curative effect of Annao Pingchong pills on neurological function after minimally invasive surgery for intra-cerebral hemorrhage at basal ganglia area. Methods Eighty-four patients suffering from basal ganglia intra-cerebral hemorrhage were enrolled, and they were randomly divided into control group and observation group, 42 patients in each group. The same minimally invasive surgery was performed for patients in the two groups, primarily crashing and aspirating hematoma under CT. In both groups, western basic treatments were given to the patients, such as dehydration of intracranial pressure, blood pressure control, infection prevention, trophic nerve therapy, etc. after surgery, while in observation group, additionally the patients received 4 Annao Pingchong pills, 3 times daily. The therapeutic course for both groups was 2 weeks. After treatment the curative effects were observed in both groups, before and after treatment for 1 week and 2 weeks, Chinese stroke clinical neural function defect score （CSS） and Glasgow coma scale （GCS） were determined once in each time point in both groups and the cerebral edema volume and aquaporin 4 （AQP4） levels were measured in both groups. Pearson straight line correlative analysis was applied to analyze the correlations between serum AQP4 and CSS as well as cerebral edema volume. Results After treatment the total effective rate in observation group was significantly higher than that in the control group [90.5% （38/42） vs. 73.8% （31/42）, P 〈 0.01], and CSS and GCS scores in both groups were improved compared with those before treatment, and the scores at 2 weeks in observation group was superior to those in control group （CSS： 11.24 ± 5.60 vs. 15.90 ± 6.49, GCS： 13,57 ± 1.68 vs. 11.98 ± 2.04, both P 〈 0.05）. The cerebral edema volume and AQP4 level at each time point after treatment in observation group were lower than those in control group, the above phenomena at 2 weeks after treatment heing more obvious, and the differences between two groups had statistical significance [cerebral edema volume （mL）： 4.05 ± 1.20 vs. 7.67 ±2.43; AQP4 （A value）： 0.055 ±0.032 vs. 0.116 ± 0.046, both P 〈 0.01]. Conclusion Annao Pingchong pill can obviously decrease the volume of cerebral edema after minimally invasive surgery for intra-cerebral hemorrhage at basal ganglia area, improve neurologie impairment and promote the patients＇ recovery of neural function.