云南红药胶囊联合阿托伐他汀治疗术后复发性慢性硬膜下血肿疗效及对血清IL-6、VEGF、MMP-9、D-二聚体水平的影响

Effect of Yunnan Hongyao Capsule combined with atorvastatin on postoperative recurrent chronic subdural hematoma and effects on serum levels of IL-6,VEGF,MMP-9 and D-Dimer

目的观察云南红药胶囊联合阿托伐他汀治疗术后复发性慢性硬膜下血肿疗效及对血清白细胞介素-6(IL-6)、血管内皮生长因子(VEGF)、基质金属蛋白酶-9(MMP-9)、D-二聚体水平的影响。方法将76例术后复发性慢性硬膜下血肿患者随机分为观察组38例及对照组38例,2组均给予预防感染、营养脑神经、抗凝、补液等治疗。在此基础上,对照组给予阿托伐他汀治疗,观察组在对照组基础上给予云南红药胶囊口服。观察2组治疗前及治疗第2周、第4周、第8周脑CT检查、神经功能缺损评分(CSS)、日常生活能力量表(ADL)评分和血清IL-6、VEGF、MMP-9、D-二聚体水平变化情况。结果治疗后2组血肿量逐渐减少,脑中线移位逐渐缩小,CSS评分和血清IL-6、VEGF、MMP-9、D-二聚体水平逐渐降低,ADL评分逐渐升高,且观察组治疗第2周、第4周、第8周上述指标改善情况均显著优于对照组,差异均有统计学意义(P均<0. 05)。2组治疗第2周、第4周、第8周不良反应发生率比较差异均无统计学意义(P均> 0. 05)。结论云南红药胶囊联合阿托伐他汀治疗能够促进术后复发性慢性硬膜下血肿吸收,改善近期神经功能和日常生活能力,且安全性良好,其机制可能与降低血清IL-6、VEGF、MMP-9、D-二聚体水平有关。

Objective It is to observe the efficacy of Yunnan Hongyao Capsule combined with atorvastatin in the treatment of postoperative recurrent chronic subdural hematoma and its effect on serum levels of interleukin-6 （IL-6）, vascular endothelial growth factor （VEGF）, matrix metalloproteinase-9 （MMP-9） and D-dimer. Methods 76 patients with postoperative recurrent chronic subdural hematoma were randomly divided into observation group （ n =38） and control group （ n =38）. Both groups were treated with normal therapy such as infection prevention, nutrition of cranial nerve, anticoagulation and fluid replacement. Additionally, the patients in the control group were treated with atorvastatin, the patients in the observation group were treated with Yunnan Hongyao Capsule combined with atorvastatin by oral administration. The changes of brain CT examination, neurological deficit score （CSS）, daily life ability scale （ALD） scores and serum levels of IL-6, VEGF, MMP-9, D-dimer were observed before treatment and at the 2nd, 4th and 8th week of treatment. Results After treatment in both groups, the amount of hematoma and the midline shift of the brain were decreased gradually, the CSS scores and serum levels of IL-6, VEGF, MMP-9, D-dimer levels were gradually decreased, and the ALD scores were gradually increased, the improvements of the above indicators in the second week, the fourth week and the eighth week were significantly better in the observation group than those in the control group （ P 〈0.05）. There was no significant difference in the incidence of adverse reactions between the two groups at the 2nd week, 4th week, and 8th week of treatment （ P 〉0.05）. Conclusion Yunnan Hongyao Capsule combined with atorvastatin can promote the hematoma absorption, improve the recent neurological function and daily living ability, with good safety in the treatment of postoperative recurrent chronic subdural hematoma, the mechanism may be related to the reduction of serum levels of IL-6, VEGF, MMP-9, D-dimer.