牛黄承气汤治疗脓毒症脑病临床疗效的观察

Observation on the clinical effect of the Niuhuang Chengqi decoction on sepsis encephalopathy

目的:观察牛黄承气汤治疗脓毒症脑病的临床疗效。方法:收集脓毒症脑病病例50例,随机分成对照组25例与观察组25例。对照组予标准西药治疗,观察组在标准西药治疗的基础上予牛黄承气汤治疗。观察两组患者在治疗开始前,治疗7 d后格拉斯哥昏迷指数(Glasgow Coma Scale,GCS)变化及血清学指标神经元特异性烯醇化酶(Neuron Specific Enolase,NSE)、肿瘤坏死因子-α(Tumor Necrosis Factor-α,TNF-α)、白细胞介素-6(Interleukin-6,IL-6)水平,并进行临床疗效评定。结果:两组GCS评分较治疗前均有不同程度提高,观察组(12.7±1.6)分高于对照组(11.8±1.4)分(P <0.05)。临床疗效方面,观察组总有效率为88.0%(22/25),对照组总有效率64.0%(16/25)(P <0.05)。两组血清NSE、TNF-α、IL-6水平均有不同程度下降,观察组低于对照组(P <0.05或P <0.01)。结论:牛黄承气汤治疗脓毒症脑病是有效的,能改善患者意识状态,其作用机制可能与抑制炎症因子有关。

Objective:To observe the clinical effect of Niuhuang Chengqi decoction(牛黄承气汤)in treating sepsis encephalopathy(SE).Methods:50 cases of SE were collected and randomly divided into the control group(25 cases)and the observation group(25 cases).The control group was treated with standard western medicine,while the observation group was treated with Niuhuang Chengqi Decoction on the basis of standard western medicine treatment.Changes in Glasgow coma score(GCS)and serological indicators(NSE,TNF-α,IL-6)were observed before and 7 days after treatment,and clinical efficacy was assessed.Results:GCS scores of the two groups were improved to different degrees compared with those before treatment,and the GCS score of the observation group(12.7±1.6)was higher than that of the control group(11.8±1.4)(P<0.05).In terms of clinical efficacy,the total effective rate of the observation group was 88.0%(22/25),and that of the control group was 64.0%(16/25)(P<0.05).Levels of NSE,TNF-αand IL-6 in both groups decreased to different degrees,while those in the observation group were lower than those in the control group(P<0.05 or P<0.01).Conclusion:Niuhuang Chengqi decoction is effective in treating SE and it can improve patients'consciousness state.Its mechanism may be related to inhibiting inflammatory factors.