黄连温胆汤加减联合依达拉奉治疗颅脑损伤效果及对血清因子水平的影响

Effect of Huanglian Wendan Decoction combined with Edaravone on brain injury and the serum factors

目的分析黄连温胆汤加减联合依达拉奉治疗颅脑损伤对患者血清硫氧还蛋白1(TRX1)、核转录因子(NF-κB)水平的影响。方法纳入颅脑损伤患者96例,按照随机数字表法分为联合组和对照组,联合组给予黄连温胆汤联合依达拉奉治疗,对照组仅给予依达拉奉治疗。比较2组治疗后临床疗效、不良反应发生率,以及治疗前后格拉斯哥昏迷评分(GCS)、神经功能缺损评分(NIHSS)、血清TRX1、NF-κB及脑钠肽(BNP)、胶质原纤维酸性蛋白(GFAP)、神经元特异性烯醇化酶(NSE)水平。结果治疗后2组GCS评分均明显升高,NIHSS评分明显降低(P<0.05),且联合组对GCS评分、NIHSS评分改善明显优于对照组(P<0.05)。联合组临床总有效率为97.9%,明显高于对照组的85.4%(P<0.05)。治疗后2组TRX1水平均明显升高,NF-κB水平明显降低(P<0.05),且联合组对TRX1、NF-κB水平改善明显优于对照组(P<0.05)。治疗后2组BNP水平均明显升高,NSE、GFAP水平明显降低(P<0.05),且联合组对BNP、NSE、GFAP水平改善明显优于对照组(P<0.05)。2组不良反应发生率比较差异无统计学意义(P>0.05)。结论黄连温胆汤加减联合依达拉奉治疗颅脑损伤效果显著,可促进神经功能恢复,药理机制可能与减轻患者脑氧化应激损伤以及颅脑炎症反应,进而起到脑保护作用有关。

Objective To analyze the effects of Huanglian Wenchu Tang combined with Edaravone on serum thioredoxin 1(TRX1)and NF-κB levels in patients with craniocerebral injury.Methods Ninety-six patients with craniocerebral injury were included and divided into a combination group and a control group according to the random number table method.The combination group was given Huanglian Wenchu Tang combined with Edaravone,while the control group was only given Edaravone.The clinical efficacy,incidence of adverse effects,and levels of Glasgow Coma Score(GCS),Neurological Impairment Score(NIHSS),serum TRX1,NF-κB and brain natriuretic peptide(BNP),glial pro-fibrillary acidic protein(GFAP),and neuron-specific enolase(NSE)before and after treatment were compared between the two groups.Results GCS scores were significantly higher and NIHSS scores were significantly lower in both groups after treatment(P<0.05),and the improvement of GCS scores and NIHSS scores in the combined group was significantly better than that in the control group(P<0.05).The total clinical effective rate of the combined group was 97.9%,which was significantly higher than that of the control group(85.4%)(P<0.05).TRX1 levels were significantly higher and NF-κB levels were significantly lower in both groups after treatment(P<0.05),and the improvement of TRX1 and NF-κB levels in the combined group was significantly better than that in the control group(P<0.05).BNP levels were significantly higher and SE and GFAP levels were significantly lower in both groups after treatment(P<0.05),and the improvement of BNP,NSE and GFAP levels in the combined group was significantly better than that in the control group(P<0.05).There was no difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion Huanglian Wenzhi Tang combined with Edaravone is effective in treating craniocerebral injury and can promote neurological recovery,and the pharmacological mechanism may be related to reducing the oxidative stress injury in the brain and the inflammatory response in the cranial brain of patients,which in turn plays a cerebral protective role.