瓜蒌承气汤加减联合奥拉西坦治疗急性脑出血的临床疗效及对患者体液免疫功能、炎症水平的影响

Clinical efficacy of modified Gualou Chengqi Decoction combined with oxiracetam in the treatment of acute cerebral hemorrhage and its impact on humoral immune function and inflammation

目的探讨急性脑出血患者采用瓜蒌承气汤加减联合奥拉西坦治疗的临床疗效及对患者体液免疫功能和血清炎症水平的影响。方法80例急性脑出血患者,随机分为对照组和观察组,每组40例。对照组患者采用奥拉西坦单药注射治疗,观察组患者在对照组基础上联用瓜蒌承气汤加减治疗。比较两组患者改良爱丁保堡-斯堪的纳维亚脑卒中评定表(MESSS)评分、临床疗效以及血清B型利钠肽(BNP)、C反应蛋白(CRP)、免疫球蛋白(Ig)A、IgG、IgM水平。结果与治疗前比较,治疗后两组患者的MESSS评分均有所降低,且与对照组患者的(21.59±2.27)分比较,观察组患者的MESSS评分(15.48±1.19)分更低(P<0.05)。与治疗前比较,治疗后两组患者的血清中BNP、CRP水平均有所降低,且与对照组的(132.54±7.35)pg/ml、(5.59±0.38)mg/L比较,观察组患者的血清BNP(95.10±5.62)pg/ml、CRP(3.94±0.12)mg/L更低(P<0.05)。与治疗前比较,治疗后两组患者的血清IgA、IgG、IgM水平均有所改善,且与对照组的(3.14±0.05)、(12.57±0.73)、(1.29±0.54)g/L比较,观察组患者血清IgA(3.50±0.10)g/L、IgG(13.89±0.79)g/L更高,IgM(0.90±0.53)g/L更低(P<0.05)。与对照组的85.0%比较,观察组患者临床总有效率97.5%更高(P<0.05)。结论奥拉西坦联合瓜蒌承气汤加减治疗急性脑出血的临床疗效明显,其能有效降低患者血清炎症水平,改善体液免疫功能,调节体液微循环,从而改善患者的神经功能,减轻疾病相关症状,符合急性脑出血患者治疗的临床需求。

Objective To explore the clinical efficacy of modified Gualou Chengqi Decoction combined with oxiracetam in the treatment of acute cerebral hemorrhage and its impact on humoral immune function and inflammation.Methods 80 patients with acute cerebral hemorrhage were randomly divided into a control group and an observation group,with 40 cases in each group.The control group was treated with oxiracetam,and the observation group was treated with modified Gualou Chengqi Decoction on the basis of the control group.The modified Edinburgh-Scandinavia Stroke Scale(MESSS)score,clinical efficacy and serum levels of B-type natriuretic peptide(BNP),C-reactive protein(CRP),immunoglobulin(Ig)A,IgG and IgM were compared between the two groups.Results The MESSS score in both groups was reduced after treatment compared with that before treatment,and the MESSS score of(15.48±1.19)points in the observation group were lower than(21.59±2.27)points in the control group(P<0.05).Compared with before treatment,the serum levels of BNP and CRP in both groups were decreased after treatment,and compared with(132.54±7.35)pg/ml and(5.59±0.38)mg/L in control group,the serum BNP of(95.10±5.62)pg/ml and CRP of(3.94±0.12)mg/L in the observation group were lower(P<0.05).Compared with before treatment,the serum IgA,IgG and IgM levels in both groups were improved after treatment;compared with(3.14±0.05),(12.57±0.73)and(1.29±0.54)g/L in the control group,the serum IgA of(3.50±0.10)g/L and IgG of(13.89±0.79)g/L in the observation group were higher,and IgM of(0.90±0.53)g/L was lower(P<0.05).Compared with 85.0%in the control group,the total clinical effective rate of 97.5%in the observation group was higher(P<0.05).Conclusion Oxiracetam combined with modifed Gualou Chengqi Decoction has obvious clinical efficacy in the treatment of acute cerebral hemorrhage,which can effectively reduce the serum inflammation level of patients,improve the humoral immune function,regulate the microcirculation of the body fluids,so as to improve the neurological function of the patients and alleviate the symptoms related to the disease,which is in line with the clinical needs of the patients with acute cerebral hemorrhage.