安宫牛黄丸治疗重型颅脑损伤的神经保护作用及对肠黏膜通透性的影响
Neuroprotective effect of Angong Niuhuang pill in severe traumatic brain injury patients and its effect on the permeability of enteric mucosa
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摘要: 目的:探究安宫牛黄丸治疗重型颅脑损伤(STBI)的神经保护作用及对肠黏膜通透性的影响。方法:选择STBI病人180例作为研究对象,按照随机数字表法分成观察组和对照组,各90例,其中对照组病人采取常规药物治疗,观察组病人在对照组治疗的基础上采用安宫牛黄丸治疗。比较2组病人治疗前和治疗后5 d、10 d时格拉斯哥昏迷评分、血清神经元特异性烯醇化酶(NSE)水平、白细胞介素(IL)-6水平、乳果糖排泄率和血浆二胺氧化酶水平变化情况,分析2组病人临床疗效和并发症发生情况。结果:观察组病人治疗总有效率为95.6%,高于对照组的80.0%(P<0.05);观察组治疗后5 d和治疗后10 d的格拉斯哥昏迷评分明显高于对照组(P<0.01),血清NSE水平和IL-6水平均明显低于对照组(P<0.01);观察组治疗5 d和10 d的乳果糖排泄率和血浆二胺氧化酶水平均明显低于对照组(P<0.01);各项并发症发生率均低于对照组(P<0.05~P<0.01)。结论:安宫牛黄丸可以有效降低STBI病人血清NSE含量及IL-6水平,抑制机体炎症反应,并能明显改善病人肠黏膜通透性,促进病人受损神经和胃肠黏膜功能恢复。Abstract: Objective: To explore the neuroprotective effects of Angong Niuhuang pill in severe traumatic brain injury(STBI) patients,and its effect on the permeability of enteric mucosa.Methods: One hundred and eighty patients with STBI were randomly divided into the control group and observation group(90 cases each group).The control group was treated with conventional drug,and the observation group was additionally treated with Angong Niuhuang pill based on the control group.The glasgow coma scale score,serum levels of neuron-specific enolase,IL-6 and diamine oxidase,and lactulose excretion rate between two groups before treatment and after 5 and 10 days of treatment were compared.The clinical effects and incidence rate of complication were analyzed.Results: The total effective rate in observation group(95.6%) was higher than that in control group(80.0%)(P<0.05).After 5 and 10 days of treatment,the scores of glasgow coma scale in observation group were significantly higher than those in control group(P<0.05),and the serum levels of neuron-specific enolase,IL-6 and diamine oxidase,and lactulose excretion rate in observation group were significantly lower than those in control group(P<0.01).The incidence rate of complications in observation group after treatment was significantly lower than that in control group(P<0.05 to P<0.01).Conclusions: Angong Niuhuang pill can effectively decrease the levels of neuron-specific enolase and IL-6,inhibit the inflammatory reaction,improve the permeability of enteric mucosa and promote the function recovery of the injured nerve and enteric mucosa in STBI patients.
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Key words:
- brain injury /
- neuroprotection /
- permeability of enteric mucosa /
- Angong Niuhuang pill
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[1] 黄齐兵,张源,苏雨行,等.重型颅脑损伤病人的颅内压监测与预后的相关性[J].中华医学杂志,2013,93(23):1788. [2] REIS C,WANG Y,AKYOL O,et al.What's new in traumatic brain injury:update on tracking,monitoring and treatment[J].Int J Mol Sci,2015,16(6):11903. [3] 袁淮涛,黄良文,项晓伟,等.安宫牛黄丸对重型颅脑损伤急性期血清镁离子的影响[J].中国中医急症,2013,22(10):1650. [4] 卓杰,闫华.静脉注射纳美芬联合鼻饲安宫牛黄丸治疗脑干出血导致的意识障碍[J].中药材,2014,37(4):717. [5] SONG TJ,CHOI YC,LEE KY,et al.Serum and cerebrospinal fluid neuron-specific enolase for diagnosis of tuberculous meningitis[J].Yonsei Med J,2012,53(6):1068. [6] CHATZIPANTELI K,VITARBO E,ALONSO OF,et al.Temporal profile of cerebrospinal fluid,plasma,and brain interleukin-6 after normothermic fluid-percussion brain injury:effect of secondary hypoxia[J].Ther Hypothermia Temp Manag,2012,2(4):167. [7] 黄维蘅,施燕飞.活血化瘀法联合安宫牛黄丸治疗高血压脑出血临床观察[J].中国中医急症,2014,23(6):1184. [8] 李鸣,詹怀义,叶建平,等.丙氨酰-谷氨酰胺对重型颅脑损伤后肠黏膜屏障损害的保护作用[J].中国现代医学杂志,2013,23(33):107. [9] 赵永华,杨开敏,贾秀艳,等.丙氨酰谷氨酰胺对重型颅脑损伤病人肠黏膜通透性及血浆二胺氧化酶水平的影响[J].中国全科医学,2014,17(2):214. [10] VAN BOVEN RW,HARRINGTON GS,HACKNEY DB,et al.Advances in neuroimaging of traumatic brain injury and posttraumatic stress disorder[J].J Rehabil Res Dev,2009,46(6):717. [11] MEANEY DF,MORRISON B,DALE BASS C.The mechanics of traumatic brain injury:a review of what we know and what we need to know for reducing its societal burden[J].J Biomech Eng,2014,136(2):0210081. [12] 郑铁军.安宫牛黄丸治疗颅脑外伤昏迷疗效观察[J].中国中医急症,2012,21(2):294. [13] 冯跃明,杨辉.安宫牛黄丸治疗急性脑梗死昏迷病人促醒作用的观察[J].中国实验方剂学杂志,2015,21(6):179. [14] 朱宝贤,张宝国.醒脑静注射液对急性脑出血病人的神经保护作用及机制[J].山东医药,2015,55(33):38. [15] 廖创新,叶惠韶,郭泽龙,等.醒脑注射液对颅脑损伤后大鼠血清S100B、NSE的干预作用[J].中国微侵袭神经外科杂志,2006,11(9):416. [16] 李志刚,卓友光,张国明,等.安宫牛黄丸加减治疗脑出血急性期脑损伤的临床疗效及对脑钠肽水平的影响[J].中国中医急症,2015,24(8):1448. [17] FUKUDOME I,KOBAYASHI M,DABANAKA K,et al.Diamine oxidase as a marker of intestinal mucosal injury and the effect of soluble dietary fiber on gastrointestinal tract toxicity after intravenous 5-fluorouracil treatment in rats[J].Med Mol Morpholo,2014,47(2):100. [18] 卢阳珍,应满珍,张为民.醒脑静与安宫牛黄丸序贯联合生大黄治疗重型颅脑损伤临床观察[J].中国中医急症,2012,21(1):114.
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