大黄蛭丹汤对脑出血术后灶周液TNF-α、IL-6及预后的影响  

The Effect of Dahuang Zhidan Decootion on Perilesional TNF-α,IL-6 and Prognosis in Patients with Cerebral Hemorrhage after Operation

作　　者：黄建龙[1] 李云辉[1] 赖海标[1] 林中平[1] 金丹[1] 王雪涛[1] 吴为强[1] 伍伟超[1] 

机构地区：[1]广东省中山市中医院,广东中山528400

出　　处：《中医药学报》2013年第1期40-43,共4页Acta Chinese Medicine and Pharmacology

基　　金：中山市科学技术委员会2010年度科研资助项目(20102A023)

摘　　要：目的:通过动态观察中药制剂大黄蛭丹汤对高血压脑出血血肿灶周炎性细胞因子的影响,探讨中药大黄蛭丹汤治疗高血压脑出血的临床疗效及机制。方法:120例高血压脑出血术后病人随机分成两组,对照组60例采用清除颅内血肿及术后西医常规治疗,治疗组60例在对照组基础上加用大黄蛭丹汤内服,于术中、术后24h、48h、72h和120h留取脑出血病灶周液,检测TNF-α和IL-6的浓度;治疗30天、90天后,比较分析两组患者苏醒时间、清醒率、重残率、死亡率、并发症发生率、神经功能改善情况和日常生活自理能力情况,并应用SPSS10.0统计软件进行分析处理。结果:治疗组术后48h、72h和120h脑出血灶周TNF-α、IL-6等炎性细胞因子含量明显低于对照组(P<0.05),7天、14天和30天的清醒率分别为38.33%、63.33%和88.33%,均优于对照组(P<0.01);治疗30天和90天神经功能缺损程度评分及90天日常生活能力均明显改善(P<0.01)。结论:大黄蛭丹汤可提高脑出血术后病人的生存率和清醒率,改善神经功能和生活质量,降低重残率和病死率,其改善神经功能的作用可能是通过抑制脑出血后炎症反应、减轻脑水肿实现的。Objective：To study the clinical curative effects of Dahuang Zhidan decoction on treating hypertensive cerebral hemorrhage,and explore its mechanism.Methods： 90 cases were allocated into two groups randomly.The control group（60cases） was treated by western medicine,the treatment group（60cases）by Dahuang Zhidan decoction and western medicine.The time for treatment in both groups was 14 days,and related indexes were assessed after treatment.Results： Compared with the control group,at 48h,72h and 120h after treatment,plasma interleukin-6 or tumor necrosis factor-α concentration in treatment group was significantly lower than that inat control group（P0.05）.The recovery rate in the treatment group was 38.33%,63.33% and 88.33% on the 7th,14th and 20th day after treatment,which was superior to the control group（P0.01）.the neurological deficit score（National Institute of Health Stroke Scale,NIHSS）determined on the 30th and the 90th day after treatment was a melioration in the treatment group（P0.01）,and the ability of daily living was superior to the control group（P0.01）.Conclusion：Dahuang Zhidan decoction used in this study may increase the survival rate and recovery rate,improve neural function and quality of life among hypertensive cerebral hemorrhage patients,and reduce the mortality and severe disability rate.The effect can inhibit inflammatory reaction,and decrease cerebral edema,and further improve neurological function after intracerebral hemorrhage.

关 键 词：脑出血 TNF-Α IL-6 大黄蛭丹汤 

分 类 号：R743.34[医药卫生—神经病学与精神病学]