黄连解毒汤对急性脑出血与脑梗塞火毒证的效应差异及相关机制  

Effect difference of Huanglian Jiedu Decoction on heat-toxicity syndrome of acute cerebral hemorrhage and acute cerebral infarction and the mechanism

作　　者：王革生[1] 张允岭[1] 张志辰[1] 郑宏[1] 刘雪梅[1] 王乐[1] 东潇博[1] 杜勇[1] 王雷[1] 周玉嘉[1] 刘佳霖[1] 

机构地区：[1]北京中医药大学东方医院,北京100078

出　　处：《中华中医药杂志》2013年第11期3178-3181,共4页China Journal of Traditional Chinese Medicine and Pharmacy

基　　金：国家重点基础研究发展计划(973计划)(No.2006CB504805)~~

摘　　要：目的:对急性脑出血(ACH)火毒证与急性脑梗塞(ACI)火毒证进行比较,探索清热解毒法对ACH与ACI火毒证的效应差异及可能的作用机制。方法:以黄连解毒汤对ACH火毒证和ACI火毒证患者进行干预,采集两组患者入院后第1、5、14天的四诊信息变化,以及治疗前后生物学指标群、神经功能缺损评分的变化,并进行差异分析比较。结果:ACH与ACI组患者在入院第1天和第5天的NIHSS评分、GCS评分无显著性差异,但在第14天,两组患者NIHSS评分分别为(12.97±8.60)和(6.82±9.86),GCS评分分别为(10.90±3.81)和(12.43±2.17),两者有显著性差异(P<0.05)。ACI火毒证组患者和ACH火毒证组患者在治疗14d后,高敏C反应蛋白(Hs-CRP)、基质金属蛋白酶9(MMP-9)水平较前明显降低,两组患者氧化低密度脂蛋白(Ox-LDL)水平治疗后均有所降低。结论:以黄连解毒汤为代表的清热解毒法对ACH与ACI火毒证均具有临床改善作用。但其对ACH与ACI火毒证的效应存在一定差异,效应机制与炎症因子调节有关。Objective： By making a comparison between heat-toxicity syndromes of acute cerebral hemorrhage and cerebral infarction, we planed to explore the effect difference of Huanglian Jiedu Decoction on heat-toxicity syndromes of acute cerebral hemorrhage and cerebral infarction, and clarify the possible mechanism. Methods： We intervened in heat-toxicity syndromes of acute cerebral hemorrhage and cerebral infarction with Huanglian Jiedu Decoction and collected the patients＇ four diagnostic informations at dayl, day 5 and day 14 after hospitalization. Also, we tested and analyzed the level of oxidized low density lipoprotein, matrix metalloproteinase, interleukin-6 and high sensitive c-reactive protein before and after treatment. Furthermore, we tested the neurological deficit scores for all the eligible patients. Results： The NIHSS and GCS scores in Huanglian Jiedu Decoction group and control group showed no significant statistics difference at day 1 and day 5, but these numbers showed significant statistics difference at day 14 [（12.97＋_8.60） and （6.82＋_9.86）, respectively, P〈0.05]. The GCS scores at the same time point were （10.90＋_3.81） and （12.43-＋2.17） respectively （P〈0.05）. The level of Hs-CRP and MMP-9 in both acute cerebral hemorrhage and cerebral infarction experiences an obvious decrease. The level of Ox-LDL in both acute cerebral hemorrhage group and cerebral infarction group decreased. Conclusion： The method of clearing away the heat-evil and expelling superficial evils, represented by Huanglian Jiedu Decoction, improves the clinical results in both Heat-toxicity syndrome of acute cerebral hemorrhage and cerebral infarction, but the effect difference can be related, which may be related with inflammatory factor.

关 键 词：黄连解毒汤 急性脑出血 急性脑梗塞 效应差异 

分 类 号：R277.7[医药卫生—中医学]