羚蝎胶囊对脑出血后迟发性脑损害干预作用的临床与实验研究  

Clinical and experimental studies on the intervention effects of Lingxie capsule(羚蝎胶囊) on delayed brain injury after cerebral hemorrhage

作　　者：吕嵘[1] 徐敏华[2] 卫洪昌[1] 朱晓梅[1] 朱扬[2] 朱兴进[2] 张洪[2] 

机构地区：[1]上海中医药大学,上海200032 [2]上海市第二人民医院,上海200011

出　　处：《中国中西医结合急救杂志》2001年第4期206-209,共4页Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care

基　　金：上海市科技发展基金资助项目 ( No.9840 190 40 )

摘　　要：目的 :观察羚蝎胶囊治疗脑出血的临床疗效并探讨其作用机制。方法 :实验部分 :采用胶原酶与肝素制造大鼠脑出血模型。通过 Fura 2荧光法测定脑细胞内 Ca2 +浓度 ,化学法测定脑组织内超氧化物歧化酶(SOD)、丙二醛 (MDA)含量 ,HPL C法测定海马组织中兴奋性氨基酸 (EAA)含量。临床部分 :纳入观察范围的患者共有 6 0例 ,随机分成羚蝎胶囊组、清开灵注射液组 (各 30例 )。通过神经功能缺损积分、中风病中医积分、血肿吸收率 ,观察羚蝎胶囊对急性脑出血的临床疗效。结果 :动物实验发现 :羚蝎胶囊可以降低细胞内 Ca2 + 浓度 ,提高 SOD的活力 ,减少 MDA的生成 ,并能抑制海马组织中 EAA含量 ,经统计学处理 ,均有显著差异 (P均<0 .0 5 )。临床研究发现 :羚蝎胶囊组有效率 80 .0 % ,清开灵组 76 .7% ,二者间差异无显著性 (P>0 .0 5 ) ;羚蝎胶囊组血肿吸收率为 96 .0 % ,高于清开灵组 89.0 % (P<0 .0 5 ) ;但在改善神经功能缺损方面清开灵组优于羚蝎胶囊组 (P<0 .0 5 )。结论 :羚蝎胶囊可促进急性脑出血患者脑内血肿的吸收 ,明显减轻患者神经功能缺损程度。其部分作用机制可能是减轻了 Ca2 +超载和自由基损害 ,抑制了 EAA的神经毒作用。Objective:To observe the clinical effect of Lingxie capsule(羚蝎胶囊) on acute cerebral hemo rrhage and to discover the mechanism.Methods:Experimental section:collegians and heparin combination were injected into rat's nuclei caudate to use a rat model of acute cerebral hemorrhage.Each group had rats to measure cellular free calciumion concentration 〔Ca 2+〕i of neuron using Fura2/AM fluoremetry technique,and the content of superoxide dismutase(SOD),malondialdehyde(MDA) in brain tissue using chemical method,and the content of excitatory amino acid(EAA) in hippocampus tissue using HPLC respectively.Clinical section:In this study,60 patients were randomly divided into Lingxie group and Qingkailing(清开灵) group.By analyzed the neural ability defect integration,strokeTCM integration and the hematoma absorption ratio,the effect of Lingxie capsule on acute cerebral hemorrhage was observed.Results:In experiment,we found out Lingxie capsule can decrease the concentration of 〔Ca 2+〕i in injured neural cells,and increase the activity of SOD and reduce the generation of MDA in brain tissue,and inhibit the increasing of the content of EAA in hippocampus tissue.Those effects were significant statistically analysis (all P<0.05).In clinic,we found out the effective ratio of Lingxie capsule's treatment was 80.0%,and which of Qingkailing's was 76.7%.There was no efficient difference between the groups (P>0.05).The hematoma absorption ratio of Lingxie capsule was 96.0%,compared with 89.0% of Qingkailing (P<0.05).On aspect of improving the injured neural ability,the result of Qingkailing group was better than Lingxie group (P<0.05).Conclusions:Lingxie capsule can facilitate the hematoma absorption,and reduce the degree of neural ability defect in acute cerebral hemorrhage patients.According to the result,the mechanism of the Lingxie capsule effect is partially due to its reducing Ca 2+ overload and free radical in neuron cells,and inhibiting the neural toxicity of EAA in brain tissue.

关 键 词：脑出血 细胞内CA^2+ 羚蝎胶囊 超氧化物岐化酶 丙二醛 兴奋性氨基酸 

分 类 号：R743.34[医药卫生—神经病学与精神病学]