丹参注射液联合神经节苷脂治疗ASIA分级C,D级脊髓损伤患者康复期疗效及机制  

Efficacy and Mechanism of Danshen Injection Combined with Ganglioside in Treatment of ASIA Grade C and D Spinal Cord Injury

作　　者：卜范艳[1] 张昕红[1] 阮智[2] 马辉[2] 陈文礼 王伊林 BU Fan-yan;ZHANG Xin-hong;RUAN Zhi;MA Hui;CHEN Wen-li;WANG Yi-lin(Affiliated Hospital of Inner Mongolia University for the Nationalities, Tongliao 028000, China;The First Affiliated Hospital of Medical College, Shihezi University, Shihezi 832008, China;Guangxi University of Chinese Medicine, Nanning 530200, China)

机构地区：[1]内蒙古民族大学附属医院,内蒙古通辽028000 [2]新疆石河子大学医学院第一附属医院,新疆石河子832008 [3]广西中医药大学,南宁530200

出　　处：《中国实验方剂学杂志》2018年第9期166-172,共7页Chinese Journal of Experimental Traditional Medical Formulae

基　　金：国家自然科学基金项目(81660676)

摘　　要：目的：探讨丹参注射液联合神经节苷脂治疗美国脊髓损伤学会（ASIA）分级C,D级脊髓损伤（SCI）患者康复期的临床疗效,挖掘其作用机制。方法：将98例脊髓损伤患者随机分为丹参注射液组（30例）、神经节苷脂组（31例）及联合组（37例）,神经节苷脂组在康复训练基础上,给予静脉滴注神经节苷脂治疗60 mg,1次/d,丹参注射液组在康复训练基础上给予静脉滴注丹参注射液治疗10 m L,1次/d,联合组在神经节苷脂治疗基础上给予丹参注射液治疗,连续治疗20 d,停药10 d。比较两组患者的治疗总有效率和不良反应发生率,同时比较治疗前后3组患者各炎症因子水平和运动、痛觉及触觉等神经功能康复指标评分;采用酶联免疫法（ELISA）检测各组患者治疗前后血清中血清肿瘤坏死因子-α（TNF-α）,白细胞介素-8（IL-8）,白细胞介素-1β（IL-1β）,超氧化物歧化酶（SOD）,丙二醛（MDA）,维生素E（VE）,脑源性神经生长因子（BDNF）及星形胶质原性钙结合蛋白S-100β（S-100β）含量。结果：联合组疗效最佳,总有效率为83.78%,高于丹参注射液组（78.57%）及神经节苷脂组（80.65%）;联合组患者运动、痛觉及触觉的ASIA评分均明显高于丹参注射液组及神经节苷脂组（P〈0.05）,且联合组肌力恢复正常时间、住院时间及可下地行走时间均明显低于其他两组（P〈0.05）;所有入组患者治疗后血清TNF-α,IL-8,IL-1β及S-100β含量均低于本组治疗前,BDNF含量高于本组治疗前,其中联合组变化趋势最明显（P〈0.05）;丹参注射液组及联合组患者治疗后血清SOD,VE含量升高,MDA含量降低（P〈0.05）。结论：丹参注射液与神经节苷脂联合应用有助于ASIA分级C,D级SCI患者恢复,预防脊髓继发性损害,其作用机制可能与抗炎、抗氧化有关。Objective：To investigate the clinical efficacy of Dashen injection combined with ganglioside in the treatment of American Spinal Injury Association（ASIA） grade C and D spinal cord injury（SCI） patients,in order to explore its mechanism.Method：A total of 98 patients with spinal cord injury were randomly divided into Dashen injection group（30 cases）,ganglioside group（31 cases） and combined group（37 cases）.In addition to rehabilitation training,Ganglioside group were also given intravenous ganglioside treatment,60 mg,1 time/d; in addition to rehabilitation training,Danshen injection group was also given Danshen injection through intravenous infusion,10 m L,1 time/d; combined group was treated with Danshen,in addition to ganglioside therapy.The treatment lasted for 20 days and was discontinued for 10 days.The total effective rate and the incidence of adverse reactions were compared between the two groups.At the same time,the levels of inflammatory factors and exercise,pain,sense of tough and other neurological rehabilitation index scores were compared; The levels of tumor necrosis factor-α（TNF-α）,interleukin-8（IL-8）,interleukin-1β（IL-1β）,superoxide dismutase（SOD）,malondialdehyde（MDA）,Vitamin E（VE）,brain-derived neurotrophic factor（BDNF） and astrocyte primary calcium binding protein S-100β（S-100β） in serum were measured by enzyme linked immunosorbent assay（ELISA）.Result：The total effective rate was 83.78% in combined group,which was significantly higher than78.57% of the Danshen injection group and 80.65% of ganglioside group.The ASIA scores of exercise,pain and touch were significantly higher in the combined group than in Danshen injection group and ganglioside group（P 〈 0.05）,and the recovery time,the hospitalization time and the talking time in the combined group were significantly shorter than those in other groups（P 〈 0.05）.The levels of TNF-α,IL-8 and IL-1β were lower in all of the groups after treatment than those before treatment,

关 键 词：丹参注射液 神经节苷脂 脊髓损伤 炎症 氧化应激 继发性损伤 

分 类 号：R22[医药卫生—中医基础理论] R24[医药卫生—中医学]