醒神活血通腑方治疗急性大面积脑梗死术后昏迷疗效及对VCAM-1、IL-10、TNF-α水平的影响  

Curative effect of Xingshen Huoxue Tongfu Decoction on postoperative coma after acute large-area cerebral infarction and its influence on the levels of VCAM-1,IL-10 and TNF-α

作　　者：曹勇[1] 郑慧军[1] 刘彪[1] 谢磊[1] CAO Yong;ZHENG Huijun;LIU Biao;XIE Lei(Henan Provincial Hospital of Traditional Chinese Medicine, Zhengzhou 450003, Henan, China)

机构地区：[1]河南省中医院,河南郑州450003

出　　处：《现代中西医结合杂志》2021年第13期1394-1397,1402,共5页Modern Journal of Integrated Traditional Chinese and Western Medicine

基　　金：河南省中医药科学研究专项课题(2019ZY2052)。

摘　　要：目的观察醒神活血通腑方对急性大面积脑梗死术后昏迷的治疗效果及对白细胞介素-10(IL-10)、血管细胞黏附分子(VCAM-1)、肿瘤坏死因子-α(TNF-α)的影响。方法选取2017年10月—2019年10月河南省中医院收治的急性大面积脑梗死术后昏迷患者84例为研究对象,随机分为2组,每组42例。对照组予以常规降血压、抗凝剂、血糖管理干预,同时给予患者常规依达拉奉注射液治疗,研究组在常规干预治疗基础上给予醒神活血通腑方治疗。2组均治疗2周,比较2组患者术后格拉斯哥昏迷(GCS)评分、神经功能(NIHSS)评分、日常生活能力(Barthel指数评分)、昏迷的疗效以及VCAM-1、IL-10、TNF-α水平。结果治疗后,研究组患者的NIHSS评分显著低于对照组,而Barthel指数评分、GCS评分均显著高于对照组,差异均有统计学意义(P均<0.05);研究组患者临床总有效率为97.6%(41/42),对照组为59.5%(25/42),研究组明显高于对照组(P<0.05);治疗后,研究组患者的VCAM-1、TNF-α水平均下降而IL-10水平则显著升高,且均优于对照组,差异均有统计学意义(P均<0.05)。结论在常规治疗基础上予以醒神活血通腑方治疗急性大面积脑梗死术后昏迷,可以获得良好疗效,可明显减轻神经功能缺损程度,提高患者生活能力,其作用机制与有效调节VCAM-1、IL-10、TNF-α水平有关。Objective It is to observe the therapeutic effect of Xingshen Huoxue Tongfu Decoction on postoperative coma after acute large-area cerebral infarction and its effect on interleukin-10(IL-10),vascular cell adhesion molecule(VCAM-1),tumor necrosis factor-α(TNF-α).Methods A total of 84 patients with postoperative coma after acute large-area cerebral infarction who were admitted to Henan Provincial Hospital of Traditional Chinese Medicine from October 2017 to October 2019 were selected as the research objects.They were randomly divided into two groups with 42 cases in each group.The control group was treated with routine antihypertensive,anticoagulation therapy and blood sugar management,and normally given edaravone injection at the same time.The study group was treated with Xingshen Huoxue Tongfu Decoction on the basis of routine intervention in the control group.Both groups were treated for 2 weeks.After treatment,the Glasgow coma(GCS)score,neurological function(NIHSS)score,ability of daily living(Barthel index score),coma efficacy,and the levels of VCAM-1,IL-10 and TNF-αwere compared between the two groups.Results After treatment,the NIHSS score of the study group was significantly lower than that of the control group,while the Barthel index score and GCS score were significantly higher than those of the control group,the differences were all statistically significant(P<0.05);the total clinical effective rate of the study group was 97.6%(41/42),that of the control group was 59.5%(25/42),the total clinical effective rate in the study group was significantly higher than that in the control group(P<0.05);after treatment,the levels of VCAM-1 and TNF-αin the study group were decreased while the levels of IL-10 was significantly increased,and they were better than those in the control group,the differences were statistically significant(all P<0.05).Conclusion Xingshen Huoxue Tongfu Decoction based on the conventional treatment can obtain good curative effect in the treatment of postoperative coma after acute large-a

关 键 词：醒神活血通腑方 急性大面积脑梗死 昏迷 生活能力 神经功能 

分 类 号：R743.33[医药卫生—神经病学与精神病学]