解痉汤联合地佐辛注射液治疗自发性蛛网膜下腔出血的疗效及对血清可溶性血管内皮生长因子受体-1、可溶性细胞间黏附分子-1的影响  

Efficacy of Jiejing Decoction combined with dezocine injection in treating spontaneous subarachnoid hemorrhage and its influences on serum sFlt-1 and sICAM-1

作　　者：丁奇[1] 高永荣[1] 刘熙鹏[2] 曹兵[2] 张艺 王鹏飞[2] 乔建新[2] DING Qi;GAO Yongrong;LIU Xipeng;CAO Bing;ZHANG Yi;WANG Pengfei;QIAO Jianxin(Department of Pharmacy,the First Affiliated Hospital of Hebei North University,Zhangjiakou,Hebei 075000;Department of Neurosurgery,the First Affiliated Hospital of Hebei North University,Zhangjiakou,Hebei 075000)

机构地区：[1]河北北方学院附属第一医院药学部,河北张家口075000 [2]河北北方学院附属第一医院神经外科,河北张家口075000

出　　处：《河北中医》2024年第7期1102-1106,共5页Hebei Journal of Traditional Chinese Medicine

基　　金：河北省张家口市科学技术局2019年度市级科技计划(编号:1921034D);河北省2018年度医学科学研究重点课题计划项目(编号:20180814)。

摘　　要：目的观察解痉汤联合地佐辛注射液治疗自发性蛛网膜下腔出血(SAH)的疗效及对血清可溶性血管内皮生长因子受体-1(sFlt-1)、可溶性细胞间黏附分子-1(sICAM-1)的影响。方法将88例SAH患者按照随机数字表法分为2组,对照组44例予地佐辛注射液治疗,治疗组44例在对照组治疗基础上加解痉汤治疗,2组均治疗14天。比较2组疗效;比较2组治疗前、治疗7天、治疗后大脑中动脉平均血流速度(MBF)、脑血管痉挛发生情况;比较2组治疗前后氧化应激指标变化;比较2组治疗前后血管内皮损伤因子水平;比较2组治疗前后美国国立卫生研究院卒中量表(NIHSS)、格拉斯哥昏迷量表(GCS)、简易智力状态检查量表(MMSE)评分;比较2组不良反应发生率。结果治疗组总有效率95.45%(42/44),对照组总有效率79.55%(35/44),治疗组疗效优于对照组(P<0.05)。治疗组治疗7天、治疗后MBF、脑血管痉挛发生率均低于对照组治疗同期(P<0.05)。2组治疗后血清还原型谷胱甘肽(GSH)、超氧化物歧化酶(SOD)水平均较本组治疗前升高(P<0.05),丙二醛(MDA)水平较本组治疗前降低(P<0.05);治疗后治疗组血清GSH、SOD水平均高于对照组(P<0.05),MDA水平低于对照组(P<0.05)。2组治疗后血清sFlt-1、sICAM-1水平均较本组治疗前降低(P<0.05),且治疗组降低更明显(P<0.05)。2组治疗后NIHSS评分均较本组治疗前降低(P<0.05),GCS、MMSE评分均较本组治疗前升高(P<0.05);治疗后治疗组NIHSS评分低于对照组(P<0.05),GCS、MMSE评分均高于对照组(P<0.05)。2组不良反应发生率比较差异无统计学意义(P>0.05)。结论解痉汤联合地佐辛注射液治疗SAH,能降低脑血管痉挛发生率,改善患者脑部血流、氧化应激及血管内皮损伤,促进神经功能恢复。Objective To investigate the curative effect of Jiejing Decoction combined with dezocine injection in treating spontaneous subarachnoid hemorrhage(sSAH)and its influences on serum soluble fms-like tyrosine kinase-1(sFlt-1)and soluble intercellular cell adhesion molecule-1(sICAM-1).Methods Eighty-eight sSAH patients were randomly grouped into the control group(n=44)and the combined group(n=44).All patients were given intramuscular injection of dezocine,and those in the combined group were additionally given Jiejing Decoction.A 14-day treatment was performed in the both groups.The clinical efficacy was compared between groups.Before treatment,7 days of treatment,and after treatment,the incidence of the mean blood flow velocity(MBF)and cerebral vasospasm(CV)of the middle cerebral artery were recorded.The indicators of oxidative stress,the levels of vascular endothelial damage factors,the scores of National Institutes of Health Stroke Scale(NIHSS),Glasgow Coma Scale(GCS),and Mini-Mental State Examination(MMSE),as well as the incidence of adverse reactions were included as comparators.Results The total effective rate of the combined group was significantly better than that of the control group(95.45%[42/44]vs 79.55%[35/44],P<0.05).The incidences of MBF and CV in the combined group were significantly lower than those of the control group after 7 days of treatment and after treatment(P<0.05).After treatment,the serum levels of reduced glutathione(GSH)and superoxide dismutase(SOD)in the both groups were significantly higher than those before treatment(P<0.05),but the levels of malondialdehyde(MDA)were significantly lower(P<0.05),the improvement was more pronounced in the combined group relative to the control group(P<0.05).After treatment,the levels of serum sFlt-1 and sICAM-1 in the both groups were obviously lower than those before treatment(P<0.05),the decrease was more common in the combined group compared to the control group(P<0.05).After treatment,the NIHSS scores of the both groups were significantly lower than t

关 键 词：蛛网膜下腔出血 中药疗法 中西医结合疗法 

分 类 号：R743.350.58[医药卫生—神经病学与精神病学]