CAJ | 학술논문

目的探讨通腑化瘀导痰汤对重型颅脑损伤血清S-100β蛋白及血清神经元特异性烯醇化酶(NSE)浓度变化及预后的影响.方法将60例重型颅脑损伤患者随机分为对照组和治疗组,对照组采用西医综合治疗,治疗]组予通腑化瘀导痰汤加西医综合治疗.两组患者分别于入院时,治疗后24 h、36 h、72 h、5 d及7 d抽血进行血清S-100β蛋白及血清神经元特异性烯醇化酶(NSE)浓度检测,并于伤后第2周及第4周用COS预后分级方法及神经功能缺损评分评定临床疗效,将所得数据进行统计学分析.结果入院时、治疗后24 h及36 h两组血清NSE、S-100β蛋白含量无显著性差异(P＞0.05);治疗后72 h,5 d,7 d,治疗组血清NSE、S-100β蛋白含量明显降低(P＜0.01);治疗后治疗组GOS预后分级评分及神经功能缺损评分明显优于对照组(P＜0.01).结论通腑化瘀导痰汤能降低重型颅脑损伤患者血清S-100β蚩白及血清神经元特异性烯醇化酶(NSE)含量,结合西医综合治疗能提高重型颅脑损伤COS预后分级、神经功能缺损评分和临床疗效.
목적 탐토통부화어도담탕대중형로뇌손상혈청S-100β단백급혈청신경원특이성희순화매(NSE)농도변화급예후적영향.방법 장60례중형로뇌손상환자수궤분위대조조화치료조,대조조채용서의종합치료,치료]조여통부화어도담탕가서의종합치료.량조환자분별우입원시,치료후24 h、36 h、72 h、5 d급7 d추혈진행혈청S-100β단백급혈청신경원특이성희순화매(NSE)농도검측,병우상후제2주급제4주용COS예후분급방법급신경공능결손평분평정림상료효,장소득수거진행통계학분석.결과 입원시、치료후24 h급36 h량조혈청NSE、S-100β단백함량무현저성차이(P＞0.05);치료후72 h,5 d,7 d,치료조혈청NSE、S-100β단백함량명현강저(P＜0.01);치료후치료조GOS예후분급평분급신경공능결손평분명현우우대조조(P＜0.01).결론 통부화어도담탕능강저중형로뇌손상환자혈청S-100β치백급혈청신경원특이성희순화매(NSE)함량,결합서의종합치료능제고중형로뇌손상COS예후분급、신경공능결손평분화림상료효.
Objective To explore the effects of Tongfu Huayu Daotan Decoction (通化阏导痰汤)on the serum concentration of S-100β protein, neuron-specific enolase(NSE) and Prognosis in patients with severe craniocerebral injury.Methods Sixty patients with severe craniocerebral injury were randomly divided into a a'eatment group and a control group.The treated group was treated with Tongfu Huayu Daotan Decoction plus conventional treatments including dehydration,antibiotics, organ functional support, nerve nutrition, prevention of complication, etc.; the control group was treated with conventional treatments alone. The concentration of serum S-100β protein and neuron-specific enolase(NSE) in plasma at admission and at24, 36, 72huors, and 5, 7 days after treatment were determined respectively; the Glasgow outcome scale (GOS)and neurological deficits scoring at 2weeks and 4weeks after hospitalization were compared to observe the efficacy of the patients. Results The concentration of serum S-100β protein and neuron-specific enolase (NSE) in plasma at previous treatment and at 24, 36 hours after the treatment had no statistical difference in the two groups(P＞0.05 ), The concentration of serum S-100β protein and neuron-specific enolase (NSE) in plasma at 72huors, 5 and 7 days after the treatment in the Tongfu Huayu Daotan Decoction group were lower than those in the control group, the differences being significant (P＜0.01). The Glasgow outcome scale (GOS) and neurological deficits scoring at 2weeks and 4weeks after the treatment in the Tongfu Huayu Daotan Decoction group were significantly nigher than those in the control group, the differences being significant (P＜0.01) .Conclusion Tongfu Huayu Daotan Decoction can alleviate the plasma concentrations of S-100β protein and neuron-specific enolase (NSE) in patients with severe craniocerebral injury and markedly improve the clinical therapeutic effects. Combined Tongfu Huayu Daotan Decoction and western medicine can significantly reduce mortality and improve the Glasgow outcome scale (GOS), neurological deficits scoring and therapeutic effect.