醒脑静注射液对急性脑梗死血瘀证患者细胞因子以及临床疗效的影响
성뇌정주사액대급성뇌경사혈어증환자세포인자이급림상료효적영향
The effects of Xingnaojing injection on cytokine and clinical efficacy of patients with acute cerebral infarction and blood stasis syndrome
  • 万方数据
    中国中西医结合急救杂志 중국중서의결합급구잡지
    Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care
    2015年 6期 573-575,576 ,共4页

    卢志刚%刘芸%杨丽霞

    로지강%류예%양려하

    醒脑静注射液%脑梗死%血瘀证%细胞因子 醒腦靜註射液%腦梗死%血瘀證%細胞因子
    성뇌정주사액%뇌경사%혈어증%세포인자
    Xingnaojing injection%Acute cerebral infarction%Blood stasis syndrome%Cytokine
    目的：探讨醒脑静注射液对急性脑梗死（ACI）血瘀证患者细胞因子和临床疗效的影响。方法采用前瞻性随机对照研究方法，选择湖北省荆门市第一人民医院神经内科的70例ACI住院患者，按随机数字表法分为对照组和中西医结合治疗组，每组35例。对照组采用西医常规治疗；中西医结合治疗组在常规治疗基础上加用醒脑静注射液30 mL静脉滴注，每日1次；两组疗程均为14 d。检测两组治疗前后血清γ-干扰素（IFN-γ）和白细胞介素（IL-2、IL-5、IL-10）水平；观察两组患者治疗前后神经功能缺损程度评分（NFDS）、改良的Rankin量表（MRS）评分和日常生活活动能力（ADL）评分。结果两组治疗后血清细胞因子IFN-γ和IL-2水平均较治疗前明显降低〔IFN-γ（ng/L）：对照组为32.62±5.34比45.89±9.28，中西医结合治疗组为20.45±6.39比46.02±8.15；IL-2（ng/L）：对照组为8.62±1.51比14.23±2.19，中西医结合治疗组为3.47±0.76比13.09±1.32〕，IL-5及IL-10明显升高〔IL-5（ng/L）：对照组为68.39±8.89比36.80±6.32，中西医结合治疗组为89.20±9.17比37.26±6.08；IL-10（ng/L）：对照组为27.66±5.47比15.59±3.27，中西医结合治疗组为38.54±7.66比16.17±4.29〕，且以中西医结合治疗组变化更显著〔IFN-γ（ng/L）：20.45±6.39比32.62±5.34，IL-2（ng/L）：3.47±0.76比8.62±1.51，IL-5（ng/L）：89.20±9.17比68.39±8.89，IL-10（ng/L）：38.54±7.66比27.66±5.47，均P＜0.05〕。两组治疗后NFDS评分、MRS评分均较治疗前明显降低〔NFDS（分）：对照组为12.38±4.26比27.16±6.35，中西医结合治疗组为7.59±2.09比28.53±7.57；MRS（分）：对照组为3.39±1.51比4.58±1.07，中西医结合治疗组为1.39±0.76比4.65±1.12〕，ADL评分则较治疗前明显升高（分：对照组为38.17±2.24比24.25±3.53，中西医结合治疗组为48.43±1.32比23.51±2.17），且以中西医结合治疗组的改善更显著〔NFDS（分）：7.59±2.09比12.38±4.26，MRS（分）：1.39±0.76比3.39±1.51，ADL评分（分）：48.43±1.32比38.17±2.24，均P＜0.05〕。结论醒脑静注射液能明显调控ACI血瘀证患者血清炎性细胞因子IFN-γ、IL-2、IL-5、IL-10水平，对神经功能缺损程度的恢复及ADL具有较好的改善作用。
    목적：탐토성뇌정주사액대급성뇌경사（ACI）혈어증환자세포인자화림상료효적영향。방법채용전첨성수궤대조연구방법，선택호북성형문시제일인민의원신경내과적70례ACI주원환자，안수궤수자표법분위대조조화중서의결합치료조，매조35례。대조조채용서의상규치료；중서의결합치료조재상규치료기출상가용성뇌정주사액30 mL정맥적주，매일1차；량조료정균위14 d。검측량조치료전후혈청γ-간우소（IFN-γ）화백세포개소（IL-2、IL-5、IL-10）수평；관찰량조환자치료전후신경공능결손정도평분（NFDS）、개량적Rankin량표（MRS）평분화일상생활활동능력（ADL）평분。결과량조치료후혈청세포인자IFN-γ화IL-2수평균교치료전명현강저〔IFN-γ（ng/L）：대조조위32.62±5.34비45.89±9.28，중서의결합치료조위20.45±6.39비46.02±8.15；IL-2（ng/L）：대조조위8.62±1.51비14.23±2.19，중서의결합치료조위3.47±0.76비13.09±1.32〕，IL-5급IL-10명현승고〔IL-5（ng/L）：대조조위68.39±8.89비36.80±6.32，중서의결합치료조위89.20±9.17비37.26±6.08；IL-10（ng/L）：대조조위27.66±5.47비15.59±3.27，중서의결합치료조위38.54±7.66비16.17±4.29〕，차이중서의결합치료조변화경현저〔IFN-γ（ng/L）：20.45±6.39비32.62±5.34，IL-2（ng/L）：3.47±0.76비8.62±1.51，IL-5（ng/L）：89.20±9.17비68.39±8.89，IL-10（ng/L）：38.54±7.66비27.66±5.47，균P＜0.05〕。량조치료후NFDS평분、MRS평분균교치료전명현강저〔NFDS（분）：대조조위12.38±4.26비27.16±6.35，중서의결합치료조위7.59±2.09비28.53±7.57；MRS（분）：대조조위3.39±1.51비4.58±1.07，중서의결합치료조위1.39±0.76비4.65±1.12〕，ADL평분칙교치료전명현승고（분：대조조위38.17±2.24비24.25±3.53，중서의결합치료조위48.43±1.32비23.51±2.17），차이중서의결합치료조적개선경현저〔NFDS（분）：7.59±2.09비12.38±4.26，MRS（분）：1.39±0.76비3.39±1.51，ADL평분（분）：48.43±1.32비38.17±2.24，균P＜0.05〕。결론성뇌정주사액능명현조공ACI혈어증환자혈청염성세포인자IFN-γ、IL-2、IL-5、IL-10수평，대신경공능결손정도적회복급ADL구유교호적개선작용。
    Objective To observe the effects of Xingnaojing injection on cytokine and clinical efficacy of patients with acute cerebral infarction (ACI) and blood stasis syndrome (BSS).Methods A prospective randomized controlled trial was conducted. Seventy hospitalized patients with ACI in the Neurological Department of the First People's Hospital of Jingmen of Hubei Province were enrolled, and they were randomly divided into a combination of traditional Chinese and western medicine group and a control group, 35 cases in each group. Both groups received conventional treatment. The combination therapy group additionally received Xingnaojing intravenous drip 30 mL, once a day on the basis of the control remedy. The therapeutic course in both groups was 14 days. In the two groups before and after treatment, the serum levels of γ-interferon (IFN-γ) and interleukins (IL-2, IL-5 and IL-10) were detected; the neurological function defect scale (NFDS) score, the modified Rankin scale (MRS) score and the daily living activity (ADL) score were observed.Results Compared with the levels before treatment, serum levels of IFN-γ and IL-2 were significantly decreased after treatment [IFN-γ (ng/L): the control group was 32.62±5.34 vs. 45.89±9.28, combination therapy group was 20.45±6.39 vs. 46.02±8.15; IL-2 (ng/L): the control group was 8.62±1.51 vs. 14.23±2.19, combination therapy group was 3.47±0.76 vs. 13.09±1.32], while the levels of IL-5 and IL-10 were obviously increased [IL-5 (ng/L): the control group was 68.39±8.89 vs. 36.80±6.32, combination therapy group was 89.20±9.17 vs. 37.26±6.08; IL-10 (ng/L): the control group was 27.66±5.47 vs. 15.59±3.27, combination therapy group was 38.54±7.66 vs. 16.17±4.29], and the changes in the combination therapy group were more significant [IFN-γ (ng/L):20.45±6.39 vs. 32.62±5.34, IL-2 (ng/L): 3.47±0.76 vs. 8.62±1.51, IL-5 (ng/L): 89.20±9.17 vs. 68.39±8.89, IL-10 (ng/L): 38.54±7.66 vs. 27.66±5.47, allP < 0.05]. Compared with the scores before treatment, NFDS score and MRS score were significantly decreased after treatment (NFDS score: the control group was 12.38±4.26 vs. 27.16±6.35, the combination therapy group was 7.59±2.09 vs. 28.53±7.57; MRS score: the control group was 3.39±1.51 vs. 4.58±1.07, the combination therapy group was 1.39±0.76 vs. 4.65±1.12), but the ADL score was significantly increased after treatment (the control group was 38.17±2.24 vs. 24.25±3.53, the combination therapy group was 48.43±1.32 vs. 23.51±2.17), and the improvement in the combination therapy group was more significant (NFDS score: 7.59±2.09 vs. 12.38±4.26, MRS score: 1.39±0.76 vs. 3.39±1.51, ADL score: 48.43±1.32 vs. 38.17±2.24, allP < 0.05).Conclusion The Xingnaojing injection can significantly regulate the levels of serum cytokines IFN-γ, IL-2, IL-5, IL-10, and improve the recovery of function of damaged nerve and the ADL in patients with ACI.
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