新疆医科大学学报

目的观察龙琥醒脑颗粒联合西医治疗对脑出血后脑水肿患者脑脊液白介素-1β(IL-1β)、S-100蛋白(S-100)水平的影响。方法选取安徽省六安市人民医院神经内科2016年1月-2018年7月收治的110例脑出血患者,按随机数表法分为中西医结合组与西医组,每组55例。所有患者入院后立即给予常规治疗,其中西医组静脉注射托拉塞米注射液,20 mg/次,12 h/次。连续治疗2周。中西医结合组在西医组治疗基础上联合龙琥醒脑颗粒,l包/次,2次/d,连续服用2周。比较2组总有效率以及治疗前与治疗2周后患者的脑水肿体积、血肿体积、脑脊液IL-1β、S-100水平及治疗期间不良反应总发生率。结果中西医结合组整体疗效优于西医组,差异有统计学意义(P<0.05)。中西医结合组治疗总有效率为94.55%(52/55),显著高于西医组81.82%(45/55)(P<0.05)。2组患者治疗前脑水肿体积、血肿体积的差异无统计学意义(P>0.05);治疗2周后,2组患者的脑水肿体积、血肿体积均较治疗前减小,差异有统计学意义(P<0.05)。中西医结合组治疗2周后患者的脑水肿体积、血肿体积分别为(12.45±2.95) mL与(21.01±4.77) mL,低于西医组[(14.40±2.86) mL与(24.02±4.85) mL],差异有统计学意义(P<0.05)。2组治疗前脑脊液IL-1β、S-100水平差异无统计学意义(P>0.05);治疗2周后,2组脑脊液IL-1β、S-100均较治疗前降低,差异有统计学意义(P<0.05)。中西医结合组治疗2周后患者脑脊液IL-1β、S-100水平分别为(2.11±0.10) pg/mL与(1.04±0.10) pg/mL,低于西医组[(2.18±0.11) pg/mL与(1.18±0.12) pg/mL],差异有统计学意义(P<0.05)。中西医结合组不良反应总发生率为10.91%(6/55),西医组为7.27%(4/55),差异无统计学意义(P>0.05)。结论龙琥醒脑颗粒联合西医治疗脑出血后脑水肿可有效促进血肿及脑水肿的消退,减轻脑水肿对脑组织的损害,促使脑脊液中IL-1β、S-100水平降低,且安全、可靠,值得推广。

Objective To observe the effect of Longhu Xingnao Granule combined with western medicine on the levels of interleukin-1 beta(IL-1β) and S-100 protein in cerebrospinal fluid(CSF) of patients with cerebral edema after cerebral hemorrhage. Methods A total of 110 patients with cerebral hemorrhage admitted to the Department of Neurology, Liuan People′s Hospital in Anhui Province from January 2016 to July 2018 were randomly divided into the integrated group of traditional Chinese and western medicine and the western medicine group with 55 cases in each group. All patients were given routine treatment immediately after admission, of which the western medicine group was given intravenous torasemide injection, 20 mg/time, 12 h/time, lasting for 2 weeks. On the basis of the treatment of western medicine group, combined with Longshu Xingnao Granule, the integrated group took Longshu Xingnao Granule twice a day for another 2 weeks. The total effective rate, the volume of brain edema, the volume of hematoma, the levels of IL-1β and S-100 in CSF and the total incidence of adverse reactions during treatment were compared between the two groups. Results The overall curative effect of the integrated traditional Chinese and western medicine group was better than that of the western medicine group, and the difference was statistically significant(P<0.05). The total effective rate of the integrated traditional Chinese and western medicine group was 94.55%(52/55), which was significantly higher than that of the western medicine group [81.82%(45/55), P<0.05]. There was no significant difference in the volume of brain edema and hematoma between the two groups before treatment(P>0.05); after 2 weeks of treatment, the volume of brain edema and hematoma in the two groups decreased compared with before treatment, and the difference was statistically significant(P<0.05). Two weeks after treatment, the volume of brain edema and hematoma in the integrated group were(12.45±2.95) mL and(21.01±4.77) mL respectively, which were lower than those in the western group [(14.40±2.86) mL and(24.02±4.85) mL], with significant difference(P<0.05). There was no significant difference in the levels of IL-1β and S-100 in CSF between the two groups before treatment(P>0.05); after 2 weeks of treatment, the levels of IL-1β and S-100 in CSF of the two groups were significantly lower than those before treatment(P<0.05). After 2 weeks of treatment, the levels of IL-1β and S-100 in CSF of patients in the integrated traditional Chinese and western medicine group were(2.11±0.10) pg/mL and(1.04±0.10) pg/mL respectively, which were lower than those in the western medicine group [(2.18±0.11) pg/mL and(1.18±0.12) pg/mL], with significant difference(P<0.05). The total incidence of adverse reactions was 10.91%(6/55) in the integrated Chinese and western medicine group and 7.27%(4/55) in the western medicine group, with no significant difference(P>0.05). Conclusion The Longhu Xingnao Granule combined with western medicine treatment of cerebral edema after cerebral hemorrhage can effectively promote the regression of hematoma and cerebral edema, reduce brain edema damage to brain tissue, promote the reduction of IL-1β and S-100 levels in CSF, and it is safe and reliable, which is worthy of promotion.