瓜蒌承气汤加减联合奥拉西坦治疗急性脑出血患者的疗效评价

文章信息/Info

• Title:瓜蒌承气汤加减联合奥拉西坦治疗急性脑出血患者的疗效评价

• 卷期:2024年22卷14期

• 作者:董自鹏

• 巨野县中医医院脑病科 山东菏泽 274900

• Author(s):Dong Zipeng

• Department of Encephalopathy, Juye County Hospital of Traditional Chinese Medicine, Heze, Shandong 274900

• 关键词瓜蒌承气汤加减；奥拉西坦；急性脑出血；炎性因子；氧化应激指标

• Keywords:Addition and subtraction of Gualou Chengqi Decoction; Oracetam; Acute cerebral hemorrhage; Inflammatory factors; Oxidative stress index

• 摘要:目的:探讨瓜蒌承气汤加减联合奥拉西坦在急性脑出血患者中的治疗效果。方法：选择2017年4月-2022年1月急性脑出血患者92例，随机数字表法分为两组各46例。对照组采用奥拉西坦治疗，观察组联合瓜蒌承气汤加减治疗，比较两组临床疗效、美国国立卫生研究所脑卒中评分（NIHSS）、日常生活活动状态（Barthel）指数、炎性因子及氧化应激指标。结果：观察组治疗4周有效率高于对照组（P<0.05）；观察组治疗4周后NIHSS评分低于对照组（P<0.05）；Barthel指数高于对照组（P<0.05）；观察组治疗4周后hs-CRP、NSE及IL-6低于对照组（P<0.05）；观察组治疗4周后BDNF、SOD高于对照组（P<0.05）；NGF、MDA水平低于对照组（P<0.05）。结论：瓜蒌承气汤加减联合奥拉西坦能提高急性脑出血患者有效率，能减轻神经缺损，降低炎性因子及氧化应激水平。                                                                                                                                                                                

• AbstractTo investigate the therapeutic effect of Gualou Chengqi Decoction plus oxiracetam in patients with acute cerebral hemorrhage. Methods: 92 patients with acute cerebral hemorrhage from April 2017 to January 2022 were selected and randomly divided into two groups with 46 patients in each group. The control group was treated with oxiracetam, and the observation group was treated with Gualou Chengqi Decoction. The clinical efficacy, NIHSS, Barthel index, inflammatory factors and oxidative stress indicators of the two groups were compared. Results: The 4-week effective rate of the observation group was higher than that of the control group (P<0.05); NIHSS score in the observation group was lower than that in the control group after 4 weeks of treatment (P<0.05); Barthel index was higher than that of the control group (P<0.05); After 4 weeks of treatment, hs CRP, NSE and IL-6 in the observation group were lower than those in the control group (P<0.05); BDNF and SOD in the observation group were higher than those in the control group after 4 weeks of treatment (P<0.05); The levels of NGF and MDA were lower than those in the control group (P<0.05). Conclusion: Gualou Chengqi Decoction plus oxiracetam can improve the effective rate of patients with acute cerebral hemorrhage, reduce nerve defects, and reduce inflammatory factors and oxidative stress levels.

  急性脑出血是由于多种原因引起的脑内血管破裂、出血，导致脑部组织在短时间内水肿、坏死[1]。冯庆琪研究表明[2]：急性脑出血多与脑血管病理性改变有关，好发于高血脂、高血压及老年人群中，常在情绪激动、过度劳累或用力时发病，临床多表现为突然瘫倒、口歪眼斜及说话含糊不清，成为我国居民死亡的重要原因。奥拉西坦属于临床常用的神经营养药，药物有效成分能通过血脑屏障，增强脑内三磷酸腺苷，从而为大脑提供重组的能量，有助于促进脑组织功能重建[3]。但是，随着奥拉西坦用药时间、药物剂量的增加，患者远期预后较差，难以达到理想效果。