龙琥醒脑颗粒治疗重型颅脑损伤的疗效及对血清TNF-α、IL-6的影响Effect of Longhu Xingnao Granules on Severe Traumatic Brain Injury and Its Effect on Serum TNF-α and IL-6
曾劲松,罗刚,张占伟,余文运,唐宁,喻坚柏
摘要(Abstract):
目的观察龙琥醒脑颗粒治疗重型颅脑损伤(sTBI)的疗效;探讨血清肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)含量与继发性脑损伤的相关性及龙琥醒脑颗粒的作用机制。方法将患者随机分为两组,对照组给予西医常规治疗;观察组在对照组基础上予龙琥醒脑颗粒鼻饲,疗程14 d。通过监测格拉斯哥昏迷指数(GCS)评分、颅内压、脑损伤灶及周围水肿带体积改变评定两组疗效,采用ELISA法检测患者血清TNF-α、IL-6的含量。结果治疗7、14 d后,观察组GCS评分、颅内压、脑水肿改善情况均明显优于对照组(P <0.05或P <0.01);观察组临床疗效优于对照组(P <0.05);两组患者TNF-α、IL-6含量均于第3天达高峰,与脑水肿高峰期及GCS评分最低值相吻合;第7天两组患者TNF-α、IL-6含量均较第3天明显下降,观察组下降更快(P <0.05或P <0.01)。结论血清TNF-α、IL-6的含量可反映sTBI继发性脑损伤的严重程度;龙琥醒脑颗粒可提高sTBI的临床疗效,其作用机制可能与降低患者血清TNF-α、IL-6的含量,抑制炎症反应而减轻继发性脑损伤有关。
关键词(KeyWords): 重型颅脑损伤;龙琥醒脑颗粒;临床疗效;TNF-α;IL-6
基金项目(Foundation): 湖南省中医药科研计划项目(201969);; 湖南中医药大学中西医结合一流学科开放基金项目(2018ZXYJH15);; 湖南省教育厅科研计划项目(17C1207)
作者(Author): 曾劲松,罗刚,张占伟,余文运,唐宁,喻坚柏
参考文献(References):
- [1] Ladak AA,Enam SA,Ibrahim MT. A review of the molecular mechanisms of Traumatic Brain Injury[J]. World neurosurgery,2019,7(10):e1878-8769.
- [2] Dijkland SA,Foks KA,Polinder S,et al. Prognosis in moderate and severe traumatic brain injury:A systematic review of contemporary models and validation studies[J]. Journal of neurotrauma,2019,5(17):e1557-9042.
- [3]周逸,刘宁宁,能晖.早期应用中医药保护血脑屏障及改善颅脑损伤患者神经功能的作用探讨[J].中国中医急症,2017,26(9):1625-1628.
- [4]曾旭,张鹏,徐如祥.重型颅脑损伤急性期中医证型及中西医结合治疗[J].吉林中医药,2016,36(11):1118-1121.
- [5]潘祥龙,郝二伟,谢金玲,等.活血化瘀中药调节血瘀证的分子机制研究进展[J].中国实验方剂学杂志,2018,24(24):227-234.
- [6] Ma XJ,Yin HJ,Chen KJ. Research progress of correlation between blood-stasis syndrome and inflammation[J]. Chinese journal of integrated traditional and Western medicine,2007,27(7):669-672.
- [7]余文运,喻坚柏,罗刚.龙琥醒脑颗粒治疗急性脑出血后脑水肿形成的临床研究[J].中医药导报,2018,24(6):63-65.
- [8]胡世华,韩景光,喻坚柏.龙琥醒脑颗粒防治外伤性脑血管痉挛[J].中国医药指南,2012,10(19):304-305.
- [9]王忠诚.王忠诚神经外科学[M]. 2版.湖北科学技术出版社,2015:317-318.
- [10]陈园桃.中医病症诊疗常规[M].南京:东南大学出版社,2008:211.
- [11]孙传兴.临床疾病诊断依据治愈好转标准[M]. 2版.北京:人民军医出版社,2002:388-389.
- [12] Shi K,Zhang J,Dong JF,et al. Dissemination of brain inflammation in traumatic brain injury[J]. Cellular&molecular immunology,2019,16(6):523-530.
- [13] Rowland B,Savarraj JPJ,Karri J,et al. Acute inflammation in traumatic brain injury and polytrauma patients using network analysis[J]. Shock,2019,3(28):e1540-0514.
- [14] Mashhadizadeh S,Farbood Y,Dianat M,et al. Therapeutic effects of ellagic acid on memory,hippocampus electrophysiology deficits,and elevated TNF-alpha level in brain due to experimental traumatic brain injury[J]. Iranian journal of basic medical sciences,2017,20(4):399-407.
- [15] Zhang Y,Wang J,Zhang Y,et al. Overexpression of long noncoding RNA Malat1 ameliorates traumatic brain injury induced brain edema by inhibiting AQP4 and the NF-kappaB/IL-6 pathway[J]. Journal of cellular biochemistry,2019(3):18-20.
- [16] Maclean FL,Horne MK,Williams RJ,et al. Review:Biomaterial systems to resolve brain inflammation after traumatic injury[J]. APL bioengineering,2018,2(2):021502.