醒脑静注射液联合曲克芦丁脑蛋白水解物治疗老年脑卒中并发意识障碍的疗效及机制研究

Efficacy and mechanism of Xingnaojing injection combined with troxerutin brain protein hydrolysate in the treatment of senile stroke with conscious disturbance

摘要:

目的 分析醒脑静注射液联合曲克芦丁脑蛋白水解物治疗老年脑卒中并发意识障碍的疗效及对患者神经功能、炎症反应的影响，并探讨药物相关机制。方法 选取2018年3月—2019年10月于重庆市涪陵中心医院就诊的104例老年脑卒中并发意识障碍患者，按照数字随机对照原则以1∶1分为对照组和联合组，每组52例。患者均接受常规治疗。对照组实施醒脑静注射液治疗，联合组实施静注射液+曲克芦丁脑蛋白水解物治疗，均为2个疗程。对比两组疗效、体温、白细胞计数、中性粒细胞计数、用药安全性，观察治疗前、治疗2个疗程后白细胞介素-6（IL-6）、白细胞介素-8（IL-8）、超氧化物歧化酶（SOD）、丙二醛（MDA）、神经元特异性烯醇化酶（NSE）、神经生长因子（NGF）、脑源性神经细胞营养因子（BDNF）的变化。结果 联合组总有效率高于对照组（P <0.05）。两组患者治疗后体温、白细胞计数、中性粒细胞计数比较，差异无统计学意义（P >0.05）。联合组治疗前后血清IL-6、IL-8、MDA、SOD、NSE、NGF、BDNF水平差值高于对照组（P <0.05）。两组患者不良反应发生率比较，差异无统计学意义（P >0.05）。结论 给予老年脑卒中并发意识障碍患者醒脑静注射液联合曲克芦丁脑蛋白水解物疗效明显，促进意识状态改善，且未明显增加不良反应，其机制可能与联合用药提高神经功能、减轻炎症反应及增强清除自由基能力相关。

Abstract:

Objective To analyze the efficacy of Xingnaojing injection combined with troxerutin brain protein hydrolysate in the treatment of senile stroke with conscious disturbance and its effect on neurological function and inflammatory response in patients, and to explore the drug-related mechanisms.Methods According to the principle of randomized control, 104 elderly patients with stroke and concomitant consciousness who were treated in our hospital from March 2018 to October 2019 were grouped. All patients received conventional treatment, and the control group (52 cases) received Xingnaojing injection. Liquid therapy, combined group (52 cases) received Xingnaojing injection plus troxerutin brain protein hydrolysate, both for 2 courses. Body temperature, white blood cell count, neutrophil count, and medication safety of the two groups, and observe the inflammatory factors (IL-6, IL-8), lipid peroxygen products [superoxide dismutase (SOD), malondialdehyde (MDA)], neurocytokines [neuron-specific enolase (NSE), nerve growth factor (NGF), brain-derived neuronal trophic factor (BDNF)] were compared.Results The difference of the total effective rate of the combined group and the control group was statistically significant (P < 0.05), and the combined group was higher than the control group; after two courses of treatment, the temperature, white blood cell count, and neutrophil count of the combined group had no statistically significant difference compared with the control group (P > 0.05); the differences of serum IL-6, IL-8, mdasod, NSE, NGF, and BDNF between the combined group and the control group before and after treatment were statistically significant (P < 0.05). The incidence of adverse reactions in the combination group was higher than that in the control group, and the difference was not statistically significant (P > 0.05).Conclusion Xingnaojing injection combined with Troxerutin Cerebroprotein hydrolysate is effective in the treatment of senile stroke patients complicated with disturbance of consciousness, which can improve the state of consciousness without increasing the adverse reaction. The mechanism may be related to the improvement of nerve function, the reduction of inflammatory reaction, and the enhancement of free radical scavenging ability.