丹参注射液联合神经节苷脂治疗ASIA分级C，D级脊髓损伤患者康复期疗效及机制

卜范艳; 张昕红; 阮智; 马辉; 陈文礼; 王伊林

doi:10.13422/j.cnki.syfjx.20180927

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丹参注射液联合神经节苷脂治疗ASIA分级C，D级脊髓损伤患者康复期疗效及机制

临床 | 更新时间：2024-01-04

- 丹参注射液联合神经节苷脂治疗ASIA分级C，D级脊髓损伤患者康复期疗效及机制
- Efficacy and Mechanism of Danshen Injection Combined with Ganglioside in Treatment of ASIA Grade C and D Spinal Cord Injury
- 中国实验方剂学杂志 2018年24卷第9期页码：166-172
- 作者机构：
- 作者简介：
- 基金信息：
  
  国家自然科学基金项目（81660676）
- DOI：10.13422/j.cnki.syfjx.20180927
  中图分类号： R651.2
- 纸质出版日期：2018
- 稿件说明：
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卜范艳, 张昕红, 阮智, 等. 丹参注射液联合神经节苷脂治疗ASIA分级C，D级脊髓损伤患者康复期疗效及机制[J]. 中国实验方剂学杂志, 2018,24(9):166-172.

BU Fan-yan, ZHANG Xin-hong, RUAN Zhi, et al. Efficacy and Mechanism of Danshen Injection Combined with Ganglioside in Treatment of ASIA Grade C and D Spinal Cord Injury[J]. Chinese journal of experimental traditional medical formulae, 2018, 24(9): 166-172.
卜范艳, 张昕红, 阮智, 等. 丹参注射液联合神经节苷脂治疗ASIA分级C，D级脊髓损伤患者康复期疗效及机制[J]. 中国实验方剂学杂志, 2018,24(9):166-172. DOI： 10.13422/j.cnki.syfjx.20180927.

BU Fan-yan, ZHANG Xin-hong, RUAN Zhi, et al. Efficacy and Mechanism of Danshen Injection Combined with Ganglioside in Treatment of ASIA Grade C and D Spinal Cord Injury[J]. Chinese journal of experimental traditional medical formulae, 2018, 24(9): 166-172. DOI： 10.13422/j.cnki.syfjx.20180927.

摘要

目的：探讨丹参注射液联合神经节苷脂治疗美国脊髓损伤学会（ASIA）分级C，D级脊髓损伤（SCI）患者康复期的临床疗效，挖掘其作用机制。方法：将98例脊髓损伤患者随机分为丹参注射液组（30例）、神经节苷脂组（31例）及联合组（37例），神经节苷脂组在康复训练基础上，给予静脉滴注神经节苷脂治疗60 mg，1次/d，丹参注射液组在康复训练基础上给予静脉滴注丹参注射液治疗10 mL，1次/d，联合组在神经节苷脂治疗基础上给予丹参注射液治疗，连续治疗20 d，停药10 d。比较两组患者的治疗总有效率和不良反应发生率，同时比较治疗前后3组患者各炎症因子水平和运动、痛觉及触觉等神经功能康复指标评分；采用酶联免疫法（ELISA）检测各组患者治疗前后血清中血清肿瘤坏死因子-α（TNF-α），白细胞介素-8（IL-8），白细胞介素-1β（IL-1β），超氧化物歧化酶（SOD），丙二醛（MDA），维生素E（VE），脑源性神经生长因子（BDNF）及星形胶质原性钙结合蛋白S-100β（S-100β）含量。结果：联合组疗效最佳，总有效率为83.78%，高于丹参注射液组（78.57%）及神经节苷脂组（80.65%）；联合组患者运动、痛觉及触觉的ASIA评分均明显高于丹参注射液组及神经节苷脂组（P<0.05），且联合组肌力恢复正常时间、住院时间及可下地行走时间均明显低于其他两组（P<0.05）；所有入组患者治疗后血清TNF-α，IL-8，IL-1β及S-100β含量均低于本组治疗前，BDNF含量高于本组治疗前，其中联合组变化趋势最明显（P<0.05）；丹参注射液组及联合组患者治疗后血清SOD，VE含量升高，MDA含量降低（P<0.05）。结论：丹参注射液与神经节苷脂联合应用有助于ASIA分级C，D级SCI患者恢复，预防脊髓继发性损害，其作用机制可能与抗炎、抗氧化有关。

Abstract

Objective: To investigate the clinical efficacy of Dashen injection combined with ganglioside in the treatment of American Spinal Injury Association(ASIA) grade C and D spinal cord injury (SCI) patients

in order to explore its mechanism. Method: A total of 98 patients with spinal cord injury were randomly divided into Dashen injection group (30 cases)

ganglioside group (31 cases) and combined group (37 cases). In addition to rehabilitation training

Ganglioside group were also given intravenous ganglioside treatment

60 mg

1 time/d; in addition to rehabilitation training

Danshen injection group was also given Danshen injection through intravenous infusion

10 mL

1 time/d; combined group was treated with Danshen

in addition to ganglioside therapy. The treatment lasted for 20 days and was discontinued for 10 days. The total effective rate and the incidence of adverse reactions were compared between the two groups. At the same time

the levels of inflammatory factors and exercise

pain

sense of tough and other neurological rehabilitation index scores were compared; The levels of tumor necrosis factor-α (TNF-α)

interleukin-8 (IL-8)

interleukin-1β (IL-1β)

superoxide dismutase (SOD)

malondialdehyde (MDA)

Vitamin E (VE)

brain-derived neurotrophic factor (BDNF) and astrocyte primary calcium binding protein S-100β (S-100β) in serum were measured by enzyme linked immunosorbent assay (ELISA). Result: The total effective rate was 83.78% in combined group

which was significantly higher than 78.57% of the Danshen injection group and 80.65% of ganglioside group. The ASIA scores of exercise

pain and touch were significantly higher in the combined group than in Danshen injection group and ganglioside group (P<0.05)

and the recovery time

the hospitalization time and the talking time in the combined group were significantly shorter than those in other groups (P<0.05). The levels of TNF-α

IL-8 and IL-1β were lower in all of the groups after treatment than those before treatment

but with the lowest levels in the combined group (P<0.05). After treatment

patients of Danshen injection group and combined group showed increase in expressions of serum SOD

VE and decrease in MDA (P<0.05). Conclusion: Dashen injection combined with gangliosides can help ASIA graded C and D grade SCI patients to restore

and prevent secondary spinal cord damage. Its mechanism may be related to anti-inflammation and anti-oxidation.

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