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北海市人民医院,广西 北海 536000
王光绿,硕士,主任医师,教授,从事脑血管疾病的诊治、颅脑损伤研究,E-mail:13977979853@163.com
收稿日期:2023-05-08,
网络出版日期:2023-10-10,
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王光绿, 潘明远, 邓峰, 等. 黄芪配方膳营养支持联合吡拉西坦对高血压脑出血术后阴虚阳亢证疗效及血清TRAIL、TGF-
WANG Guanglyu, PAN Mingyuan, DENG Feng, et al. Effect of Astragalus Formula Diet Nutrition Support Combined with Piracetam on Yin Deficiency and Yang Hyperactivity Syndrome and Serum TRAIL,TGF-
王光绿, 潘明远, 邓峰, 等. 黄芪配方膳营养支持联合吡拉西坦对高血压脑出血术后阴虚阳亢证疗效及血清TRAIL、TGF-
WANG Guanglyu, PAN Mingyuan, DENG Feng, et al. Effect of Astragalus Formula Diet Nutrition Support Combined with Piracetam on Yin Deficiency and Yang Hyperactivity Syndrome and Serum TRAIL,TGF-
目的
2
评估黄芪配方膳营养支持联合吡拉西坦对高血压脑出血术后阴虚阳亢证疗效及血清肿瘤坏死因子相关凋亡诱导配体(TRAIL)、转化生长因子-
β
1
(TGF-
β
1
)的影响。
方法
2
纳入2021年6月至2022年12月期间北海市人民医院神经外科收治的70例接受定向软通道微创血肿引流术的高血压脑出血患者,采用随机数字表法将患者按1∶1分为对照组和观察组。对照组术后给予吡拉西坦,观察组在对照组的基础上给予黄芪配方膳营养支持,均治疗3周。分别于治疗前后采用美国国立卫生院卒中量表(NIHSS)评分量表评估患者神经功能缺损情况,采用Barthel指数量表评估患者日常生活能力。分别于治疗前后采集患者血清样本,采用硝酸盐还原酶法检测一氧化氮(NO)水平,采用放射免疫分析法检测内皮素-1(ET-1)水平,采用酶联免疫吸附法检测TRAIL、TGF-
β
1
水平,并比较两组患者中医证候积分及临床疗效。
结果
2
治疗后观察组总有效率为91.43%(32/35),高于对照组的71.43%(25/35),差异具有统计学意义(
χ
2
=8.068,
P
<
0.05)。观察组患者术后苏醒时间短于对照组(
P
<
0.01),中医证候证积分改善优于对照组(
P
<
0.01)。与本组治疗前比较,治疗后两组患者NIHSS评分均显著降低、Barthel评分均显著升高(
P
<
0.01);与对照组治疗后比较,观察组患者治疗后NIHSS评分显著降低、而Barthel评分显著升高(
P
<
0.01)。与本组治疗前比较,治疗后两组患者ET-1、TRAIL表达水平均显著降低(
P
<
0.01);与对照组治疗后比较,观察组患者ET-1、TRAIL表达降低更显著(
P
<
0.01)。与本组治疗前比较,治疗后两组不安者NO和TGF-
β
1
的表达水平均显著升高(
P
<
0.01);与对照组治疗后比较,观察组患者NO和TGF-
β
1
表达水平升高更显著(
P
<
0.01)。治疗期间,两组患者不良反应总发生率差异无统计学意义。
结论
2
黄芪配方膳营养支持联合吡拉西坦可有效改善高血压脑出血患者的阴虚阳亢证、神经功能缺损、日常生活能力及血管内皮功能损伤,且不增加不良反应发生率。
Objective
2
Evaluate clinical effect of astragalus formula diet combined with piracetam on Yin deficiency and Yang hyperactivity after hypertensive cerebral hemorrhage and impact on expression of tumor necrosis factor related apoptosis inducing ligand (TRAIL) and transforming growth factor-
β
1
(TGF-
β
1
).
Methods
2
Seventy patients with hypertensive intracerebral hemorrhage who underwent minimally invasive drainage of hematoma through a soft-channel were enrolled during June 2021 to December 2022,and 1∶1 randomly divided into control group and observation group. The control group was given piracetam after operation,while observation group was additionally given astragalus formula diet as nutritional support. Both groups were treated continuously for 3 weeks.the National Institutes of Health Stroke Scale (NIHSS) score scale was used to evaluate the neurological impairment of the patients before and after treatment,and the Barthel index scale was used to evaluate the daily living ability of the patients. Serum samples of the patients were collected before and after treatment and endothelin-1 (NO) levels were detected by nitrate reductase method,endothelin-1 (ET-1) levels were detected by radioimmunoassay,TRAIL and TGF-
β
1
levels were detected by enzyme-linked immunosorbent assay. Traditional Chinese medicine(TCM)syndrome score and clinical efficacy were compared between the two groups.
Result
2
After treatment,the total effective rate of the observation group was higher than that of the control group,the postoperative recovery time was shorter than that of the control group (
P
<
0.05),and the improvement of TCM syndrome score was better than that of the control group (
P
<
0.01). Compared with before treatment,NIHSS was decreased and Barthel score was increased in both groups after treatment (
P
<
0.01). Compared with control group,NIHSS score was lower and Barthel score was higher in observation group after treatment (
P
<
0.01). Compared with before treatment,the expression levels of ET-1 and TRAIL in both groups were decreased after treatment,and compared with control group,the expression levels of ET-1 and TRAIL in observation group were decreased (
P
<
0.01). Compared with before treatment,the expression levels of NO and TGF-
β
1
were increased after treatment,and compared with the control group,the expression levels of NO and TGF-
β
1
were increased in the observation group (
P
<
0.01). During treatment,there was no difference in the total incidence of adverse reactions between the two groups.
Conclusion
2
Astragalus formula diet nutritional support combined with piracetam can effectively improve the syndrome,neurological deficit,daily living function and vascular endothelial function damage in patients with hypertensive cerebral hemorrhage,and does not increase the incidence of adverse reactions.
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