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

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。

Effect of Longhu Xingnao Granules on Severe Traumatic Brain Injury and Its Effect on Serum TNF-α and IL-6

Objective:To observe the curative effect and mechanism of Longhu Xingnao Granules on severe traumatic brain injury(sTBI),and to explore the correlation between serum TNF-αand IL-6 and secondary brain injury.Methods:62 cases were randomly divided into two groups:30 cases in the control group were treated with routine Western medicine;32 cases in the observation group were given Longhu Xingnao Granules nasal feeding on that basis.The therapeutic effects were evaluated by GCS,intracranial pressure,volume changes of brain lesions and surrounding edema zones.The serum levels of TNF-αand IL-6 were measured by ELISA.Results:After 7 days and 14 days of treatment,the improvement of GCS,intracranial pressure,brain edema and curative effect in the observation group were significantly better than those in the control group(P<0.05 or P<0.01).The levels of TNF-αand IL-6 in both groups reached peak on the third day,consistent with the peak period of brain edema and the lowest GCS score.On the seventh day,the levels of TNF-αand IL-6 in both groups were significantly lower than those in the third day,and the decrease in the observation group was faster(P<0.05 or P<0.01).Conclusion:The serum TNF-αand IL-6 can reflect the severity of secondary brain injury caused by sTBI.Longhu Xingnao Granules can improve the clinical efficacy of sTBI,whose mechanism may be related to reducing the levels of TNF-αand IL-6,so as to inhibit inflammatory reaction and alleviate secondary brain injury.