通窍耳聋丸联合巴曲酶治疗突发性耳聋的疗效及对血液流变学的影响

目的 研究5种活血化瘀类中药注射剂对大鼠局灶性脑缺血损伤的保护作用。方法 制备大鼠暂时性左侧中动脉栓塞（middle cerebral artery occlusion，tMCAO）模型，造模成功后实验动物随机分成7组，分别为模型组、注射用丹参多酚酸（11.71 mg/kg）组、注射用丹参多酚酸盐（17.86 mg/kg）组、银杏内酯注射液（0.91 mL/kg）组、银杏二萜内酯葡胺注射液（0.45 mL/kg）组、注射用血塞通（冻干） （18.02 mg/kg）组和丁苯酞氯化钠注射液（阳性药，9 mL/kg）组。假手术组同法造模，不栓塞大脑中动脉。各组大鼠尾iv给药14 d后，评估神经功能评分；干湿比质量法测定脑含水量；TTC染色法评价脑梗死面积；伊文思蓝法测定血脑屏障通透性；酶联免疫吸附试剂盒检测组织匀浆中白细胞介素-6（IL-6）、白细胞介素-1β（IL-1β）、γ-干扰素（IFN-γ）、肿瘤坏死因子-α（TNF-α）水平；生化分析法测定丙二醛（MDA）、超氧化物歧化酶（SOD）活性；HE染色法检测组织病理学变化；末端标记法（TUNEL）观察神经细胞及神经元凋亡情况。结果 给药后，与模型组比较，各给药组神经功能评分均降低，其中注射用丹参多酚酸组和注射用丹参多酚酸盐组差异显著（P<0.01）；各给药组脑含水量均不同程度的降低，除注射用血塞通（冻干）和丁苯酞氯化钠注射液组外，其他各给药组均差异显著（P<0.01）；各给药组脑梗死面积均显著下降，差异有统计学意义（P<0.01）；各给药组给药后伊文思蓝渗出量均有不同程度的降低，其中注射用丹参多酚酸、注射用丹参多酚酸盐、注射用血塞通（冻干）和丁苯酞氯化钠注射液组差异显著（P<0.05、0.01）；各给药组IFN-γ、IL-1β、IL-6和TNF-α含量均显著降低，差异均有统计学意义（P<0.05、0.01）；各给药组均能不同程度抑制SOD的降低，其中注射用丹参多酚酸和注射用银杏内酯注射液组差异有统计学意义（P<0.01）；各给药组均能不同程度抑制MDA的升高，其中注射用丹参多酚酸、注射用丹参多酚酸盐和银杏内酯注射液组差异均有统计学意义（P<0.01）； 5种中药注射剂均能在不同程度抑制脑组织神经细胞和神经元病理形态的改变以及神经细胞的凋亡。结论 5种活血化瘀类中药注射剂对MCAO大鼠的损伤均具有较好的保护作用，但其改善各指标的程度不同。

Efficacy of Tongqiao Erlong Pills combined with batroxobin in treatment of sudden deafness and its effect on hemorheology

Objective To investigate the clinical effect of Tongqiao Erlong Pills combined with Batroxobin Injection in the treatment of sudden deafness. Methods Patients (102 cases) with sudden deafness in the First Affiliated Hospital of Zhengzhou University from July 2018 to December 2020 were divided into control and treatment groups according to the difference of medication, and each group had 51 cases. Patients in the control group were po administered with Batroxobin Injection, the first dose was 10 UB, then 5 UB Batroxobin Injection was added into 150 mL normal saline. Patients in the treatment group were po administered with Tongqiao Erlong Pills, 6 g/time, twice daily. Patients in two groups were treated for 2 weeks. After treatment, the clinical evaluation was evaluated, the disappearance time of clinical symptoms, the levels of HCT, WBV, FIB, and PV in two groups before and after treatment were compared. Results After treatment, the effective rates of the control group and the treatment group were 84.31% and 98.04%, respectively (P<0.05). After treatment, the time of symptom improvement in the treatment group was significantly earlier than that in the control group (P<0.05). After treatment, HCT, WBV, FIB, and PV in two groups were significantly decreased (P<0.05), and the indexes of patients in the treatment group were decreased more significantly (P<0.05). Conclusion Tongqiao Erlong Pills combined with batroxobin in treatment of sudden deafness can not only improve clinical symptoms, but also improve hemorheological indexes, which has a certain clinical application value.