醒脑静注射液治疗急性脑出血的临床疗效及对血清hs-CRP和NSE的影响

目的： 评价醒脑静注射液治疗急性脑出血的有效性及安全性，探讨其可能的药理作用分子机制。 方法： 将110例成年急性脑出血患者按随机数字法分为醒脑静治疗组和常规治疗组，每组55例。常规治疗组给予脱水降颅压、神经营养及辅助康复等处理；醒脑静治疗组在常规治疗基础上，辅助给予醒脑静注射液30 mL静脉滴注，每天1次，连续7 d。于治疗前及治疗第1，3，7天采用格拉斯哥昏迷评分（glasgow coma score， GCS）及美国国立卫生研究院卒中量表（national institutes of health stroke scale，NIHSS） 评定两组神经缺失功能状况，抽取静脉血检测血清神经元特异性烯醇化酶（neuron specific enolase， NSE）和血清超敏C反应蛋白（high-sensitivity C-reactive protein， hs-CRP）水平，治疗过程中监测患者的血、尿常规及肝、肾功能。 结果： 与常规治疗组比较，醒脑静治疗组治疗第7天时GCS评分和NIHSS评分明显改善（P<0.05）；治疗第3天和第7天时，醒脑静治疗组血清hs-CRP含量较常规治疗组明显降低（P<0.05）；治疗第7天时，醒脑静治疗组血清NSE浓度显著低于对照组（P<0.01）。治疗过程中，两组患者肝肾功能指标无明显变化，且未发现药物相关的不良反应。 结论： 醒脑静注射液可有效抑制脑出血后炎症反应，减轻神经损害，对急性脑出血患者可发挥积极治疗作用，且安全性好。

Clinical Observation of Xingnaojing Injection for Acute Intracerebral Hemorrhage and Its Effects on Levels of hs-CRP and NSE in Serum of Patients

Objective: To evaluate the clinical efficacy and safety of Xingnaojing injection for acute cerebral hemorrhage,and explore its possible molecular mechanisms of pharmacological action. Method: One hundred and ten cases of acute cerebral hemorrhage were randomized into 2 groups by random number table method, including Xingnaojing treatment group and routine treatment group, with 55 cases in each group. The routine treatment group was given regular treatment with ICP-lowering, neurotrophic drug treatment and symptomatic treatment. On the basis of regular treatment, Xingnaojing treatment group was given Xingnaojing injection, as an adjuvant therapy, via intravenous infusion at a dose of 30 mL daily for seven days. Glasgow coma score (GCS) and the national institutes of health stroke scale (NIHSS) were performed to evaluate the states of consciousness and neural function before treatment and after treatment for 1, 3 and 7 days. Venous bloods of patients were collected for detecting the levels of high-sensitivity C-reactive protein(hs-CRP)and neuron specific enolase(NSE)in the serum at the different time points mentioned above. Immunoturbidimetry was applied for detecting the level of hs-CRP,and the ELISA was employed to analysis the content of NSE. Moreover, clinical symptoms, vital signs, routine blood and urine tests, as well as hepatic and renal function were observed before and after IV infusion of Xingnaojing. Result: Compared with routine treatment group, significant improvements of GCS score and NIHSS score were evident in patients treated with Xingnaojing injection for 7 days (P<0.05), the levels of hs-CRP in the serum were decreased remarkably after treatment for 3 days and 7 days(P<0.05), and the content of NSE in the serum from sub-group that treated with Xingnaojing injection for 7 days was significantly lower than that in control group as well. However, Xingnaojing injection did not change liver and kidney function indices after treatment for 7 days, and no adverse event occurred during the treatment with Xingnaojing injection. Conclusion: Xingnaojing injection exerted obvious therapeutic effects on acute cerebral hemorrhage with no servere adverse effects, and suppressing inflammatory response and alleviating neuronal damage may serve as an important pharmacological action mechanism.