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健神利水颗粒联合呋塞米治疗脑出血继发性脑水肿的临床研究
谭璐璐1      黄荣森2      周观2      陈兴华1      刘永辉1
1.广西中医药大学第一附属医院脑病科,广西南宁   530023;
2.广西中医药大学研究生学院,广西南宁   530023
Clinical study of Jianshi Lishui Granules combined with Furosemide in the treatment of secondary cerebral edema after cerebral hemorrhage
TAN Lulu1   HUANG Rongsen2   ZHOU Guan2   CHEN Xinghua1   LIU Yonghui1
1.Department of Encephalopathy, the First Affiliated Hospital of Guangxi University of Chinese Medicine, Guangxi Zhuang Autonomous Region, Nanning   530023, China; 
2.Graduate School, Guangxi University of Chinese Medicine, Guangxi Zhuang Autonomous Region, Nanning   530023, China
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摘要 目的 探讨健神利水颗粒联合呋塞米治疗脑出血继发性脑水肿的临床效果。 方法 选取2017年4月—2020年4月广西中医药大学第一附属医院收治的脑出血继发性脑水肿患者100例,根据随机数字表法将其分为对照组和研究组,每组各50例。对照组给予呋塞米治疗,研究组在对照组的基础上联合健神利水颗粒治疗,两组均治疗14 d。比较两组疗效、美国国立卫生研究院卒中量表(NIHSS)评分、超敏C反应蛋白(hs-CRP)、S-100β蛋白、白细胞介素-1β(IL-1β)、血肿体积、脑水肿体积、收缩期峰值血流速度、平均血流速度、脑血流量及不良反应发生情况。 结果 研究组临床总有效率高于对照组,差异有统计学意义(P < 0.05)。两组治疗后NIHSS评分均较治疗前下降,且研究组低于对照组,差异均有统计学意义(均P < 0.05)。两组治疗后平均血流速度、收缩期峰值血流速度、脑血流量均较治疗前升高,且研究组高于对照组,差异均有统计学意义(均P < 0.05)。两组治疗后hs-CRP、S-100β蛋白、IL-1β均较治疗前降低,且研究组低于对照组,差异均有统计学意义(均P < 0.05)。两组治疗后血肿体积、脑水肿体积均较治疗前缩小,且研究组小于对照组,差异均有统计学意义(均P < 0.05)。两组不良反应发生率比较,差异无统计学意义(P > 0.05)。 结论 健神利水颗粒联合呋塞米治疗脑出血继发性脑水肿,可促进血肿体积、脑水肿体积缩小,改善脑部血流,降低脑组织炎症反应及过氧化损伤,减轻脑组织损伤,疗效肯定。
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谭璐璐1 黄荣森2 周观2 陈兴华1 刘永辉1
关键词 健神利水颗粒呋塞米脑出血继发性脑水肿临床疗效    
Abstract:Objective To investigate the clinical effect of Jianshi Lishui Granules combined with Furosemide in the treatment of secondary cerebral edema after cerebral hemorrhage. Methods A total of 100 patients with secondary cerebral edema after cerebral hemorrhage admitted to the First Affiliated Hospital of Guangxi University of Chinese Medicine from April 2017 to April 2020 were selected and they were divided into control group and study group according to random number table method, with 50 cases in each group. The control group was treated with Furosemide, and the study group was treated with Jianshi Lishui Granules on the basis of the control group. Both groups were treated for 14 days. The efficacy, the United States national institutes of health stroke scale (NIHSS) score, hypersensitive C-reactive protein (hs-CRP), S-100β protein, interleukin-1β (IL-1β), hematoma volume, cerebral edema volume, peak systolic blood flow velocity, average blood flow velocity, cerebral blood flow and incidence of adverse reactions were compared between the two groups. Results The clinical total effective rate of the study group was higher than that of the control group, and the difference was statistically significant (P < 0.05). After treatment, NIHSS scores in both groups were decreased compared with before treatment, and those in the study group were lower than those in the control group, with statistical significance (all P < 0.05). After treatment, average blood flow velocity, peak systolic blood flow velocity and cerebral blood flow in both groups were increased compared with before treatment, and those in the study group were higher than those in the control group, with statistical significance (all P < 0.05). After treatment, hs-CRP, S-100β protein and IL-1β were decreased in both groups compared with before treatment, and those in the study group were lower than those in the control group, with statistical significance (all P < 0.05). After treatment, hematoma volume and cerebral edema volume in both groups were decreased compared with before treatment, and the those in the study group were smaller than those in the control group, with statistical significance (all P < 0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P > 0.05). Conclusion In the treatment of secondary cerebral edema after cerebral hemorrhage, Jianshi Lishui Granules combined with Furosemide can promote the reduction of hematoma volume and cerebral edema volume, improve cerebral blood flow, reduce the inflammatory response and peroxidation damage of brain tissue, and reduce the injury of brain tissue, with definite curative effect.
Key wordsJianshi Lishui Granules    Furosemide    Secondary cerebral edema after cerebral hemorrhage    Clinical efficacy
    
基金资助:广西中医药适宜技术开发与推广项目(GZSY20-29);
广西壮族自治区卫生厅自筹经费科研项目(Z2014100)。
通讯作者: 刘永辉(1982.10-),男,硕士,副主任医师;研究方向:中医脑病科的临床及科研。   
作者简介: 谭璐璐(1983.1-),女,硕士,副主任医师;研究方向:脑血管病的防治。
引用本文:   
谭璐璐1 黄荣森2 周观2 陈兴华1 刘永辉1. 健神利水颗粒联合呋塞米治疗脑出血继发性脑水肿的临床研究[J]. 中国医药导报, 2021, 18(14): 72-75,80.
TAN Lulu1 HUANG Rongsen2 ZHOU Guan2 CHEN Xinghua1 LIU Yonghui1. Clinical study of Jianshi Lishui Granules combined with Furosemide in the treatment of secondary cerebral edema after cerebral hemorrhage. 中国医药导报, 2021, 18(14): 72-75,80.
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