摘要
目的:探讨安宫牛黄丸联合常规治疗对痰热内闭型脑出血(ICH)患者神经功能恢复的影响,评估安宫牛黄丸在改善患者神经功能、促进脑组织修复及抗氧化应激等方面的疗效,并基于AMPK-PGC1α-NRF2通路,揭示其潜在的作用机制。方法:选取痰热内闭型ICH患者130例,采用随机数字表法分为对照组(常规治疗)和研究组(安宫牛黄丸联合常规治疗),每组65例。收集治疗后两组患者美国国立卫生研究院卒中量表(NIHSS)评分、格拉斯哥昏迷量表(GCS)评分、改良Rankin量表(mRS)评分及机体组织中腺苷酸活化蛋白激酶(AMPK)、过氧化物酶体增殖物激活受体γ共激活因子1α(PGC1α)、核因子E2相关因子2(NRF2)表达水平,血清超氧化物歧化酶(SOD)、丙二醛(MDA)、活性氧(ROS)、白介素-10(IL-10)、肿瘤坏死因子-α(TNF-α)、白介素-6(IL-6)、谷胱甘肽过氧化物酶4(GPX4)、酰基辅酶A合成酶长链家族成员4(ACSL4)、铁离子水平、血肿体积、脑水肿体积和不良反应发生率,评估整体疗效。结果:对照组和研究组各入组65例。治疗后,研究组NIHSS评分[(9.97±1.22)分]和mRS评分[(2.29±0.33)分]均低于对照组[(11.17±1.52)分和(2.64±0.45)分](P<0.05);研究组GCS评分[(14.57±1.19)分]高于对照组[(13.18±1.05)分](P<0.05)。治疗后,研究组患者AMPK[(3.34±0.81)ng/mL]、PGC1α[(2.30±0.67)ng/mL]、NRF2[(3.72±0.85)ng/mL]在组织中的表达高于对照组[(2.63±0.65)ng/mL、(1.83±0.70)ng/mL、(2.91±0.96)ng/mL](P<0.05)。治疗后,研究组患者血清SOD[(98.76±6.67)U/mL]、IL-10[(40.37±5.61)pg/mL]水平高于对照组[(89.65±6.89)U/mL、(35.69±4.65)pg/mL](P<0.05);研究组患者血清MDA[(3.36±0.62)nmol/mL]、ROS[(126.35±23.74)U/mL]、TNF-α[(17.22±2.07)pg/mL]、IL-6[(33.37±3.76)pg/mL]水平低于对照组[(3.76±0.83)nmol/mL、(159.85±26.67)nmol/mL、(19.15±2.34)nmol/mL、(41.26±4.91)nmol/mL](P<0.05)。治疗后,研究组患者血清GPX4水平[(9.87±1.25)ng/mL]高于对照组[(8.16±1.12)ng/mL](P<0.05);研究组患者血清ACSL4[(8.74±1.45)ng/mL]、铁离子水平[(27.44±3.35)μmol/L]低于对照组[(10.12±2.11)ng/mL、(30.46±3.17)μmol/L](P<0.05)。治疗后,研究组血肿体积[(6.46±1.13)mL]和脑水肿体积[(11.47±1.76)mL]较对照组[(8.71±1.02)mL、(3.41±2.04)mL]改善更佳(P<0.05)。结论:安宫牛黄丸联合常规治疗在改善患者神经功能、促进脑组织修复及抗氧化应激等方面具有显著疗效,应用价值高。
AIM:To examine the impact of An-gong Niuhuang pill in conjunction with conventional therapy on the recovery of neurological function in patients with cerebral hemorrhage(ICH)charac-terized by phlegm-heat internal obstruction,and to evaluate its efficacy in enhancing neurological function,promoting brain tissue repair,and mitigating oxidative stress.Additionally,this study aims to elucidate the potential mechanisms underlying these effects through the AMPK-PGC1α-Nrf2 pathway.(1.83±0.70)ng/mL,(2.91±0.96)ng/mL](P<0.05).After treatment,the levels of serum SOD[(98.76±6.67)U/mL]and IL-10[(40.37±5.61)pg/mL]in the research group were higher than those in the Control group group[(89.65±6.89)U/mL,(35.69±4.65)pg/mL](P<0.05);the serum levels of MDA[(3.36±0.62)nmol/mL],ROS[(126.35±23.74)U/mL],TNF-α[(17.22±2.07)pg/mL]and IL-6[(33.37±3.76)pg/mL]in the group were lower than those in the control group group[(3.76±0.83)nmol/mL,(159.85±26.67)nmol/mL,(19.15±2.34)nmol/mL,(41.26±4.91)nmol/mL](P<0.05).After treatment,the serum GPX4 level in the Research Group[(9.87±1.25)ng/mL]was higher than that in the control group[(8.16±1.12)ng/mL](P<0.05).The serum levels of ACSL4[(8.74±1.45)ng/mL]and iron ion[(27.44±3.35)μmol/L]in the study group were lower than those in the control group(10.12±2.11)ng/mL,(30.46±3.17)μmol/L](P<0.05).After treatment,the hematoma volume[(6.46±1.13)mL]and brain edema volume[(11.47±1.76)mL]in the research group were bet-ter than those in the Control group[(8.71±1.02)mL,(3.41±2.04)mL](P<0.05).CONCLUSION:The combination of Angong Niuhuang pill with conven-tional treatment demonstrates significant efficacy in improving neurological function,promoting brain tissue repair,and alleviating oxidative stress,thereby exhibiting high application value in clinical practice.
作者
武雨幸
李祎
岳晓晴
张晨露
张燕平
WU Yuxing;Li Yi;YUE Xiaoqing;ZHANG Chenlu;ZHANG Yanping(Brain Disease Center,the First Affiliated Hospital of Henan University of Chinese Medicine,Zhengzhou 450000,Henan,China;The First Clinical Medical College,Henan University of Chinese Medicine,Zhengzhou 450000,Henan,China)
出处
《中国临床药理学与治疗学》
北大核心
2025年第10期1391-1399,共9页
Chinese Journal of Clinical Pharmacology and Therapeutics
基金
河南省中医药科学研究专项课题(2024ZY1007)
河南省中医药科学研究专项(2022ZY1009)。
关键词
安宫牛黄丸
痰热内闭型脑出血
神经功能恢复
抗氧化应激
炎症因子
铁死亡相关标志物
影像学
Angong Niuhuang pill
phlegm-heat internal closed intracerebral hemorrhage
recovery of neurological function
anti-oxidative stress
inflammatory factors
ferroptosis-related markers
imaging
