加减通窍活血汤对颅脑损伤患者血清CNP、D-二聚体影响的临床研究
Clinical Study on the Effect of Jiajian Tongqiao Huoxue Decoction on Serum CNP and D-Dimer in Patients with Craniocerebral Injury
摘要: 目的：探讨加减通窍活血汤治疗中、重型颅脑损伤的疗效及对血清CNP、D-二聚体水平的影响。方法：选取台州市黄岩区中医院中、重型颅脑损伤患者60例，随机分为两组各30例。对照组患者给予胞磷胆碱胶囊治疗，观察组在对照组基础上给予加减通窍活血汤，两组患者均持续治疗14 d。结果：治疗后，观察组总有效率明显增高(P < 0.01)；两组患者治疗前GCS评分比较差异无统计学意义(P > 0.05)；观察组治疗后GCS评分显著升高(P < 0.05)；两组治疗前血清CNP和D-二聚体水平比较差异无统计学意义(P > 0.05)；观察组治疗后血清CNP水平显著升高(P < 0.05)；D-二聚体水平显著降低(P < 0.05)。结论：采用加减通窍活血汤治疗中、重型颅脑损伤具有较好的治疗效果，能够升高血清CNP，降低D-二聚体，且安全性较高，值得在临床上推广应用。
Abstract: Objective: To investigate the curative effect of Modified Tongqiao Huoxue Decoction in the treat-ment of moderate and severe craniocerebral injury and its effect on serum CNP and D-dimer levels. Methods: A total of 60 patients with moderate and severe craniocerebral injury from Huangyan District Hospital of Traditional Chinese Medicine, Taizhou City were selected and randomly divided into two groups with 30 cases in each group. The patients in the control group were given Citicoline Capsules for treatment, and the patients in the observation group were given Modified Tongqiao Huoxue Decoction on the basis of the control group, and the two groups were treated for 14 days. Results: After treatment, the total effective rate in the observation group was significantly in-creased (P < 0.01); there was no significant difference in the GCS score between the two groups be-fore treatment (P > 0.05); the GCS score in the observation group was significantly increased after treatment (P < 0.05); there was no significant difference in serum CNP and D-dimer levels between the two groups before treatment (P > 0.05); serum CNP levels in the observation group were signif-icantly increased after treatment (P < 0.05); D-dimer levels significantly decreased (P < 0.05). Con-clusion: Modified Tongqiao Huoxue Decoction has a good therapeutic effect in the treatment of moderate and severe craniocerebral injury, can increase serum CNP, reduce D-dimer, and has high safety, which is worthy of clinical application.
文章引用：魏博洋, 凌元仁. 加减通窍活血汤对颅脑损伤患者血清CNP、D-二聚体影响的临床研究[J]. 医学诊断, 2022, 12(4): 279-283. https://doi.org/10.12677/MD.2022.124045

参考文献

[1] 孙新亭, 张小年, 张皓. 脑外伤与脑血管病所致认知障碍发生机制的研究进展[J]. 中国康复医学杂志, 2014, 29(2): 188-191.
[2] Wu, X., Hu, J., Zhuo, L., et al. (2008) Epidemiology of Traumatic Brain Injury in Eastern China, 2004: A Pro-spective Large Case Study. Journal of Trauma and Acute Care Surgery, 64, 1313-1319. [Google Scholar] [CrossRef] 
[3] Shi, J., Dong, B., Mao, Y., et al. (2016) Review: Traumatic Brain Injury and Hyperglycemia, a Potentially Modifiable Risk Factor. Oncotarget, 7, 71052-71061. [Google Scholar] [CrossRef] [PubMed]
[4] Posta, N., Oros, M., et al. (2020) Hemoglobin Oxidation Generates Glo-bin-Derived Peptides in Atherosclerotic Lesions and Intraventricular Hemorrhage of the Brain, Provoking Endothelial Dysfunc-tion. Laboratory Investigation, 100, 986-1002. [Google Scholar] [CrossRef] [PubMed]
[5] Xue, M. and Del Bigio, M.R. (2000) Intracortical Hemorrhage Injury in Rats: Relationship between Blood Fractions and Brain Cell Death. Stroke, 31, 1721-1727. [Google Scholar] [CrossRef] 
[6] Chen, X., Wang, H., Yu, W., et al. (2017) IDH1 Associated with Neuronal Apoptosis in Adult Rats Brain Following Intracerebral Hemorrhage. Cellular and Molecular Neurobiology, 37, 831-841. [Google Scholar] [CrossRef] [PubMed]
[7] 刘培凤, 刘启华, 凌江红, Akarayosapong Pichamon, 李东鑫. 活血化瘀类中药注射液治疗中、重型颅脑损伤患者的系统评价[J]. 中成药, 2016, 38(1): 38-46.
[8] 范秀云, 彭俊, 张明伟, 等. 针灸配合通窍活血汤治疗脑外伤后头痛疗效观察[J]. 西部医学, 2011, 23(4): 668-669.
[9] 田卓. 通窍活血汤加味配合针灸治疗颅脑外伤后血瘀所致头痛的临床观察[J]. 陕西中医, 2016, 37(5): 532-534.
[10] 练志明, 简林养, 谢伟坚. 通窍活血汤对重型颅脑损伤的疗效及部分机制研究[J]. 世界中医药, 2020, 15(13): 1958-1966.
[11] 陈金柱, 詹时军. 运用通窍活血汤治疗眩晕的临床体会[J]. 现代中医药, 2002, 12(3): 42.
[12] 李会琪, 刘淑霞, 张学文. 通窍活血汤在脑病中的应用[J]. 陕西中医, 2007, 28(11): 1551-1552.
[13] 杨雪梅, 杨海红, 杨春霞, 等 . 当归活性成分提取及其复合物栓剂抗炎活性研究[J]. 西北师范大学学报(自然科学版), 2012(4): 71-75.
[14] 王登科, 朱继红, 戴新文, 等. 黄芪对大鼠脑出血后半暗带神经元凋亡的影响[J]. 青海医学院学报, 2014, 35(2): 132-135.
[15] 韩金利. 黄芪对大鼠脑出血灶周围凋亡细胞形态与凋亡相关蛋白及其基因作用的研究[D]: [硕士学位论文]. 银川: 宁夏医科大学, 2013.