Abstract:

Objective　To explore the clinical effect of adjuvant treatment with Guiling Naolutong granules for patients with granules secondary hydrocephalus. Methods　A total of          92 patients with secondary hydrocephalus who were treated at Xi'an Chinese Medicine Encephalopathy Hospital from August 2020 to August 2024 and had the onset less than 3 months were selected as the study objects. The patients were divided into a western medicine treatment group and a combined treatment group by drawing lots, with 46 cases in each group. In the Western medicine treatment group, there were 29 males and 17 females, with an age of (60.43±4.66) years and a disease duration of 1 to 3 (2.44±0.31) months. In the combined treatment group, there were             25 males and 21 females, with an age of (61.65±4.71) years and a disease duration of 1 to 3 (2.49±0.37) months. The Western medicine treatment group was given basic treatments,such as nourishing the nerves, improving circulation and balancing electrolytes. The combined treatment group was given Guiling Naoluotong Granules, prepared in the preparation room of Xi 'an Traditional Chinese Medicine Brain Disease Hospital on the basis of the Western medicine treatment group. The two groups of patients were treated continuously for 4 weeks. The Chinese medicine symptom efficacies, clinical efficacies, scores of Barthel Index (BI)  and GGlasgow Coma Scale (GCS) , intracranial pressures, ventricle indexes, Huckman values, Evan's indexes, corpus callosum angles, and levels of S100β, NSE, MBP and VEGF in peripheral blood were compared between the two groups. χ² and t tests were used for the statistical analysis. Results　After treatment, the combined treatment group demonstrated significantly higher efficacy in improving TCM clinical symptoms and overall clinical effectiveness compared to the Western medicine group [97.824% (45/46) vs. 86.957% (40/46), and 95.652% (44/46) vs. 82.609%  (38/46)]; there were statistical differences  (all P<0.05).The combined treatment group exhibited significantly higher BI and GCS scores than the Western medicine group [(84.76 ± 8.66) vs. (79.44 ± 8.14), and (10.33 ± 1.57) vs. (9.62 ± 1.49)]; there were statistical differences (t=3.036、2.225，all P<0.05).Additionally, the combined treatment group showed significantly lower values in intracranial pressure, ventricular index, Huckman value, Evan's index, and corpus callosum angle compared to the Western medicine group [(168.04 ± 20.20) mmHg (1 mmHg = 0.133 kPa) vs. (179.28 ± 21.48) mmHg, (30.51 ± 2.14) vs. (32.25 ± 2.66), (15.18 ± 4.08) mm vs. (17.69 ± 4.13) mm, (0.31 ± 0.06) vs. (0.34 ± 0.08), and (90.01 ± 9.23)° vs. (94.14 ± 11.53)°]; there were statistical differences (all P<0.05).Furthermore, the combined treatment group had significantly lower levels of S100β, neuron-specific enolase (NSE), myelin basic protein (MBP), and vascular endothelial growth factor (VEGF) compared to the Western medicine group [(289.01 ± 6.43) ng/L vs. (311.62 ± 7.17) ng/L, (20.48 ± 3.12) μg/L vs. (29.17 ± 3.85) μg/L, (7.85 ± 1.95) mg/L vs. (10.15 ± 2.07) mg/L, and (87.83 ± 55.42) ng/L vs. (118.16 ± 67.63) ng/L]; there were statistical differences(all P<0.05). Conclusion　Guiling Naolutong granules as adjuvant therapy significantly improves daily living ability, consciousness status, and neuroimaging parameters (e.g, reduces intracranial pressure and ventricular indices) in patients with secondary hydrocephalus, while downregulating neuroinjury biomarkers (S100β, NSE, etc.), demonstrating favorable clinical efficacy.

Key words:

djuvant treatment with Guiling Naolutong , granules,  , Secondary hydrocephalus,  , Daily living ability,  , Intracranial pressure,  , Markers of peripheral blood nerve injury ,

摘要：

目的　探究桂苓脑路通颗粒辅助治疗继发性脑积水的临床效果。方法　选取2020年8月至2024年8月西安中医脑病医院收治的发病不超过3个月的92例轻度继发性脑积水患者为前瞻性研究对象，采用抽签法将患者分为西医治疗组和联合治疗组，各46例。西医治疗组男29例，女17例，年龄（60.43±4.66）岁，病程1～3（2.44±0.31）个月。联合治疗组男25例，女21例，年龄               （61.65±4.71）岁，病程1～3（2.49±0.37）个月。西医治疗组给予营养神经、改善循环、平衡电解质等基础治疗，联合治疗组在西医治疗组的基础上给予西安中医脑病医院制剂室制备的桂苓脑路通颗粒。两组患者持续治疗4周。比较两组患者的中医临床症状疗效、临床疗效、日常生活活动能力量表（BI）评分、格拉斯哥昏迷评分法（GCS）评分、颅内压、脑室指数、Huckman值、Evan’s指数、胼胝体夹角、外周血中枢神经特异蛋白（S100β）、神经元特异性烯醇化酶（NSE）、髓鞘碱性蛋白（MBP）和血管内皮生长因子（VEGF）水平等的差异。采用χ²检验、t检验进行统计学分析。结果　治疗后，联合治疗组中医临床症状疗效和临床疗效高于西医治疗组［97.824%（45/46）比86.957%（40/46）、95.652%（44/46）比82.609%（38/46）］，差异均有统计学意义（均P<0.05）；联合治疗组的BI、GCS评分高于西医治疗组［（84.76±8.66）分比（79.44±8.14）分、（10.33±1.57）分比（9.62±1.49）分］，差异均有统计学意义（t=3.036、2.225，均P<0.05）；联合治疗组的颅内压、脑室指数、Huckman 值、Evan’s指数和胼胝体夹角低于西医治疗组［（168.04±20.20）mmHg（1mmHg=0.133kPa）比（179.28±21.48）mmHg、（30.51±2.14）比（32.25±2.66）、（15.18±4.08）mm比（17.69±4.13）mm、（0.31±0.06）比（0.34±0.08）、（90.01±9.23）°比（94.14±11.53）°］，差异均有统计学意义（均P<0.05）；联合治疗组的S100β、NSE、MBP和VEGF水平低于西医治疗组［（289.01±6.43）ng/L比（311.62±7.17）ng/L、（20.48±3.12）μg/L比（29.17±3.85）μg/L、（7.85±1.95）mg/L比（10.15±2.07）mg/L、（87.83±55.42）ng/L比（118.16±67.63）ng/L］，差异均有统计学意义（均P<0.05）。结论　桂苓脑路通颗粒辅助治疗可显著改善继发性脑积水患者的日常生活能力、意识状态及影像学指标（降低颅内压、脑室指数等），并下调S100β、NSE等神经损伤标志物水平，具有良好临床疗效。

关键词: 桂苓脑路通颗粒辅助治疗,  ,  , 继发性脑积水,  ,  , 日常生活能力,  ,  , 颅内压,  ,  , 外周血神经损伤标志物