麦通纳治疗出血性中风脑水肿的临床及实验研究.pdf

提 要 目的：通过临床和实验研究评估麦通纳对出血性中风脑水肿及伴随神经功能缺损 的临床治疗价值和安全性。 方法：临床研究选择符合临床纳入标准的患者168例，采用随机方法分为两组， 麦通纳治疗组86例，醒脑静对照组82例，观察两组出血性中风脑水肿肿胀直径变化 情况，以及两组对出血性中风脑水肿伴随的神经功能缺损评分（NIHSS）、意识唤醒能 力评分（GCS）和出血量变化情况。动物实验研究采用蛋清诱发大鼠足趾肿胀、小鼠 二甲苯致炎两种模型，观察MTN的抗肿胀作用，并与XNJ组进行对比；用小鼠对MTN 进行了急性毒性实验，计算其LD50；用豚鼠进行过敏性研究，观察其过敏反应。 结果：临床研究证明治疗组与对照组均可明显降低出血性中风脑水肿肿胀直径、 患者神经功能损伤评分，提高 Glascow 昏迷评分，减少出血量,治疗组与对照组在治 疗剂量下静脉注射药物均未出现严重不良反应。动物实验研究证明MTN与XNJ均能减 少蛋清诱发大鼠足趾肿胀、小鼠二甲苯致炎程度，未见局部过敏反应。 结论：1.麦通纳对出血性中风脑水肿及伴随的神经功能缺损具有良好的治疗效 果，麦通纳对恢复出血性中风脑水肿患者意识障碍有积极的临床治疗意义，在给药剂 量下静脉注射是安全的。2.麦通纳对蛋清诱发大鼠足趾肿胀、小鼠二甲苯致炎均有抑 制作用，无过敏反应。 关键词 麦通纳；脑水肿；出血性中风；临床观察；实验研究 The Clinical and laboratorial study on the theraPeutic action of Aescin in hemorrhagic aPoPlexy brain edema SPeciality: Clinical medicine of integrated traditional and western medicine Author: Xue Yunli Tutor: Prof. Li Changsheng Abstract Objective: To evaluate the clinical theraPeutic value and security of Aescin in hemorrhagic aPoPlexy cerebral edema with neurologic deficits through clinical trials. Methods ：168 cases with hemorrhagic aPoPlexy brain edema were selected and were randomly divided into 2 grouPs, 86 cases of MTN treating grouP and 82 cases of XNJ control grouP. The results were assessed mainly by several indexes including the change of Swelling diameters, NIH Stroke Scale （NIHSS ）,Glasgow Coma Scale （GCS ）, and the amount of bleeding. Animal exPerimentation involved 2 models:SD male rats induced swell with egg white and male mice caused inflammation with dimethylbenzene, observed the ant-swell effect of MTN, and comPared with XNJ ;Animal exPerimentation did a test of acute toxicity of MTN on ICR mice, and calculated the LD50, th