【摘要】 目的:观察中、西医不同综合康复方案治疗急性脑出血(ACH)后对神经内分泌免疫网络(NEIN)相关指标的影响。方法:采用多中心、随机对照试验的设计方法,258例患者分别用中医综合康复方案(中康组125例)和西医综合康复方案(西康组133例)治疗,并观察下丘脑-垂体-肾上腺轴(HPA)激素[促肾上腺皮质激素释放激素(CRH)、促肾上腺皮质激素(ACTH)、皮质醇(CS)]与免疫细胞因子[肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、白细胞介素-1β(IL-1β)],T淋巴细胞亚群(CD4+、CD8+、CD4+/CD8+)等相关指标。结果:ACI后CRH、TNF-α等指标均明显高于正常值,说明ACH时存在NEIN功能紊乱。治疗28天后中康组在降低CRH、ACTH、CS和TNF-α、IL-6、IL-1β水平,改善CD4+、CD4+/CD8+含量等方面均优于西康组(P<0.05或0.01)。结论:中医综合康复治疗较西医综合康复治疗更能改善ACH后NEIN免疫学相关指标。更多还原

【Abstract】 Objective:To observe the effect of different synthetic rehabilitation program of Chinese medicine or western medicine on related indexes of NEIN in treating ACH.Methods:A multi-center,random and control clinical trial was adopted with 258 patients with ACH,they were divided into the Chinese medicine group(125 cases)treated with synthetic rehabilitation program of TCM,and the western medicine group(133 cases)treated with synthetic rehabilitation program of western medicine,and NEIN related indexes hypothalamus-pituitary-adrenal(HPA) axis hormones [corticotropin releasing hormone (CRH),adrenocorticotropic hormone(ACTH),corticosteroid (CS)],immune cell factor[tumor necrosis factor-a(TNF-α),interleukin-6(IL-6),interleukin1β(IL-1β)]and T-lymphocyte subsets(CD4 +,CD8 +,CD4 + /CD8 +) were assessed at the 28th day after treatment.Results:The serum levels of HPA hormones in the patients with ACH were significantly higher than those of healthy people which showed that there existed NEIN dysfunction after ACH.Compared with the control group,the levels of HPA hormones and immune cell factors were obviously down-regulated(P < 0.05 or 0.01),and the levels of CD4 + and CD4 + /CD8 + were ameliorated after treatment(P < 0.05 or 0.01).Conclusion:The synthetic rehabilitation program of TCM can ameliorat related indexes of NEIN in treating ACH than those of synthetic rehabilitation program of western medicine.更多还原