【摘要】 目的 探讨宁神止痉汤对颅内动脉瘤破裂所致蛛网膜下腔出血(aneurysmal subarachnoid hemorrhage, aSAH)介入术后脑血管痉挛患者脑损伤、自由基、脑血流及神经功能的影响。方法 选取治疗的aSAH患者80例，随机分为对照组与研究组，每组40例，患者给予尼莫地平等药物常规治疗，研究组在对照组治疗基础上给予宁神止痉汤口服治疗，治疗时间14 d,观察患者治疗前后血清神经元特异性烯醇化酶(neuron specific enolase, NSE)、星形胶质源性蛋白(astroglia-derived protein, S100β)、超氧化物歧化酶(superoxide dismutase, SOD)、丙二醛(malondialdehyde, MDA)、内皮素-1(endothelin-1,ET-1)、一氧化氮(nitric oxide, NO)变化，大脑中动脉平均血流速度(median cerebral artery velocity, Vm)、脑血管痉挛指数(linde-gard)、血管自我调节功能指标脉冲指数(impulse index of vascular self-regulation function, PI)变化，采用格拉斯哥(Glasgow coma scale, GCS)和美国国立卫生研究院卒中量表(National Institutes of Health Stroke Scale, NIHSS)评分对患者神经功能状况进行评价。结果 两组患者治疗前血清NSE及S100β水平比较差异无统计学意义(P>0.05),治疗后较治疗前下降(P<0.05),且研究组下降程度大于对照组(P<0.05);两组患者治疗前血清SOD、MDA、ET-1、NO水平比较差异无统计学意义(P>0.05),MDA、ET-1治疗后较治疗前下降(P<0.05),且研究组下降程度大于对照组(P<0.05),SOD、NO治疗后较治疗前升高(P<0.05),且研究组升高程度大于对照组(P<0.05),比较差异有统计学意义(P<0.05);两组患者治疗前大脑中动脉Vm、linde-gard、PI比较差异无统计学意义(P>0.05),治疗后较治疗前下降(P<0.05),且研究组下降程度大于对照组(P<0.05);两组患者治疗前血清GCS及NIHSS评分比较差异无统计学意义(P>0.05),NIHSS治疗后较治疗前下降(P<0.05),且研究组下降程度大于对照组(P<0.05),GCS治疗后较治疗前升高(P<0.05),且研究组升高程度大于对照组(P<0.05)。结论 aSAH介入术后脑血管痉挛患者采用宁神止痉汤治疗，可有助于减轻脑损伤，降低自由基，改善脑血流，促进神经功能的恢复。更多还原

【Abstract】 Objective To discuss the effects of Ningshen Zhijing Decoction(宁神止痉汤) on brain injury, free radical, cerebral blood flow and nerve function in patients with cerebral vasospasm afteraneurysmal subarachnoid hemorrhage(aSAH) intervention. Methods Eighty cases with cerebral vasospasm after aSAH intervention were divided into control group(40 cases) and study group(40 cases). The control group was treated with nimodipine and routine treatment. On this basis, the study group was treated with Ningshen Zhijing Decoction once a day. The two groups were treated for 14 days. The changes of neuron specific enolase(NSE),astroglia-derived protein(S100β),superoxide dismutase(SOD),malondialdehyde(MDA),endothelin-1(ET-1) and nitric oxide(NO) in serum were observed before and after treatment. The median cerebral artery velocity(Vm),cerebral vasospasm index(linde-gard),impulse index of vascular self-regulation function(PI),Glasgow coma scale(GCS) and National Institutes of Health Stroke Scale(NIHSS) scores were used to assess the neurological function. Results There was no significant difference between the two groups in serum NSE or S100β before treatment(P>0.05). The serum NSE and S100β of the two groups after treatment were lower than those before treatment(P<0.05) and those of the study group were lower than those of the control group(P<0.05). There was no significant difference between the two groups in serum SOD,MDA,ET-1 or NO before treatment(P>0.05). The serum levels of MDA and ET-1 of the two groups after treatment were lower than those before treatment(P<0.05) and the levels of the study group were lower than those of the control group(P<0.05). The serum levels of SOD and NO of the two groups after treatment were higher than those before treatment(P<0.05) and the levels of the study group were higher than those of the control group(P<0.05). There was no significant difference between the two groups in Vm, lindegard or PI before treatment(P>0.05) and those of the two groups after treatment were lower than those before treatment(P<0.05). The values of Vm, linde-gard and PI of the study group were lower than those of the control group(P<0.05). There was no significant difference between the two groups in GCS or NIHSS scores before treatment(P>0.05). NIHSS scores of the two groups after treatment were lower than those before treatment(P<0.05) and the scores of the study group were lower than those of the control group(P<0.05). GCS scores of the two groups after treatment were higher than those before treatment(P<0.05) and the scores of the study group were higher than those of the control group(P<0.05). Conclusion Ningshen Zhijing Decoction can help to reduce brain injury and free radicals, improve the cerebral blood flow and promote the recovery of nerve function of patients with cerebral vasospasm after aSAH intervention.更多还原