期 刊 ：中国中药杂志 2008年 33卷 21期 页码：2545.
Keywords:intracerebral hemorrhage, sodium ferulate, pharmacotherapy,
摘 要 ：目的：探讨川芎素(阿魏酸钠)用于脑出血早期的临床应用价值。方法：选择本院大脑基底节区脑出血24 h以内的病人共60例，随机分成两组，两组病人年龄、入院时血肿体积、周围水肿体积、病灶中心CT值、神经功能损伤评分等基线资料具有可比性。对照组采用脱水、脑细胞活化剂、调控血压及血糖，处理应激性并发症及对症支持等常规治疗，治疗组在常规治疗基础上发病24 h后静脉滴注川芎素。治疗14 d后观察两组血肿体积、中心CT值、周围水肿体积的改变，治疗14，28 d后进行神经功能损伤分评价，测定两组血清内皮素(endothelin，ET)的动态变化。结果：治疗组较对照组周围水肿减轻(P<0.01)、中心CT值下降(P<0.05)，血肿有缩小趋势；治疗组神经功能损伤改善优于对照组(P<0.05)，临床疗效优于对照组(P<0.05)；2组患者发病后血清ET均明显高于正常组(P<0.01)，对照组在7 d持续升高后逐渐下降，在14 d时较治疗前有下降但仍较正常组高(P<0.05)，治疗组治疗第3 天ET即明显降低，接近正常组，14 d时较正常组降低(P<0.05)。对血压无明显影响，未见明显心、肝、肾功能损害。结论：脑出血病人早期应用川芎素治疗，能有效减轻脑水肿，促进血肿的吸收，改善血肿周围的低灌注区血供，改善患者的神经功能，疗效优于常规内科处理，且应用安全。
Abstract:Objective: To evaluate the clinical application value of sodium ferulate for intracerebral hemorrhage in early stage. Method: Sixty patients with cerebral hemorrhage in basal ganglia onset within 24 h were randomly divided into two groups. The two groups showed no evident differences in age, hematoma volume and edema volume, computerized tomographynumber, and Chinese Stroke Scale. Both groups were given basic treatment with dehydrating, cytidine diphosphocholine, controlling blood pressure, blood sugar and complicating diseases, while the observation group added the treatment of sodium ferulate intravenous drip after 24 h. The hematoma volume, edema volume, and computerized tomographynumber were examined in the 1st day and 14th day, Chinese Stroke Scale in the 1st day, 14th day and 28th day, and the level of serum endothelin in the 1, 3, 5, 7, 14th day. Result: After treatment, edema volume and computerized tomographynumber in the observation group were lower than those in the control group (P<0.01, P<0.05). Patients’ recovery of neural function were markedly improved in the observation group better than that in the control group (P<0.05), and also the therapeutic effectiveness (P<0.05). The serum endothelin level of the 60 patients showed higher significantly than the healthy group in 24 h after hemorrhage (P<0.01). The control group kept higher in 14 days (P<0.05), while the observation group showed declined significantly in the 3rd day and close to the healthy group, and lower than the healthy group in the 14th day (P<0.05). Conclusion: With the basic medical therapy, applying sodium ferulate can effectually improve the resolution of the haematoma, reduce the peripheral edema, and enhance the recovery of neural function for the patients with intracerebral hemorrhage in early stag. The therapeutic effectiveness of adding sodium ferulate in patients with intracerebral hemorrhage in early stag is better than that of the basic medical therapy in most of the fields as the above. No evident effect on secondary hemorrhage, or harmful impact on heart, liver and kidney function was found.