目的 探讨灯盏细辛注射液联合依达拉奉注射液治疗高血压脑出血的临床疗效。方法 选取上海市静安区闸北中心医院在2023年4月—2024年3月收治的100例高血压脑出血患者，按随机数字表法分为对照组和治疗组，每组50例。对照组静脉滴注依达拉奉注射液，2次/d，3支/次，加入适量生理盐水在30 min内滴完。治疗组在对照组基础上静脉滴注灯盏细辛注射液，1次/d，40 mL/次，加入250 mL生理盐水充分稀释后滴注。两组持续治疗14 d。比较两组的临床疗效、神经功能、颅内血管状态、脑血管功能和血清指标。结果 治疗组的总有效率较对照组更高，差异有统计学意义（96.00% vs 84.00%，P＜0.05）。治疗后，两组的国家卫生研究院卒中评分量表（NIHSS）评分均降低（P＜0.05），治疗组的NIHSS评分较对照组更低（P＜0.05）。治疗后，两组的脑血肿量、水肿量、半暗带面积较治疗前降低（P＜0.05），治疗组的脑血肿量、水肿量、半暗带面积与对照组比较更低（P＜0.05）。治疗后，两组的动态阻力、周围阻力均降低，平均流速升高（P＜0.05）；治疗组的动态阻力、周围阻力低于对照组，平均流速高于对照组（P＜0.05）。治疗后两组的血清白细胞介素-18（IL-18）、热休克蛋白47（HSP47）、CD163、中枢神经特异性蛋白S100β（S100β）水平均降低（P＜0.05）；治疗组的血清IL-18、HSP47、CD163、S100β水平低于对照组（P＜0.05）。结论 灯盏细辛注射液联合依达拉奉注射液可提高高血压脑出血的治疗效果，改善神经功能，降低脑血肿症状，改善脑血管功能，降低神经炎性损伤。

Objective To investigate the clinical efficacy of Dengzhan Xixin Injection combined with Edaravone Injection in treatment of hypertensive intracerebral hemorrhage. Methods 100 Patients with hypertensive intracerebral hemorrhage were divided into two groups, with 50 cases every group. The control group patients were treated with intravenous infusion of Edaravone Injection, twice daily, 15 mL each time. On the basis of the control group, patients in the treatment group received intravenous drip of Dengzhan Xixin Injection, once daily, 40 mL/time. Two groups were treated for 14 d. The clinical efficacy, neurological function, intracranial vascular status, cerebrovascular function, and serum indicators between two groups were compared. Results The total effective rate of the treatment group was higher than that of the control group (96.00% vs 84.00%, P < 0.05). NIHSS scores of both groups were decreased (P < 0.05), and NIHSS scores in the treatment group was lower than those of the control group (P < 0.05). After treatment, the amount of cerebral hematoma, edema, and penumbra area in both groups were decreased (P < 0.05). Compared with the control group, the treatment group had lower amounts of cerebral hematoma, edema, and penumbra area (P < 0.05). The dynamic resistance and peripheral resistance of both groups were decreased, but the average flow velocity was increased (P < 0.05). The dynamic resistance and peripheral resistance of the treatment group were lower than those of the control group, but the average flow velocity was higher than that of the control group after treatment (P < 0.05). After treatment, the levels of IL-18, HSP47, CD163, and S100β in both groups were decreased (P < 0.05), and these factors in the treatment group were lower than those in the control group (P < 0.05).Conclusion The combination of Dengzhan Xixin Injection and Edaravone Injection can improve the therapeutic effect of hypertensive intracerebral hemorrhage, improve neurological function, reduce symptoms of cerebral hematoma, improve cerebrovascular function, and reduce neuroinflammatory injury.

R971

上海市“十四五”中医特色专科和中医急诊能力提升（第一批）项目（ZYTSZK2-6）