Objective  To investigate the clinical correlation of Naomai Jiejing decoction with cerebrovascular hemodynamics, thromboelastography (TEG) and rehabilitation outcome in patients with aneurysmal subarachnoid hemorrhage (aSAH).

Methods  A total of 160 patients with aSAH admitted to Zhongshan Traditional Chinese Medicine Hospital from January 2020 to December 2022 were selected as the study objects, and were divided into study groupand control group according to whether the patients used Naomai Jiejing decoction. The control group was treated with basic therapy combined with nimodipine, the study group was treated with basic therapy combined with nimodipine and Naomai Jiejing decoction (No. 1) before surgery, and was treated with basic therapy combined with Nimodipine and naomai Jiejing decoction (No. 2) after surgery. Chinese medicine symptom score, cerebrovascular hemodynamics indexes [systolic peak velocity (Vs), mean blood velocity (Vm), end-diastolic peak velocity (Vd), pulsatile index (PI) and resistance index (RI)] and TEG parameters [maximum amplitude (MA), α angle and coagulation index (CI)] were compared between the two groups before and after treatment. Finally, the short-term prognosis of the two groups was evaluated by glasgow prognostic score, and the short-term prognosis of the two groups was compared.

Results  A total of 160 aSAH patients were included, with 85 in the study group and 75 in the control group. After treatment, the Chinese medicine symptom scores in the study group were significantly lower than those in the control group (P>0.05). After treatment, the indexes of cerebrovascular hemodynamics in the study group were better than those in the control group (P<0.05). After treatment, the TEG parameters in the study group were significantly lower than those in the control group (P<0.05). The overall prognosis of the study group was better than that of the control group, and the proportion of patients with good recovery was significantly higher than that of the control group (P<0.05).

Conclusion  Naomai Jiejing decoction has a good treatment effect on aSAH patients, can improve cerebrovascular hemodynamics and TEG parameters, relieve clinical symptoms, and improve the short-term prognosis of patients.

1.Griswold DP, Fernandez L, Rubiano AM. Traumatic subarachnoid hemorrhage: a scoping review[J]. J Neurotrauma. 2022, 39(1-2): 35-48. DOI: 10.1089/neu. 2021.0007.

2.Ran KR, Wang AC, Nair SK, et al. Acute multidisciplinary management of aneurysmal subarachnoid hemorrhage (aSAH)[J]. Balkan Med J. 2023, 40(2): 74-81. DOI: 10.4274/balkanmedj.galenos.2023.2023-1-100.

3.牛永彬, 曹碧, 张毫, 等. 苏合香丸联合尼莫地平治疗蛛网膜下腔出血后脑血管痉挛的临床研究[J]. 现代药物与临床, 2022, 37(1): 75-80. [Niu YS, Cao B, Zhang H, et al. Clinical study on suhexiang pills combined with nimodipine in treatment of cerebral vasospasm after subarachnoid hemorrhage[J]. Drugs & Clinic, 2022, 37(1): 75-80.] DOI: 10.7501/j.issn.1674-5515.2022.01.011.

4.Roelz R, Schubach F, Coenen VA, et al. Stereotactic cisternal lavage in patients with aneurysmal subarachnoid hemorrhage with urokinase and nimodipine for the prevention of secondary brain injury (SPLASH): study protocol for a randomized controlled trial[J]. Trials, 2021, 22(1): 285-285. DOI: 10.1186/s13063-021-05208-6.

5.于伟娜, 甘宁, 刘思思, 等. 活血醒脑汤联合尼莫地平治疗动脉瘤性蛛网膜下腔出血并发脑血管痉挛瘀血阻络证疗效研究[J]. 陕西中医, 2022, 43(12): 1702-1705. [Yu WN, Gan N, Liu SS, et al. Study on the curative effect of Huoxue Xingnao decoction combined with nimodipine in the treatment of aneurysmal subarachnoid hemorrhage complicated by cerebral vasospasm and blood stasis obstruction syndrome[J]. Shaanxi Journal of Traditional Chinese Medicine, 2022, 43(12): 1702-1705.] DOI: 10. 3969/j.issn.1000-7369.2022.12.011.

6.向兴刚, 周益凡, 林琳,等. 熄风解痉汤联合尼莫地平防治动脉瘤性蛛网膜下腔出血后脑血管痉挛的临床研究[J]. 中国中西医结合杂志, 2019, 39(11): 1332-1335. [Xiang XG, Zhou YF, Lin L, et al. Clinical study on prevention and treatment of cerebral vasospasm after aneurysmal subarachnoid hemorrhage by Xifeng Jiejing decoction and nimodipine[J]. Chinese Journal of Integrated Traditional and Western Medicine, 2019, 39(11): 1332-1335.] DOI: 10.7661/j.cjim.20190823.307.

7.国家卫生计生委脑卒中防治工程编写委员. 中国动脉瘤性蛛网膜下腔出血诊疗指导规范[J]. 中国脑血管病杂志, 2016, 13(7): 384-392. DOI: 10.3969/j.issn.1672-5921.2016.07.012.

8.李平, 吴钟璇, 张云如,等. 中风病诊断与疗效评定标准(试行)[J]. 北京中医药大学学报, 1996, 19(1): 55-56. [Li P, Wu ZX, Zhang YR, et al. Criterion of diagnosis and therapeutic effect of apoplexy[J]. Journal of Beijing University of Traditional Chinese Medicine, 1996, 19(1): 55-56.] DOI: 10.3321/j.issn:1006-2157.1996.01.022.

9.黄培新, 黄燕, 卢明, 等. 急性脑出血中西医结合综合治疗方案研究[J]. 中国中西医结合杂志, 2006, 26(7): 590-593. [Huang PX, Huang Y, Lu M, et al. Treatment of acute intracerebral hemorrhage with a comprehensive protocol of integrated chinese and western medicine[J]. Chinese Journal of Integrated Traditional and Western Medicine, 2006, 26(7): 590-593.] DOI: 10.3321/j.issn: 1003-5370.2006.07.005.

10.郑筱萸. 中药新药临床研究指导原则(试行)[M]. 北京: 中国医药科技出版社, 2002: 234-235.

11.吉沥. GOS评分在动脉瘤性蛛网膜下腔出血患者预后评估中的作用及其危险因素分析[J]. 空军医学杂志, 2019, 35(6): 503-505, 518. [Ji L. Prognostic role of GOS score in patients with aneurysmal subarachnoid hemorrhage and its risk factors[J]. Aviation Medicine of Air Force, 2019, 35(6): 503-505, 518.] DOI: 10.3969/j.issn. 2095-3402.2019.06.013.

12.王雄. 动脉瘤性蛛网膜下腔出血的流行病学特征及破裂的血流动力学变化研究[J]. 河北医药, 2019, 41(3): 352-355, 360. [Wang X. Clinical epidemiological characteristics and hemodynamic changes of aneurysmal subarachnoid hemorrhage[J]. Hebei Medical Journal, 2019, 41(3): 352-355, 360.] DOI: 10.3969/j.issn. 1002-7386.2019.03.007.

13.Chen S, Feng H, Sherchan P, et al. Controversies and evolving new mechanisms in subarachnoid hemorrhage[J]. Prog Neurobiol. 2014, 115(2): 64-91. DOI: 10.1016/j.pneurobio.2013.09.002.

14.Endo H, Hagihara Y, Kimura N, et al. Effects of clazosentan on cerebral vasospasm-related morbidity and all-cause mortality after aneurysmal subarachnoid hemorrhage: two randomized phase 3 trials in Japanese patientsp[J]. J Neurosurg. 2022, 137(6): 1707-1717. DOI: 10.3171/2022.2.JNS212914.

15.Lunkiewicz J, Brandi G, Willms J, et al. The effect of nimodipine on pulmonary function in artificially ventilated patients with aneurysmal subarachnoid hemorrhage[J] Acta Neurochir (Wien), 2021, 163(10): 2715-2721. DOI: 10. 1007/s00701-021-04837-9.

16.Macdonald RL, Hänggi D, Ko NU, et al. Newton-2 cisternal (nimodipine microparticles to enhance recovery while reducing toxicity after subarachnoid hemorrhage): a phase 2, multicenter, randomized, open-label safety study of intracisternal eg-1962 in aneurysmal subarachnoid hemorrhage[J]. Neurosurgery, 2020, 88(1): E13-E26. DOI: 10.1093/neuros/nyaa430.

17.汪群红, 章灵芝, 徐文伟,等. 葛根素的药理作用与不良反应分析[J]. 中华中医药学刊, 2015, 33(5): 1185-1187. [Wang QH, Zang LZ, Xu WW, et al. Pharmacological effect and adverse drug reactions induced by puerarin injection[J]. Chinese Archives of Traditional Chinese Medicine, 2015, 33(5): 1185-1187.] DOI: 10.13193/j.issn. 1673-7717.2015.05.050.

18.乐娜, 周雪, 费文婷,等. 赤芍、白芍及芍药苷、芍药内酯苷对急性血瘀证大鼠血液流变学及血管内皮功能的影响[J]. 环球中医药, 2019, 12(9): 1302-1307. [Le N, Zhou X, Fei WT, et al. Effects of radix paeoniae rubra, radix paeoniae alba, paeoniflorin and albiflorin on hemorheology and vascular endothelial function in rats with acute blood stasis syndrome[J]. Global Traditional Chinese Medicine, 2019, 12(9): 1302-1307.] DOI: 10.3969/j.issn. 1674-1749.2019.09.002.

19.章丽, 赵冰洁, 袁嘉瑞,等. 牡丹皮、赤芍与白芍对急性血瘀模型大鼠活血功效的比较研究[J]. 中草药, 2016, 47(15): 2676-2683. [Zang L, Zhao BJ, Yuan JR, et al. Comparation on effects of moutan cortex, paeoniae rubra radix, and paeoniae alba radix on acute blood stasis model rats[J]. Chinese Traditional and Herbal Drugs, 2016, 47(15): 2676-2683.] DOI: 10.7501/j.issn. 0253-2670.2016.15.015.

20.何其胜, 王爱萍, 王龙海. 红花黄色素对伴应激性高血糖脑梗死患者糖代谢、C-肽水平及凝血功能的影响[J]. 临床和实验医学杂志, 2019, 18(5): 504-508.[He QS, Wang AP, Wang LH, et al. Effects of carithamine on glucose metabolism, C- peptide level and blood coagulation function in patients with stress hyperglycemia and cerebral infarction[J]. Journal of Clinical and Experimental Medicine, 2019, 18(5): 504-508.] DOI: 10.3969/j.issn.1671-4695.2019.05.018.