目的：探讨三七总皂苷辅助治疗对颅脑创伤患者脑脊髓液炎性因子表达及预后的影响。方法选择2011年6月至2013年12月解放军第一八八医院接诊的70例颅脑创伤患者为研究对象，按照随机数表法分为观察组和对照组，各35例。对照组采用神经外科的常规治疗方法进行治疗，观察组在常规治疗基础上加三七总皂苷辅助治疗，350～400 mg三七总皂苷静脉注射，2周为1个疗程，共3个疗程。比较两组患者的脑脊髓液炎性因子[肿瘤坏死因子α（ TNF－α）、白细胞介素（ IL）1、IL－6]水平以及预后情况。结果治疗后3、7、14 d两组患者的TNF－α水平均呈下降趋势，观察组治疗后不同时间点的TNF－α水平明显低于对照组；治疗后3、7 d两组患者的IL－1、IL－6水平呈上升趋势，治疗后14 d又下降，治疗后不同时间点观察组IL－1水平低于对照组。两组 TNF－α、IL－1、IL－6水平组间、不同时间点、组间・不同时间点交互作用比较差异有统计学意义（ P＜0.05）。观察组患者恢复良好率高于对照组[40.0％（14／35）比11.4％（4／35）]，差异有统计学意义（P＜0.05）。结论三七总皂苷辅助治疗颅脑创伤患者疗效显著，预后良好，值得临床推广。%Objective To evaluate the influence of the adjuvant therapy of panax notoginseng saponin on expression of spinal fluid inflammatory cytokines and prognosis for traumatic brain injury .Methods Total of 70 patients with traumatic brain injury in PLA 188th Hospital from Jun.2011 to Dec.2013 were included and divided into observation group and control group according to random number table method,35 cases each.The control group was treated by conventional neurosurgery;the observation group was treated by con-ventional neurosurgery plus adjuvant therapy of panax notoginseng saponins,350-400 mg of notoginseng sapo-nin intravenous infusion,2 weeks as a course,3 courses.Spinal fluid inflammatory cytokines [tumor necrosis factor α(TNF-α),interleukin (IL)-1,IL-6)] and prognostic evaluation results of the two groups were com-pared.Results After treatment,the levels of TNF-αon 3rd,7th,14th day of both groups decreased,and the levels of TNF-αin the observation group were significantly lower than those in the control group at different time points;the levels of IL-6 and IL-1 on 3rd,7th day after treatment of both groups were increased,and on the 14th day after treatment decreased,and the IL-1 level of the observation group was lower than the control group at different time points.TNF-α,IL-1,IL-6 levels between groups,between different time points,and the interaction between groups・ different time points were statistically significantly different ( P <0.05 ) .The good recovery rate of the observation group was higher than the control group [ 40.0%( 14/35 ) vs 11.4%(4/35)],the difference was statistically significant(P<0.05).Conclusion The adjuvant therapy of panax notoginseng saponin for traumatic brain injury patients has good efficacy and prognosis ,thus is worthy of pro-motion in clinical.
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