临床误诊误治2026，Vol.39Issue(13)：93-99,7.DOI:10.3969/j.issn.1002-3429.2026.13.015
基于TLR4/NLRP3信号通路探讨通腑泻热活血汤辅助西医治疗瘀热腑实证脑出血后脑水肿的临床效果
Clinical effect of Tongfu Xiere Huoxue decoction as an adjunct to Western medicine in the treatment of cerebral edema after intracerebral hemorrhage with stasis-heat and fu-organ excess syndrome based on TLR4/NLRP3 signaling pathway
摘要
Abstract
Objective To investigate the clinical effect of Tongfu Xiere Huoxue decoction as an adjunct to Western medicine for intracerebral hemorrhage(ICH)with stasis-heat and fu-organ excess pattern based on the Toll-like receptor 4(TLR4)/NOD-like receptor protein 3(NLRP3)signaling pathway.Methods A total of 118 ICH patients with stasis-heat and fu-organ excess pattern who were admitted to Changzhou Hospital of Traditional Chinese Medicine from January 2024 to January 2025 were selected.They were divided into the control group(n=59,treated with conventional Western medicine)and the observation group(n=59,treated with Tongfu Xiere Huoxue decoction as an adjunct to Western medicine).Both groups received treatment for 2 consecutive weeks.The two groups were compared in terms of the therapeutic effects,the National Institutes of Health Stroke Scale(NIHSS)scores,the volume of cerebral edema,intracranial pressure,peripheral blood inflammatory and oxidative stress markers[C-reactive protein(CRP),neutrophil/lymphocyte ratio(NLR),malondialdehyde(MDA),superoxide dismutase(SOD)],and the expression levels of serum TLR4 and NLRP3 mRNA,as well as adverse reactions and prognosis.Results The total effective rate of the observation group was 98.31％(58/59),which was higher than that of the control group(84.75％,50/59,P<0.05).At 1 and 2 weeks after treatment,the NIHSS score,volume of cerebral edema,intracranial pressure,mRNA expression of serum TLR4 and NLRP3,and levels of CRP,NLR,and MDA in peripheral blood of the observation group were all lower than those of the control group,while the SOD level was higher than that of the control group(P<0.05).There was no significant difference in the total incidence of adverse reactions between the two groups(P>0.05),and at 3 months after treatment,the modified Rankin scale score of the observation group was higher than that of the control group(P<0.05).Conclusion Tongfu Xiere Huoxue decoction,as an adjunct to Western medicine,can effectively improve the neurological function of patients with intracerebral hemorrhage-induced cerebral edema with stasis-heat and fu-organ excess pattern.It can also reduce cerebral edema,lower intracranial pressure,and has good safety.Its effects may be related to the alleviation of inflammation and oxidative stress responses,and the TLR4/NLRP3 signaling pathway may be involved.关键词
脑出血/脑水肿/通腑泻热活血汤/TLR4/NLRP3信号通路/炎症反应/氧化应激Key words
intracerebral hemorrhage/cerebral edema/Tongfu Xiere Huoxue decoction/TLR4/NLRP3 signaling pathway/inflammatory response/oxidative stress引用本文复制引用
孔炎铖,阮永兰,黄智,王迪..基于TLR4/NLRP3信号通路探讨通腑泻热活血汤辅助西医治疗瘀热腑实证脑出血后脑水肿的临床效果[J].临床误诊误治,2026,39(13):93-99,7.基金项目
国家自然科学基金资助项目(82405288) （82405288）
