Effect Of Xingnao-kaiqiao Acupunct Ure On The Clinical Effect And Plasma Levels Of S-100B, NSE,MBP And GFAP In Patients With Severe Acute Traumatic Brain Injury

Objective:To obeserve the effect of Xingnao-kaiqiao Acupuncture on the clinical Effect and plasma levels of main marker protein level of injured nerve:S-100protein (S-100B), Neuron specific enolase (NSE), Myelin basic protein (MBP) and Glial fibrillary acidic protein (GFAP) in patients with severe acute traumatic brain injury. Explore the mechanism of Xingnao-kaiqiao Acupuncture and the relationship between S-100B, NSE, MBP, GFAP levels and the severity, prognosis of severe acute traumatic brain injury.Method:Sixty cases of patients with severe acute traumatic brain injury were randomly divided into an acupuncture group and a control group. The control group were treated with routine western medicine. The acupuncture group were additionally treated with Xingnao-kaiqiao Acupuncture. The Glasgow Score (GCS) and the levels of main marker protein level of injured nerve of the two groups were detected before the treatment and at the time of3days,7days and14days after therapy and were compared. Arousal time and rate of the two groups after7days and14days were observed and compared. The Glasgow Prognosis Score (GOS) of the patients with different types after14days were compared between two groups. At the same time, the S-100B,NSE,MBP and GFAP levels before the treatment were analyzed with GCS before the treatment and GOS at the time of14days after therapy in correlation and the correlation were compared.In addition, selected30healthy volunteers (normal group) and tested the S-100B,NSE,MBP and GFAP levels.The results were compared with traumatic brain injury.Result:1. The difference of Glasgow Score in the acupuncture group before the treatment had no statistically significance compared with the control group (P>0.05); The Glasgow Score of acupuncture group was higher than the control group at the time of3days,7days and14days after therapy (P<0.05). The arousal time in the acupuncture group was shorter than the control group, and the arousal rate of acupuncture group was higher than the control group at the time of7days and14days after therapy (P<0.05). The Glasgow Prognosis Score of the acupuncture group was better than the control group at the time of14days after therapy (P<0.05)2. The plasma levels of main marker protein level of injured nerve in the two groups of patients were both increased before the treatment compared with the normal group (P<0.05). The difference of S-100B,NSE and GFAP levels in the acupuncture group before the treatment both had no statistically significance compared with the control group (P>0.05).The S-100B,NSE and GFAP levels of acupuncture group were lower than the control group at the time of3days,7days and14days after therapy (P<0.05). The difference of MBP level in the acupuncture group before the treatment and at the time of3days after therapy both had no statistically significance compared with the control group (P>0.05); The MBP levels of acupuncture group were lower than the control group at the time of7days and14days after therapy (P<0.01).3. The plasma levels of main marker protein level of injured nerve were inversely correlated with the severity and the prognosis of severe acute traumatic brain injury (Severity:rs-100B=-O.426、rNSE=-0.721、 rMBP=-0.28、rGFAP=-0.775; Prognosis:rs-100B=-0.333、rNSE=-0.823、 rMBP=-0.326、rGGFAP=-0.778). The GFAP level had the strongest correlation in the former biomarkers and the NSE level had the strongest correlation in the latter biomarkers.Conclusion:(1)Xingnao-kaiqiao Acupuncture is more beneficial to recover brain injury and consciousness when treated in the patients of severe acute traumatic brain injury compared with the western routine treatment.(2)The Xingnao-kaiqiao Acupuncture can effectively decrease the plasma levels of main marker protein level of injured nerve.It can promote restoration of the injured nerve and effectively restrain the occurrence of secondary brain injury. It might promote restoration of the brain injury by reducing the S-100B and GFAP levels.(3) The S-100B,NSE,MBP and GFAP levels in the groups of severe acute traumatic brain injury patients are increased compared with the normal group. The levels are inversely correlated with the severity and prognosis of severe acute traumatic brain injury. The higher concentration of main marker protein level of injured nerve,the more severe the degree of traumatic brain injury and the worse the prognosis. So testing the concentration of S-100B,NSE,MBP and GFAP can serve as one of the evaluation indicator on severity and prognostic in severe acute traumatic brain injury and the GFAP level is the better in the former indicators.