Administration of Yunnan Baiyao improved clinical prognosis of emergency craniotomy in patients with moderate-to-severe TBI: a randomized controlled trial
Background: Although emergency craniotomy has been performed to reduce the mortality of traumatic brain injury (TBI), it is associated with secondary injury and poor prognosis. The efficacy of a wound-healing medicine Yunnan Baiyao (YB) was compared with a TBI medicine Xingnaojing (XNJ) and orthodox therapy (OT). Method: Eighty patients (39±7 yrs.) with moderate-to-severe TBI (Glasgow Coma Scale(GOS), 3-12) received craniotomy before randomly assigned to (n=20) 7 days treatment of: 1) OT; 2)
... nt of: 1) OT; 2) OT+XNJ (20 ml i.v. drip/daily); 3) OT+low dose-YB (oral, 1,000 mg/day); 4) OT+high dose-YB, 2,000 mg/day). Serum S100B and superoxide dismutase (SOD), Glasgow Outcome Scale (GOS) and Karnofsky Performance Scale (KPS) were evaluated.Results: GCS score was lowest on admission that improved more quickly and became significantly higher in XNJ, l-YB, h-YB groups than in OT group (P<0.01). S100B peaked higher but declined more slowly and became significantly higher in OT than in other groups (P<0.01). By Day 7, S100B declined to 20% below baseline in other groups but remained 19.4% above baseline in OT group. OT lost 38% SOD activity on Day 3 and regained 69% of SOD activity on Day 7 whereas other groups lost 16.7%~23.4% SOD on Day 3 but regained 91.8%~99.5% activity on Day 7 (P<0.01). GOS and KPS scores were significantly greater (~25%~30%) in the XNJ, l-YB, h-YB groups than in OT group 1-3 months post-surgery. Conclusion: YB is significantly better than OT and non-inferior to XNJ in improving postoperative recovery and clinical prognosis after emergency craniotomy in patients with moderate-to-severe TBI.