Abstract:

AIM: To discuss the therapeutic effect of ambroxol hydrochloride combined with high-dose methylprednisolone (MP) on the recovery of neurological function after spinal cord injury in patients with thoracolumbar fractures.  METHODS: Forty eight patients with thoracolumbar fractures plus spinal cord injury admitted to our hospital from Feburary 2016 to August 2016 were randomly divided into the combination group and the control group according to random number table (n=24). All the patients were performed decompression and internal fixation operation, and MP was given 30 mg/kg intravenously for 15 min, another 5.4 mg·kg-1·h-1 MP was given intravenously for 23 h 45 minutes later. Based on the treatment of the control group, the combination group received extra ambroxol hydrochloride intravenously (60 mg/time, 1 time/12 h), continued for 30 days. Patients in both groups were given anti-infection, hemostatic, dehydration, and symptomatic treatment, and intravenous drip of omeprazole (30 mg/time, 1 time/12 h, 3 d) was administered to prevent gastrointestinal stress ulcer. All patients were followed up for 6 months; the clinical curative effect in two groups were determined according to Frankel classification method; ASIA sensory and motor score were evaluated and compared between two groups before and 1 month and 6 month after treatment; adverse drug reactions were recorded. RESULTS:No statistically significant difference were observed with the baseline data such as age,sex,heart rate,breathing and body mass index between the two groups(P>0.05).After 6 months' treatment,the total effective rate in the combination group was significantly higher than that of the control group (87.5% vs. 62.5%, P<0.05); ASIA sensory and motor score were significantly elevated compared with before treatment in both groups 1 month and 6 month after treatment (P<0.05), and between the two groups, the combination group presented more significant improvement (P<0.05); No statistically significant difference was observed with adverse reaction occurrence between the two groups (29.2% vs. 33.3%, P>0.05).CONCLUSION:Compared with simple MP shock treatment, ambroxol hydrochloride combined with high-dose MP can significantly alleviate the injured neurological function and improve neural functional recovery in patients with thoracolumbar fractures combined with spinal cord injury, whereas more clinical and laboratory research are needed to confirm the effect.

Key words: ambroxol hydrochloride, methylprednisolone, thoracolumbar fractures combined with spinal cord injury, neurological function