血栓通联合依达拉奉对急性脑梗死患者神经功能、血液流变学及炎性反应的影响
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摘要
目的:探讨血栓通联合依达拉奉治疗急性脑梗死临床疗效及对神经功能、血液流变学及炎性反应的影响。方法:100例急性脑梗死患者,分为观察组与对照组,50例/组。对照组使用依达拉奉治疗,观察组则在前者基础上加用血栓通注射液,两组均用药两周,比较两组患者症状积分、疗效以及治疗前后的神经功能、凝血功能及炎症反应指标的水平。结果:对照组总有效率为86%,观察组为94%,两组比较,P<0.05;治疗前对照组半身不遂、口眼歪斜、言语蹇涩与观察组比较无统计学意义,治疗后分别为(3.40±1.52)分、VS(2.00±1.98)分、(3.20±1.92)分VS(2.60±1.52)分、(3.70±1.70)分VS(2.70±1.64)分,两组比较,P<0.01;治疗后神经功能缺损评分比较,对照组积分为(15.83±4.58)分,观察组为8.82±3.73分,两组比较,P<0.01;治疗后APTT、TT、PT比较,观察组效果优于对照组,P<0.01;治疗后全血高切黏度、全血低切黏度、血细胞比容、纤维蛋白原、血小板聚集率比较,观察组效果优于对照组,P<0.05;IL-8、IL-6、TNF-α比较,观察组效果优于对对照组,P<0.05。结论:使用血栓通联合依达拉奉治疗急性脑梗死,不仅可以改善临床症状,还可以保护患者神经功能、调节血液流变学指标、抑制炎性反应、提高临床疗效。
Objective: To investigate the clinical effect of Xueshuan Tong combined with Edaravone on acute cerebral infarction and its influence on nerve function, Hemorheology and inflammatory reaction. Methods: 100 patients with acute cerebral infarction admitted to Mengzhou Hospital of Traditional Chinese Medicine from January 2017 to October 2018 were divided into observation group and control group, 50 cases each group according to the treatment method. The control group was treated with Edaravone, while the observation group was treated with Xueshuan Tong injection on the basis of the former. Both groups were treated with Xueshuan Tong injection for two weeks. Results: The total effective rate was 86% in the control group and 94% in the observation group(P<0.05). There was no significant difference in hemiplegia, deviation of mouth and eye, astringency of speech between the control group and the observation group before treatment, with 3.40±1.52 VS 2.00±1.98 point, 3.20±1.92 VS 2.60±1.52 point, 3.70±1.70 VS2.70±1.64 point, were compared between the two groups(P<0.01). After treatment, the score of nerve function defect in the control group was 15.83±4.58, while that in the observation group was 8.82±3.73, were compared between the two groups(P<0.01); after treatment, the effect of APTT, TT and PT in the observation group was better than that in the control group(P<0.01); after treatment, the whole blood viscosity was higher and the whole Compared with the control group, the effect of the treatment group was better than that of the control group(P<0.05); the effect of the treatmentgroup was better than that of the control group(P<0.05); the effect of IL-8, IL-6 and TNF-α was better than that of the control group(P<0.05). Conclusion: Xueshuan Tong combined with Edaravone in the treatment of acute cerebral infarction can not only improve clinical symptoms, but also protect neurological function, regulate hemorheological parameters,inhibit inflammatory reaction and improve clinical efficacy.
Objective: To investigate the clinical effect of Xueshuan Tong combined with Edaravone on acute cerebral infarction and its influence on nerve function, Hemorheology and inflammatory reaction. Methods: 100 patients with acute cerebral infarction admitted to Mengzhou Hospital of Traditional Chinese Medicine from January 2017 to October 2018 were divided into observation group and control group, 50 cases each group according to the treatment method. The control group was treated with Edaravone, while the observation group was treated with Xueshuan Tong injection on the basis of the former. Both groups were treated with Xueshuan Tong injection for two weeks. Results: The total effective rate was 86% in the control group and 94% in the observation group(P<0.05). There was no significant difference in hemiplegia, deviation of mouth and eye, astringency of speech between the control group and the observation group before treatment, with 3.40±1.52 VS 2.00±1.98 point, 3.20±1.92 VS 2.60±1.52 point, 3.70±1.70 VS2.70±1.64 point, were compared between the two groups(P<0.01). After treatment, the score of nerve function defect in the control group was 15.83±4.58, while that in the observation group was 8.82±3.73, were compared between the two groups(P<0.01); after treatment, the effect of APTT, TT and PT in the observation group was better than that in the control group(P<0.01); after treatment, the whole blood viscosity was higher and the whole Compared with the control group, the effect of the treatment group was better than that of the control group(P<0.05); the effect of the treatmentgroup was better than that of the control group(P<0.05); the effect of IL-8, IL-6 and TNF-α was better than that of the control group(P<0.05). Conclusion: Xueshuan Tong combined with Edaravone in the treatment of acute cerebral infarction can not only improve clinical symptoms, but also protect neurological function, regulate hemorheological parameters,inhibit inflammatory reaction and improve clinical efficacy.
引文
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[11]孙秀业.针灸联合醒脑开窍汤对急性脑梗死患者神经功能缺损及血清IL-6、IL-8、TNF-α的影响[J].针灸临床杂志,2018,03:4-7.
[12]Galán Asier,Mayer Iva,Rafaj Renata Baric,Bendelja Kreso,Susic Velimir,Cerón JoséJoaquín,Mrljak Vladimir.MCP-1,KC-like and IL-8 as critical mediators of pathogenesis caused by Babesia canis.[J].PloS one,2018,131:.
[13]叶涛,朱路文,唐强,李宏玉,吴孝军,姜云飞.电针预处理对大鼠脑缺血再灌注损伤后脑梗死体积及血清TNF-α、IL-10含量的影响[J].中国针灸,2017,37(10):1093-1098.
[14]Kang YH,Park MG,Noh KH,et al.Low serum TNF-related apoptosis-inducing ligand(TRAIL)levels are associated with acute ischemic stroke severity[J].Atherosclerosis,2015,240(1):228-233.
[15]晓宇,朱彩花,楼滟.血栓通联合丁苯酞对老年急性脑梗死血清中Fibulin-5、BDNF及S100B的影响[J].中华中医药学刊,2018,36(1):235-238.
[2]陈洪议.依达拉奉与大株红景天联用对急性脑梗死患者的疗效及其对脑神经功能改善及血清炎症因子水平的影响[J].抗感染药学,2018(10):1779-1782.
[3]熊劲,江显萍.疏血通、神经节苷脂、依达拉奉联合治疗老年急性脑梗死的疗效[J].中国老年学杂志,2013,33(20):5109-5110.
[4]张宇明,何辉.血栓通注射液联合依达拉奉治疗老年急性脑梗死的疗效及对细胞因子、脑血流动力学和血管内皮功能的影响[J].中国老年学杂志,2018,38(21):5155-5157.
[5]承明哲,白向荣,林晓兰,庄伟,唐晓博,贾芳芳,王秀娟.血栓通联合依达拉奉治疗急性脑梗死的Meta分析[J].北京中医药,2018,37(5):434-439.
[6]黎洁玲,李诺,陈泽锋,卢淑萍,梁日长.血栓通注射液治疗缺血性脑卒中恢复期临床观察[J].中医药临床杂志,2016,28(9):1278-1280.
[7]中华医学会神经病学分会,中华医学会神经病学分会脑血管病学组.中国急性缺血性脑卒中诊治指南2018[J].中华神经科杂志,2018,51(9):666-682.
[8]国家中医药管理局.中药新药临床研究指导原则[M].北京:中国医药科技出版社,2002:90-92.
[9]苏宏图,李明,石小晶,等.缺血修饰白蛋白与急性进展性脑梗死的关系研究[J].河北医药,2017,39(2):238-241.
[10]王晓东,周文秀,周凡,曹培卫.丹参川芎嗪注射液联合西医治疗急性脑梗死疗效及对血液流变学、TXB2、6-Keto-PGF1α水平的影响[J].现代中西医结合杂志,2018,29:3242-3245.
[11]孙秀业.针灸联合醒脑开窍汤对急性脑梗死患者神经功能缺损及血清IL-6、IL-8、TNF-α的影响[J].针灸临床杂志,2018,03:4-7.
[12]Galán Asier,Mayer Iva,Rafaj Renata Baric,Bendelja Kreso,Susic Velimir,Cerón JoséJoaquín,Mrljak Vladimir.MCP-1,KC-like and IL-8 as critical mediators of pathogenesis caused by Babesia canis.[J].PloS one,2018,131:.
[13]叶涛,朱路文,唐强,李宏玉,吴孝军,姜云飞.电针预处理对大鼠脑缺血再灌注损伤后脑梗死体积及血清TNF-α、IL-10含量的影响[J].中国针灸,2017,37(10):1093-1098.
[14]Kang YH,Park MG,Noh KH,et al.Low serum TNF-related apoptosis-inducing ligand(TRAIL)levels are associated with acute ischemic stroke severity[J].Atherosclerosis,2015,240(1):228-233.
[15]晓宇,朱彩花,楼滟.血栓通联合丁苯酞对老年急性脑梗死血清中Fibulin-5、BDNF及S100B的影响[J].中华中医药学刊,2018,36(1):235-238.