灯盏细辛注射液联合丁苯酞治疗急性脑梗死的临床研究
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摘要
目的探讨灯盏细辛注射液联合丁苯酞氯化钠注射液治疗急性脑梗死的临床疗效。方法选取2017年3月—2018年11月洛阳市第三人民医院收治的90例急性脑梗死患者为研究对象,按照随机数字表法将患者分为对照组和治疗组,每组各45例。对照组静脉滴注丁苯酞氯化钠注射液,25 mg/次,2次/d。治疗组在对照组治疗的基础上静脉滴注灯盏细辛注射液,30 mL加入到250 mL生理盐水中充分稀释,30 mL/次,1次/d。两组患者均连续治疗14 d。观察两组患者的临床疗效,同时比较两组治疗前后的神经功能缺损评分(NIHSS)、日常生活活动能力评定量表(ADL)评分和血管内皮功能指标。结果治疗后,对照组和治疗组的总有效率分别为75.56%、91.11%,两组比较差异具有统计学意义(P<0.05)。治疗后,两组NIHSS评分显著降低,ADL评分显著升高,同组治疗前后比较差异具有统计学意义(P<0.05);治疗后,治疗组NIHSS评分显著低于对照组,ADL评分显著高于对照组,两组比较差异具有统计学意义(P<0.05)。治疗后,两组的内皮素-1(ET-1)、血管生成素(Ang-1)、血管内皮生长因子(VEGF)水平明显降低,一氧化氮(NO)明显升高,同组治疗前后比较差异具有统计学意义(P<0.05);治疗后,治疗组血管内皮功能指标水平显著优于对照组,两组比较差异具有统计学意义(P<0.05)。结论灯盏细辛注射液联合丁苯酞氯化钠注射液治疗急性脑梗死具有较好的临床疗效,能改善患者的神经功能和血管内皮功能指标,具有一定的临床推广应用价值。
Objective To investigate the clinical efficacy of Dengzhanxixin Injection combined with Butylphthalide and Sodium Chloride Injection in treatment of acute cerebral infarction. Methods Patients(90 cases) with acute cerebral infarction in Luoyang Third People's Hospital from March 2017 to November 2018 were randomly divided into control and treatment groups, and each group had 45 cases. Patients in the control group were iv administered with Butylphthalide and Sodium Chloride Injection, 25 mg/time, twice daily. Patients in the treatment group were iv administered with Dengzhanxixin Injection on the basis of the control group, 30 mL added into normal saline 250 mL, 30 mL/time, once daily. Patients in two groups were treated for 14 d. After treatment, the clinical efficacy was evaluated, and the NIHSS scores, ADL scores, and vascular endothelial function indexes in two groups before and after treatment were compared. Results After treatment, the clinical efficacy in the control and treatment groups were 75.56% and 91.11%,respectively, and there were differences between two groups(P < 0.05). After treatment, NIHSS scores in two groups were significantly decreased, but ADL scores were significantly increased, and the difference was statistically significant in the same group(P < 0.05). After treatment, NIHSS scores in the treatment group were significantly lower than those in the control group, but the ADL scores were significantly higher than those in the control group, with significant difference between two groups(P < 0.05). After treatment, ET-1, Ang-1, and VEGF levels in two groups were significantly decreased, but NO levels in two groups were significantly increased, and the difference was statistically significant in the same group(P < 0.05). After treatment, the vascular endothelial function indexes levels in the treatment group were significantly better than those in the control group,with significant difference between two groups(P < 0.05). Conclusion Dengzhanxixin Injection combined with Butylphthalide and Sodium Chloride Injection has clinical curative effect in treatment of acute cerebral infarction, can improve the neurological function and vascular endothelial function, which has a certain clinical application value.
Objective To investigate the clinical efficacy of Dengzhanxixin Injection combined with Butylphthalide and Sodium Chloride Injection in treatment of acute cerebral infarction. Methods Patients(90 cases) with acute cerebral infarction in Luoyang Third People's Hospital from March 2017 to November 2018 were randomly divided into control and treatment groups, and each group had 45 cases. Patients in the control group were iv administered with Butylphthalide and Sodium Chloride Injection, 25 mg/time, twice daily. Patients in the treatment group were iv administered with Dengzhanxixin Injection on the basis of the control group, 30 mL added into normal saline 250 mL, 30 mL/time, once daily. Patients in two groups were treated for 14 d. After treatment, the clinical efficacy was evaluated, and the NIHSS scores, ADL scores, and vascular endothelial function indexes in two groups before and after treatment were compared. Results After treatment, the clinical efficacy in the control and treatment groups were 75.56% and 91.11%,respectively, and there were differences between two groups(P < 0.05). After treatment, NIHSS scores in two groups were significantly decreased, but ADL scores were significantly increased, and the difference was statistically significant in the same group(P < 0.05). After treatment, NIHSS scores in the treatment group were significantly lower than those in the control group, but the ADL scores were significantly higher than those in the control group, with significant difference between two groups(P < 0.05). After treatment, ET-1, Ang-1, and VEGF levels in two groups were significantly decreased, but NO levels in two groups were significantly increased, and the difference was statistically significant in the same group(P < 0.05). After treatment, the vascular endothelial function indexes levels in the treatment group were significantly better than those in the control group,with significant difference between two groups(P < 0.05). Conclusion Dengzhanxixin Injection combined with Butylphthalide and Sodium Chloride Injection has clinical curative effect in treatment of acute cerebral infarction, can improve the neurological function and vascular endothelial function, which has a certain clinical application value.
引文
[1]邓丽,刘晓冬,张拥波,等.急性脑梗死的治疗进展[J].中国全科医学, 2011, 14(8):825-829.
[2]朱以诚,崔丽英,高山,等.丁苯酞注射液治疗急性脑梗死的多中心、随机、双盲双模拟、对照Ⅲ期临床试验[J].中华神经科杂志, 2014, 47(2):113-118.
[3]林小娟,王梅平,刘钦华.灯盏细辛注射液对脑梗死患者血液流变学的影响[J].临床神经病学杂志,2003,16(6):375.
[4]中华医学会神经病学分会脑血管病学组急性缺血性脑卒中诊治指南撰学组.中国急性缺血性脑卒中诊治指南2010[J].中华神经科杂志, 2010, 43(2):146-153.
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[6]张明园.精神科评定量表手册[M].第2版.长沙:湖南科学技术出版社, 1998:166.
[7]王佳楠,张雄伟,王翠玉,等.急性双侧脑梗死的病因分型及发病机制分析[J].中华老年心脑血管病杂志,2015, 17(8):826-829.
[8]吴娟,陈永.丁苯酞对急性脑梗死患者临床疗效及血液流变学的影响[J].重庆医学,2012,41(33):3488-3489.
[9]李辉.急性脑梗死的中医证治[J].长春中医药大学学报, 2012, 28(6):998-999.
[10]李娜,姜义,孙海欣,等.灯盏细辛注射液治疗急性脑梗死有效性的临床研究[J].首都医科大学学报,2008, 29(3):336-339.
[11]尹文伟,陈思,毕坤,等.灯盏细辛注射液对急性脑梗死患者血清HIF-1α、Caspase-3及血尿酸水平影响研究[J].辽宁中医杂志, 2017, 44(5):996-998.
[12]苗建国,陈淑敏.灯盏细辛注射液联合胞磷胆碱钠胶囊治疗脑梗死的临床研究[J].现代药物与临床,2016,31(1):41-44.
[13]王翠兰,石秋艳,孙原,等.急性脑梗死患者血清VEGF与bFGF水平的动态变化[J].中风与神经疾病杂志, 2014, 31(4):292-294.
[14]刘媛媛,潘莉,郭晋,等.急性脑梗死患者血清VEGF及Ang-1水平的动态变化及其意义[J].蚌埠医学院学报, 2012, 37(10):1178-1180.
[15]宋芷珩,张朝东,王彦,等.ET-1及VEGF与脑梗死病变关系的探讨[J].中国医科大学学报,2003,32(3):248-249.
[16]吴晓华,闫金辉,杨晓晖.脑梗死患者血清NO及t NOS、i NOS的测定[J].中国医药导报, 2010, 7(33):9-10.
[2]朱以诚,崔丽英,高山,等.丁苯酞注射液治疗急性脑梗死的多中心、随机、双盲双模拟、对照Ⅲ期临床试验[J].中华神经科杂志, 2014, 47(2):113-118.
[3]林小娟,王梅平,刘钦华.灯盏细辛注射液对脑梗死患者血液流变学的影响[J].临床神经病学杂志,2003,16(6):375.
[4]中华医学会神经病学分会脑血管病学组急性缺血性脑卒中诊治指南撰学组.中国急性缺血性脑卒中诊治指南2010[J].中华神经科杂志, 2010, 43(2):146-153.
[5]全国第四届脑血管病学术会议.脑卒中患者临床神经功能缺损程度评分标准(1995)[J].中华神经科杂志,1996, 29(6):381-383.
[6]张明园.精神科评定量表手册[M].第2版.长沙:湖南科学技术出版社, 1998:166.
[7]王佳楠,张雄伟,王翠玉,等.急性双侧脑梗死的病因分型及发病机制分析[J].中华老年心脑血管病杂志,2015, 17(8):826-829.
[8]吴娟,陈永.丁苯酞对急性脑梗死患者临床疗效及血液流变学的影响[J].重庆医学,2012,41(33):3488-3489.
[9]李辉.急性脑梗死的中医证治[J].长春中医药大学学报, 2012, 28(6):998-999.
[10]李娜,姜义,孙海欣,等.灯盏细辛注射液治疗急性脑梗死有效性的临床研究[J].首都医科大学学报,2008, 29(3):336-339.
[11]尹文伟,陈思,毕坤,等.灯盏细辛注射液对急性脑梗死患者血清HIF-1α、Caspase-3及血尿酸水平影响研究[J].辽宁中医杂志, 2017, 44(5):996-998.
[12]苗建国,陈淑敏.灯盏细辛注射液联合胞磷胆碱钠胶囊治疗脑梗死的临床研究[J].现代药物与临床,2016,31(1):41-44.
[13]王翠兰,石秋艳,孙原,等.急性脑梗死患者血清VEGF与bFGF水平的动态变化[J].中风与神经疾病杂志, 2014, 31(4):292-294.
[14]刘媛媛,潘莉,郭晋,等.急性脑梗死患者血清VEGF及Ang-1水平的动态变化及其意义[J].蚌埠医学院学报, 2012, 37(10):1178-1180.
[15]宋芷珩,张朝东,王彦,等.ET-1及VEGF与脑梗死病变关系的探讨[J].中国医科大学学报,2003,32(3):248-249.
[16]吴晓华,闫金辉,杨晓晖.脑梗死患者血清NO及t NOS、i NOS的测定[J].中国医药导报, 2010, 7(33):9-10.