中西医结合对急性心源性脑梗死患者血清PLG和神经功能的影响
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摘要
目的:探讨中西医结合对急性心源性脑梗死(ACCE)患者血清纤溶酶原(PLG)和神经功能的影响。方法:选取2016年4月至2018年4月南阳市中心医院收治的ACCE患者98例作为研究对象,随机分为对照组和观察组,每组49例。对照组给予马来酸桂哌齐特,观察组给予马来酸桂哌齐特联合消栓宁心汤。观察和比较2组患者的纤溶指标、血流变、神经功能和疗效。结果:治疗后,2组患者的血清PLG、人凝血因子Ⅷ相关抗原(VWF-Ag)和血栓素B_2(TXB_2)显著降低,6-酮-前列腺素F_(1α)(6-kcto-PGF_(1α))显著升高,且观察组患者的血清PLG、VWF-Ag、TXB_2显著低于对照组,6-kcto-PGF_(1α)显著高于对照组(P <0. 05);观察组患者的血浆黏度、全血黏度显著低于对照组,粥样斑块减小面积显著高于对照组,2组比较差异有统计学意义(P <0. 05); 2组患者的NIHSS评分均降低,且观察组显著低于对照组,差异有统计学意义(P <0. 05);观察组的总有效率(95. 91%)显著高于对照组的总有效率(71. 42%),差异有统计学意义(P <0. 05)。结论:消栓宁心汤联合西药能有效改善ACCE患者体内的纤溶系统活性,降低血液黏度,减轻患者神经功能缺损,具有显著的临床疗效。
Objective: To explore the effects on serum PLG and neurological function in patients with acute cardiogenic cerebral embolism( ACCE) using integration of traditional Chinese and western medicine. Methods: A total of 98 patients with ACCE treated in Nanyang Central Hospital from April 2016 to April 2018 were randomly divided into the control group( 49 cases) and the observation group( 49 cases). The control group was given cinepazide maleate,and the observation group was given Xiaoshuan Ningxin decoction combined with cinepazide maleate. The fibrinolytic indexes,blood rheology,neurological function and curative effect were observed and compared between the 2 groups. Results: After treatment,the serum levels of PLG,VWF-Ag and TXB_2 in the 2 groups were significantly decreased,while the serum levels of 6-kcto-PGF_(1α)significantly increased,and the changes in the observation group were more significant than those in the control group( P < 0. 05). The plasma viscosity and total blood viscosity in the observation group were lower than those in the control group,and the reduced area of atheromatous plaque was higher than that in the control group( P < 0. 05). The scores of NIHSS in both groups decreased,and the score of NIHSS in the observation group was significantly lower than that in the control group( P < 0. 05). The total effective rate in the treatment group was higher than that in the control group( 95. 91% vs 71. 42%,P < 0. 05). Conclusion: Xiaoshuan Ningxin decoction combined with western medicine can effectively improve the fibrinolytic system activity,reduce blood viscosity,and alleviate the neurological function defect in patients with ACCE,which has significant clinical effects.
Objective: To explore the effects on serum PLG and neurological function in patients with acute cardiogenic cerebral embolism( ACCE) using integration of traditional Chinese and western medicine. Methods: A total of 98 patients with ACCE treated in Nanyang Central Hospital from April 2016 to April 2018 were randomly divided into the control group( 49 cases) and the observation group( 49 cases). The control group was given cinepazide maleate,and the observation group was given Xiaoshuan Ningxin decoction combined with cinepazide maleate. The fibrinolytic indexes,blood rheology,neurological function and curative effect were observed and compared between the 2 groups. Results: After treatment,the serum levels of PLG,VWF-Ag and TXB_2 in the 2 groups were significantly decreased,while the serum levels of 6-kcto-PGF_(1α)significantly increased,and the changes in the observation group were more significant than those in the control group( P < 0. 05). The plasma viscosity and total blood viscosity in the observation group were lower than those in the control group,and the reduced area of atheromatous plaque was higher than that in the control group( P < 0. 05). The scores of NIHSS in both groups decreased,and the score of NIHSS in the observation group was significantly lower than that in the control group( P < 0. 05). The total effective rate in the treatment group was higher than that in the control group( 95. 91% vs 71. 42%,P < 0. 05). Conclusion: Xiaoshuan Ningxin decoction combined with western medicine can effectively improve the fibrinolytic system activity,reduce blood viscosity,and alleviate the neurological function defect in patients with ACCE,which has significant clinical effects.
引文
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[3]胡鹏洲,郭代红,王啸宇,等.马来酸桂哌齐特相关皮肤变态反应及过敏样反应的自动监测研究[J].中国药物警戒,2017,14(9):541-544.
[4]陈国锋,纪建政,汪守伍,等.“活血消栓汤”对髋部骨折术后患者凝血指标的影响研究[J].江苏中医药,2017,49(3):44-46.
[5]王鲲,秦陆兵.宁心汤治疗冠心病室性心律失常的疗效评价[J].中国医药指南,2018,16(14):207-208.
[6]林杨扬.低分子肝素与银杏达莫注射液联合改善急性心源性脑栓塞患者神经功能缺损的效果分析[J].中国医药指南,2017,15(15):69-70.
[7]郑雪松,汪蓉,彭吉霞,等.丹参酮ⅡA磺酸钠联合吲哚布芬对心源性脑栓塞血液流变学的影响[J].实用药物与临床,2016,19(1):26-29.
[8]王顺治,贾春华.基于中西医比较的中医中风内风说研究[J].世界中医药,2016,11(4):614-617.
[9]茹庆玲,陈淑萍,张蕊.脑栓塞的中医治疗效果观察[J].中医临床研究,2016,8(16):65-66.
[10]王晓玲,昝强,李小群,等.“消栓汤”联合低分子肝素钙预防髋部骨折术后下肢深静脉血栓68例临床研究[J].江苏中医药,2017,49(8):35-37.
[11]陈国锋,纪建政,汪守伍,等.活血消栓汤预防骨折后下肢深静脉血栓形成疗效观察[J].新中医,2016,48(11):82-83.
[12]王露.益气养阴宁心汤对风湿性心脏病慢性心力衰竭患者血流动力学和心功能指标的影响[J].中国卫生工程学,2018,17(3):438-439.
[13]席聪,王秦川,卢蓉.马来酸桂哌齐特联合尤瑞克林对急性心源性脑栓塞患者血清PLG、VWF-Ag、6-kcto-PGF1α及TXB2含量的影响[J].脑与神经疾病杂志,2018,26(1):44-48.
[14]付强,田宏,傅诗情,等.1种新型合成水蛭肽的纤溶动力学研究[J].中国海洋药物,2016,35(6):79-87.
[15]李璐,王永香,王秀海,等.地龙及其复方治疗糖尿病肾病的机制研究进展[J].中国实验方剂学杂志,2017,23(7):227-234.
[16]张海文.加味黄芪桂枝五物汤治疗糖尿病周围神经病变的临床观察[J].光明中医,2017,32(9):1301-1303.
[17]张国明,朱涛,陈桂花,等.人参皂苷Compound K对动脉粥样硬化形成的影响[J].心肺血管病杂志,2017,36(5):408-413.
[18]曾凡玉,李思瑶,石锴.麦冬多糖的药理研究进展[J].海峡药学,2018,30(1):55-57.
[19]张小年.五味子的现代研究[J].黑龙江医药,2015,28(6):1259-1260.