川蛭通络胶囊联合瑞舒伐他汀对血脂正常急性脑梗死患者的疗效
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摘要
目的:探讨川蛭通络胶囊联合瑞舒伐他汀对血脂正常急性脑梗死患者的疗效。方法:选取2017年12月至2018年12月阜阳市人民医院收治的急性脑梗死患者(血脂正常) 80例作为研究对象,随机分为观察组和对照组,每组40例。观察组使用川蛭通络胶囊(0. 5 g,3次/d)联合瑞舒伐他汀(10 mg,1次/d)治疗,对照组使用同等剂量瑞舒伐他汀治疗。根据神经功能缺损评分制定疗效标准,统计神经功能损伤评分和有效率,观察治疗前后超敏C反应蛋白水平,比较2组患者的治疗效果。结果:2组患者治疗后神经功能缺损评分均显著低于治疗前,组间比较差异有统计学意义(P <0. 05);观察组治疗后的超敏C反应蛋白水平显著低于对照组(P <0. 05);观察组治疗总有效率97. 5%,对照组治疗总有效率82. 5%,2组比较差异有统计学意义(P <0. 05)。2组患者用药期间均无明显不良反应。结论:川蛭通络胶囊联合瑞舒伐他汀治疗血脂正常急性脑梗死的疗效显著优于瑞舒伐他汀单药治疗,且显著降低超敏C反应蛋白水平,值得临床应用。
Objective: To explore the curative effects of Chuanzhi Tongluo capsule combined with rosuvastatin on patients with acute cerebral infarction with normal blood lipid. Methods: A total of 80 patients with acute cerebral infarction( normal blood lipid)in Fuyang People's Hospital from December 2017 to December 2018 were randomly divided into 2 groups,with 40 cases in each group. The observation group was treated with Chuanzhi Tongluo capsule and rosuvastatin,while the control group was treated with rosuvastatin. According to the neurologic impairment score,the curative effect standard was established,and the therapeutic effects of the 2 groups were compared. The hypersensitivity C-protein level before and after treatment was compared. T-test and Chi-square test were used to measure the treatment effect between the 2 groups. Results: The neurological deficit scores of the 2 groups after treatment were significantly lower than those before treatment( P < 0. 05). The differences between the 2 groups after treatment were statistically significant( P < 0. 05). The level of high-sensitivity C-reactive protein in the observation group after treatment was significantly lower than that in the control group( P < 0. 05). The total effective rate was 97. 5% in the observation group and 82. 5% in the control group. The difference between the 2 groups was statistically significant( P < 0. 05). There were no obvious adverse reactions in the 2 groups. Conclusion: The curative effects of Chuanzhi Tongluo capsule combined with rosuvastatin on acute cerebral infarction with normal blood lipid is better than that of rosuvastatin,which is clinically worthy of application.
Objective: To explore the curative effects of Chuanzhi Tongluo capsule combined with rosuvastatin on patients with acute cerebral infarction with normal blood lipid. Methods: A total of 80 patients with acute cerebral infarction( normal blood lipid)in Fuyang People's Hospital from December 2017 to December 2018 were randomly divided into 2 groups,with 40 cases in each group. The observation group was treated with Chuanzhi Tongluo capsule and rosuvastatin,while the control group was treated with rosuvastatin. According to the neurologic impairment score,the curative effect standard was established,and the therapeutic effects of the 2 groups were compared. The hypersensitivity C-protein level before and after treatment was compared. T-test and Chi-square test were used to measure the treatment effect between the 2 groups. Results: The neurological deficit scores of the 2 groups after treatment were significantly lower than those before treatment( P < 0. 05). The differences between the 2 groups after treatment were statistically significant( P < 0. 05). The level of high-sensitivity C-reactive protein in the observation group after treatment was significantly lower than that in the control group( P < 0. 05). The total effective rate was 97. 5% in the observation group and 82. 5% in the control group. The difference between the 2 groups was statistically significant( P < 0. 05). There were no obvious adverse reactions in the 2 groups. Conclusion: The curative effects of Chuanzhi Tongluo capsule combined with rosuvastatin on acute cerebral infarction with normal blood lipid is better than that of rosuvastatin,which is clinically worthy of application.
引文
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[14]陈奎.他汀类药物在急性脑梗死治疗中的作用机制综述[J].临床合理用药杂志,2017,10(3):168-169,170.
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[18]王燕,杨学青,陈晓光,等.补肾疏肝汤治疗老年脑卒中后抑郁的临床观察[J].中国医药,2012,7(3):370-371.
[19]潘国庆,罗清平.脑脉通胶囊治疗缺血性中风60例临床观察[J].中医药导报,2008,14(9):31-32.
[20]程南方,谭峰,詹杰,等.活血化瘀治疗早期缺血性中风[J].河南中医,2018,38(11):1682-1685.
[21]黎辉,武紫晖,张晓云.中风病病机与治法方药探析[J].医学信息,2018,31(19):150-151.
[22]张晓慧,李光韬,张卓莉.C反应蛋白与超敏C反应蛋白的检测及其临床意义[J].中华临床免疫和变态反应杂志,2011,5(1):74-79.
[23]陈振祥,李连平,白桦.急性脑梗死患者血清超敏C-反应蛋白水平的变化和意义[J].诊断学理论与实践,2006,5(3):250-251.
[24]龙江水利女先锋---记特大型灌区青龙山灌区工程项目设计总负责人李艳杰[J].水利天地,2011,28(1):31-32.
[25]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疗指南撰写组.中国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疗指南撰写组.中国急性缺血性脑卒中诊疗指南2010[J].中华神经科杂志,2010,43(2):146-153.
[26]Rydel TJ,Tulinsky A,Bode W,et al.Refined structure of the hirudin-thrombin complex[J].J Mol Biol,1991,221(2):583-601.
[27]程颖,龚国清,郑庆香,等.脑脉通胶囊的药效学研究[J].中国生化药物杂志,2005,26(3):164-166.
[28]刘军,吴卫平,匡培根.丹参在缺血再灌注时的神经保护作用---成纤维细胞生长因子上调[J].中国神经免疫学和神经病学杂志,1996,3(4):5.
[29]赵娜,郭治昕,赵雪,等.丹参的化学成分与药理作用[J].国外医药(植物药分册),2007,22(4):155-160.
[30]姜宇懋,王丹巧.川芎嗪药理作用研究进展[J].中国现代中药.2016,10(18):1364-1370.
[31]Qian WD,Xiong XJ,Fang ZY,et al.Protective effect of tetramethylpyrazine on myocardial ischemia-reperfusion injury[J].Evid Based Complement Alternat Med,2014:107501.
[32]杨文辉,龚国清,周怡,等.川芎嗪体内抗血栓活性及机制探究[J].中国临床药理学与治疗学.2012,17(3):241-245.
[33]Cai XX,Chen Z,Pan XK,et al.Inhibition of angiogenesis,fibrosis and thrombosis by tetramethylpyrazine:mechanisms contributing to the SDF-1/CXCR4 axis[J].PLo S One,2014,9(2):e88176.
[34]Aizawa Y,Nakai T,Saito Y,et al.Calcified Amorphous Tumor-Induced Acute Cerebral Infarction:A Case Report and Histopathologic Comparison of Calcified Amorphous Tumor and Mitral Annular Calcification[J].International Heart Journal,2018,59(1):240-242.
[35]Lin ZJ,Qiu HY,Tong XX,et al.Evaluation of efficacy and safety of Reteplase and Alteplase in the treatment of hyper-acute cerebral infarction[J].Bioscience Reports,2017,38(1):730.
[36]王刚,郐世超,祁恒飞,等.他汀给药时机对行rt-PA溶栓急性脑梗死患者神经功能损伤程度、实验室指标及并发症发生风险的影响[J].实用药物与临床,2017,20(7):806-809.
[37]王丹,郭艳霞.前列地尔联合长春西汀治疗急性脑梗死的疗效观察[J].实用药物与临床,2016,19(11):1372-1375.
[2]Hankey GJ.Potential new risk factors for ischemic stroke:what is their potential?[J].Stroke,2006,37(8):2181-2188.
[3]Furie KL,Kasner SE,Adams RJ,et al.Guidelines for the Prevention of Stroke in Patients With Stroke or Transient Ischemic Attack:AGuideline for Healthcare Professionals From the American Heart Association/American Stroke Association[J].Stroke,2011,42(1):227-276.
[4]D'Agostino RB,Wolf PA,Belanger AJ.Stroke risk profile:adjustment for antihypertensive medication.The Framingham Study[J].Stroke,1994,25(1):40-43.
[5]Saver JL.Time is brain-quantified[J].Stroke,2006,37(1):263-266.
[6]Wang S,Ma T,Wang L,et al.Effect of acupuncture on cerebrovascular reserve in patients with acute cerebral infarction:protocol for a randomized controlled pilot study[J].Trials,2017,18(1):292.
[7]黎罗明,王琰,陈志斌.瑞舒伐他汀联合芪蛭通络胶囊治疗血脂水平正常急性脑梗死的疗效观察[J].中国实验方剂学杂志,2013,19(16):336-338.
[8]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2014[J].中华神经科杂志,2015,48(4):246-257.
[9]陈凯立,张汉洪,刑金莉.瑞舒伐他汀与阿托伐他汀对急性脑梗死患者血脂CRP及颈动脉粥样硬化斑块的影响比较[J].中国实用神经疾病杂志,2016,19(24):33-35.
[10]张雨时.不同剂量他汀类药物对急性脑梗死疗效的临床研究[J].中国现代药物应用,2018,12(20):62-64.
[11]Saito T,Hayashi K,Nakazawa H,et al.Clinical Characteristics and Lesions Responsible for Swallowing Hesitation After Acute Cerebral Infarction[J].Dysphagia,2016,31(4):567-573.
[12]乔军华,盖国海,乔红曼,等.化浊通瘀汤联合辛伐他汀治疗急性脑梗死合并高脂血症100例临床观察[J].中医临床研究,2015(16):105-106.
[13]Zuo L,Wan T,Xu X,et al.Relationship of Early Spontaneous Type V Blood Pressure Fluctuation after Thrombolysis in Acute Cerebral Infarction Patients and the Prognosis[J].Sci Rep,2016,6:27656.
[14]陈奎.他汀类药物在急性脑梗死治疗中的作用机制综述[J].临床合理用药杂志,2017,10(3):168-169,170.
[15]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疗指南撰写组.中国急性缺血性脑卒中诊疗指南2010[J].中华神经科杂志,2010,43(2):146-153.
[16]戴毅,吴玉泉,胡金华.瑞舒伐他汀钙对急性脑梗死患者血脂和血清超敏C反应蛋白的影响[J].中华全科医学,2015,13(6):924-925,1036.
[17]黄必武,郭韵诗,王子源.阿托伐他汀钙对急性脑梗死患者颈动脉硬化斑块及超敏C反应蛋白、血脂水平影响[J].中国当代医药,2016,23(36):45-47.
[18]王燕,杨学青,陈晓光,等.补肾疏肝汤治疗老年脑卒中后抑郁的临床观察[J].中国医药,2012,7(3):370-371.
[19]潘国庆,罗清平.脑脉通胶囊治疗缺血性中风60例临床观察[J].中医药导报,2008,14(9):31-32.
[20]程南方,谭峰,詹杰,等.活血化瘀治疗早期缺血性中风[J].河南中医,2018,38(11):1682-1685.
[21]黎辉,武紫晖,张晓云.中风病病机与治法方药探析[J].医学信息,2018,31(19):150-151.
[22]张晓慧,李光韬,张卓莉.C反应蛋白与超敏C反应蛋白的检测及其临床意义[J].中华临床免疫和变态反应杂志,2011,5(1):74-79.
[23]陈振祥,李连平,白桦.急性脑梗死患者血清超敏C-反应蛋白水平的变化和意义[J].诊断学理论与实践,2006,5(3):250-251.
[24]龙江水利女先锋---记特大型灌区青龙山灌区工程项目设计总负责人李艳杰[J].水利天地,2011,28(1):31-32.
[25]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疗指南撰写组.中国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疗指南撰写组.中国急性缺血性脑卒中诊疗指南2010[J].中华神经科杂志,2010,43(2):146-153.
[26]Rydel TJ,Tulinsky A,Bode W,et al.Refined structure of the hirudin-thrombin complex[J].J Mol Biol,1991,221(2):583-601.
[27]程颖,龚国清,郑庆香,等.脑脉通胶囊的药效学研究[J].中国生化药物杂志,2005,26(3):164-166.
[28]刘军,吴卫平,匡培根.丹参在缺血再灌注时的神经保护作用---成纤维细胞生长因子上调[J].中国神经免疫学和神经病学杂志,1996,3(4):5.
[29]赵娜,郭治昕,赵雪,等.丹参的化学成分与药理作用[J].国外医药(植物药分册),2007,22(4):155-160.
[30]姜宇懋,王丹巧.川芎嗪药理作用研究进展[J].中国现代中药.2016,10(18):1364-1370.
[31]Qian WD,Xiong XJ,Fang ZY,et al.Protective effect of tetramethylpyrazine on myocardial ischemia-reperfusion injury[J].Evid Based Complement Alternat Med,2014:107501.
[32]杨文辉,龚国清,周怡,等.川芎嗪体内抗血栓活性及机制探究[J].中国临床药理学与治疗学.2012,17(3):241-245.
[33]Cai XX,Chen Z,Pan XK,et al.Inhibition of angiogenesis,fibrosis and thrombosis by tetramethylpyrazine:mechanisms contributing to the SDF-1/CXCR4 axis[J].PLo S One,2014,9(2):e88176.
[34]Aizawa Y,Nakai T,Saito Y,et al.Calcified Amorphous Tumor-Induced Acute Cerebral Infarction:A Case Report and Histopathologic Comparison of Calcified Amorphous Tumor and Mitral Annular Calcification[J].International Heart Journal,2018,59(1):240-242.
[35]Lin ZJ,Qiu HY,Tong XX,et al.Evaluation of efficacy and safety of Reteplase and Alteplase in the treatment of hyper-acute cerebral infarction[J].Bioscience Reports,2017,38(1):730.
[36]王刚,郐世超,祁恒飞,等.他汀给药时机对行rt-PA溶栓急性脑梗死患者神经功能损伤程度、实验室指标及并发症发生风险的影响[J].实用药物与临床,2017,20(7):806-809.
[37]王丹,郭艳霞.前列地尔联合长春西汀治疗急性脑梗死的疗效观察[J].实用药物与临床,2016,19(11):1372-1375.