复方丹参注射液联合丁苯酞注射液治疗老年急性脑梗死的临床分析
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摘要
目的:观察丁苯酞注射液联合复方丹参注射液治疗老年急性脑梗死的临床治疗效果。方法:老年急性脑梗死患者67例,按照数字表法将其随机分为对照组33例和观察组34例。对照组采用丁苯酞注射液治疗,观察组采用丁苯酞注射液联合复方丹参注射液治疗,两组均连续用药治疗14 d,对比分析两组患者的临床治疗效果、血液学指标、神经功能缺损程度(NIHSS)、运动功能(Fugl-Meyer)、日常生活能力(ADL)、并发症发生率、心理状态变化及住院时间。结果:观察组患者治疗后的总有效率(97.06%)、Fugl-Meyer评分(81.45±4.67)及ADL评分(80.26±5.85)明显高于对照组的总有效率(81.81%)、Fugl-Meyer评分(69.52±3.81)及ADL评分(67.13±4.14),观察组CRP(4.82±3.23)mg/mL、D-D(2.49±0.91)mg/L、IL-6(25.57±15.75)ng/L、NIHSS评分(7.47±1.12)、并发症发生率(5.88%)、SAS评分(36.07±3.73)、SDS评分(35.21±3.23)及住院时间(22.47±2.03)d明显低于对照组的CRP(7.73±3.15)mg/mL、D-D(2.93±0.85)mg/L、IL-6(34.02±17.91)ng/L、NIHSS评分(9.32±1.07)、并发症发生率(24.24%)、SAS评分(40.53±4.14)、SDS评分(38.45±3.51)及住院时间(28.53±2.36)d,差异有统计学意义(P<0.05)。结论:丁苯酞注射液联合复方丹参注射液治疗老年急性脑梗死的临床治疗效果显著,有效改善患者临床症状,降低并发症发生率,促进血液指标恢复正常,提高患者生活质量,缩短住院时间。
Objective: To observe the clinical effect of Compound Salvia Miltiorrhiza Injection combined with Butylphthalide Injection in the treatment of elderly patients with acute cerebral infarction. Methods: Sixty-seven patients with acute cerebral infarction were randomly selected and divided into 33 cases in the control group and 34 cases in the observation group according to the digital table method. The control group was treated with Butylphthalide Injection and the observation group was treated with Butylphthalide Injection combined with Compound Salvia Miltiorrhiza Injection. The two groups were treated with continuous treatment for 14 days. The clinical treatment effect, Hematology Index, NIHSS, Fugl-Meyer, daily living ability(ADL), incidence of complications, changes in psychological status and length of stay of the two groups were compared and analyzed. Results: The total effective rate(97.06%), Fugl-Meyer score(81.45±4.67) and ADL score(80.26±5.85) in the observation group were significantly higher than those of the control group[total effective rate(81.81%), Fugl-Meyer score(69.52±3.81) and ADL score(67.13±4.14)]. In the observation group,CRP(4.82±3.23)mg/mL, D-D(2.49±0.91)mg/L, IL-6(25.57±15.75)ng/L, NIHSS score(7.47±1.12), complication rate(5.88%), SAS score(36.07±3.73), SDS score(35.21±3.23) and hospitalization time(22.47±2.03) d were significantly lower than those of the control group[CRP(7.73±3.15)mg/mL, D-D(2.93±0.85)mg/L, IL-6(34.02±17.91)ng/L, NIHSS scores(9.32±1.07), the incidence of complications(24.24%), SAS score(40.53±4.14), SDS score(38.45±3.51) and hospitalization time(28.53±2.36) d] with statistically significant difference(P<0.05). Conclusion: The therapeutic effect of butylphthalide injection combined with Compound Salvia Miltiorrhiza Injection in the treatment of senile acute cerebral infarction is significant and can effectively improve the clinical symptoms, reduce the incidence of complications, promote the recovery of blood indexes and improve the quality of life of the patients and shorten the time of hospitalization.
Objective: To observe the clinical effect of Compound Salvia Miltiorrhiza Injection combined with Butylphthalide Injection in the treatment of elderly patients with acute cerebral infarction. Methods: Sixty-seven patients with acute cerebral infarction were randomly selected and divided into 33 cases in the control group and 34 cases in the observation group according to the digital table method. The control group was treated with Butylphthalide Injection and the observation group was treated with Butylphthalide Injection combined with Compound Salvia Miltiorrhiza Injection. The two groups were treated with continuous treatment for 14 days. The clinical treatment effect, Hematology Index, NIHSS, Fugl-Meyer, daily living ability(ADL), incidence of complications, changes in psychological status and length of stay of the two groups were compared and analyzed. Results: The total effective rate(97.06%), Fugl-Meyer score(81.45±4.67) and ADL score(80.26±5.85) in the observation group were significantly higher than those of the control group[total effective rate(81.81%), Fugl-Meyer score(69.52±3.81) and ADL score(67.13±4.14)]. In the observation group,CRP(4.82±3.23)mg/mL, D-D(2.49±0.91)mg/L, IL-6(25.57±15.75)ng/L, NIHSS score(7.47±1.12), complication rate(5.88%), SAS score(36.07±3.73), SDS score(35.21±3.23) and hospitalization time(22.47±2.03) d were significantly lower than those of the control group[CRP(7.73±3.15)mg/mL, D-D(2.93±0.85)mg/L, IL-6(34.02±17.91)ng/L, NIHSS scores(9.32±1.07), the incidence of complications(24.24%), SAS score(40.53±4.14), SDS score(38.45±3.51) and hospitalization time(28.53±2.36) d] with statistically significant difference(P<0.05). Conclusion: The therapeutic effect of butylphthalide injection combined with Compound Salvia Miltiorrhiza Injection in the treatment of senile acute cerebral infarction is significant and can effectively improve the clinical symptoms, reduce the incidence of complications, promote the recovery of blood indexes and improve the quality of life of the patients and shorten the time of hospitalization.
引文
[1] 郑颖炜.丁苯酞序贯疗法联合双联抗血小板治疗老年急性脑梗死的临床疗效及其对血浆巯基丙酮酸硫基转移酶、β淀粉样蛋白42水平的影响研究[J].实用心脑肺血管病杂志,2017,25(9):33-36,46.
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[8] 吴逢波,代国友,冯小荣,等.丁苯酞胶囊联合血栓通注射液治疗急性脑梗死疗效和安全性的Meta分析[J].中国药师,2017,20(2):314-317.
[9] 肖桂荣,王赵伟,朱仁洋,等.丁苯酞注射液联合依达拉奉治疗急性脑梗死的疗效观察[J].中国神经免疫学和神经病学杂志,2016,17(1):51-54.
[10] Costa MAC,Gauer MF,Gomes RZ,et al.Risk factors for perioperative ischemic stroke in cardiac surgery[J].Revista Brasileira Cirurgia Cardiovascular,2015,30(3):365-372.
[11] 胡玉梅,徐兰芳.马来酸桂哌齐特和复方丹参注射液治疗急性脑梗死的疗效比较[J].现代医学,2017,45(9):1309-1313.
[12] 张征,刘长明,薛冰.丹参注射液与黄芪注射液对脑梗死大鼠急性期神经功能和梗死面积的影响[J].西部中医药,2017,30(1):17-19.
[13] Chin KH,Bell MJ,Wisniewski SR,et al.Effect of administration of neuromuscular blocking agents in children with severe traumatic brain injury on acute complication rates and outcomes:a secondary analysis from a randomized,controlled trial of therapeutic hypothermia[J].Pediatr Crit Care Med,2015,16(4):352-358.
[14] 田燕,方煜,胡明.丹参川芎嗪注射液与参芎葡萄糖注射液治疗脑梗死的成本-效果分析[J].中国药房,2018,29(4):487-492.
[15] 顾玉梅,杨旭.丹参注射液联合丁苯酞治疗脑梗死急性期患者及对S100B、CRP及神经功能影响[J].辽宁中医药大学学报,2018,20(4):107-110.
[16] Gersing AS,Ankenbrank M,Schwaiger BJ,et al.Mapping of cerebral metabolic rate of oxygen using dynamic susceptibility contrast and blood oxygen level dependent MR imaging in acute ischemic stroke[J].Neuroradiology,2015,57(12):125312-125361.
[17] 吴文琴,皮海菊,秦雪琴,等.丹参注射液辅助下治疗急性脑梗死对患者SOD的影响[J].河北医药,2017,39(10):1445-1448.
[18] 吴玉芙,刘晓红,郭伟成,等.丁苯酞注射液治疗急性前循环脑梗死的疗效观察[J].中国卒中杂志,2017,12(12):1111-1114.
[19] 章耀华,马志伟,王海茹.丁苯酞联合丹参酮注射液治疗急性脑梗死临床疗效观察[J].实用老年医学,2017,31(11):1082-1083.
[20] Naess H,Kurtz M,Thomassen L,et al.Serial NIHSS scores in patients with acute cerebral infarction[J].Acta Neurol Scand,2016,133(6):415-420.
[21] 刘颖丽,杨立彬,张舒石,等.丁苯酞注射液治疗老年急性脑梗死患者的疗效及其对脑血流动力和脑血管储备能力的影响[J].吉林大学学报(医学版),2017,43(2):344-348.
[22] 张贇,卢仁凯,聂方华,等.丁苯酞氯化钠注射液治疗急性脑梗死患者临床观察[J].中国实用神经疾病杂志,2018,21(4):420-423.
[2] 俞小梅,王喜丰,张静,等.丁苯酞注射液及丁苯酞胶囊治疗急性脑梗死患者的临床疗效对比[J].实用医学杂志,2016,32(17):2921-2924.
[3] Kofler M,Schiefecker A,Ferger B,et al.Cerebral taurine levels are associated with brain edema and delayed cerebral infarction in patients with aneurysmal subarachnoid hemorrhage[J].Neurocritical Care,2015,23(3):321-329.
[4] 陈娜,李虹,陆连生,等.阿替普酶静脉溶栓同时联合丁苯酞注射液治疗急性脑梗死的疗效观察[J].河北医药,2017,39(1):69-71.
[5] 中华神经科学会,中华神经外科学会.各类脑血管疾病诊断要点[J].中华神经科杂志,1996,29(6):379-381.
[6] Berkhemer OA,Fransen PSS,Beumer D,et al.A randomized trial of intraarterial treatment for acute ischemic stroke[J].NewEngl J Med,2015,372(1):11-20.
[7] 陈娜,陆连生,李虹,等.丁苯酞序贯治疗急性脑梗死合并认知功能障碍患者的疗效及其对炎性因子的影响[J].疑难病杂志,2017,16(2):117-120,126.
[8] 吴逢波,代国友,冯小荣,等.丁苯酞胶囊联合血栓通注射液治疗急性脑梗死疗效和安全性的Meta分析[J].中国药师,2017,20(2):314-317.
[9] 肖桂荣,王赵伟,朱仁洋,等.丁苯酞注射液联合依达拉奉治疗急性脑梗死的疗效观察[J].中国神经免疫学和神经病学杂志,2016,17(1):51-54.
[10] Costa MAC,Gauer MF,Gomes RZ,et al.Risk factors for perioperative ischemic stroke in cardiac surgery[J].Revista Brasileira Cirurgia Cardiovascular,2015,30(3):365-372.
[11] 胡玉梅,徐兰芳.马来酸桂哌齐特和复方丹参注射液治疗急性脑梗死的疗效比较[J].现代医学,2017,45(9):1309-1313.
[12] 张征,刘长明,薛冰.丹参注射液与黄芪注射液对脑梗死大鼠急性期神经功能和梗死面积的影响[J].西部中医药,2017,30(1):17-19.
[13] Chin KH,Bell MJ,Wisniewski SR,et al.Effect of administration of neuromuscular blocking agents in children with severe traumatic brain injury on acute complication rates and outcomes:a secondary analysis from a randomized,controlled trial of therapeutic hypothermia[J].Pediatr Crit Care Med,2015,16(4):352-358.
[14] 田燕,方煜,胡明.丹参川芎嗪注射液与参芎葡萄糖注射液治疗脑梗死的成本-效果分析[J].中国药房,2018,29(4):487-492.
[15] 顾玉梅,杨旭.丹参注射液联合丁苯酞治疗脑梗死急性期患者及对S100B、CRP及神经功能影响[J].辽宁中医药大学学报,2018,20(4):107-110.
[16] Gersing AS,Ankenbrank M,Schwaiger BJ,et al.Mapping of cerebral metabolic rate of oxygen using dynamic susceptibility contrast and blood oxygen level dependent MR imaging in acute ischemic stroke[J].Neuroradiology,2015,57(12):125312-125361.
[17] 吴文琴,皮海菊,秦雪琴,等.丹参注射液辅助下治疗急性脑梗死对患者SOD的影响[J].河北医药,2017,39(10):1445-1448.
[18] 吴玉芙,刘晓红,郭伟成,等.丁苯酞注射液治疗急性前循环脑梗死的疗效观察[J].中国卒中杂志,2017,12(12):1111-1114.
[19] 章耀华,马志伟,王海茹.丁苯酞联合丹参酮注射液治疗急性脑梗死临床疗效观察[J].实用老年医学,2017,31(11):1082-1083.
[20] Naess H,Kurtz M,Thomassen L,et al.Serial NIHSS scores in patients with acute cerebral infarction[J].Acta Neurol Scand,2016,133(6):415-420.
[21] 刘颖丽,杨立彬,张舒石,等.丁苯酞注射液治疗老年急性脑梗死患者的疗效及其对脑血流动力和脑血管储备能力的影响[J].吉林大学学报(医学版),2017,43(2):344-348.
[22] 张贇,卢仁凯,聂方华,等.丁苯酞氯化钠注射液治疗急性脑梗死患者临床观察[J].中国实用神经疾病杂志,2018,21(4):420-423.