中西医结合治疗脑梗死的疗效及其对患者侧支循环建立的影响
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摘要
目的:探讨中医西结合治疗脑梗死的疗效及对患者侧支循环建立的影响。方法:选取2017年6月至2019年1月北京市第二医院收治的脑梗死患者128例作为研究对象,按照随机数字表法分为对照组和观察组,每组64例。对照组患者应用常规西医治疗(依达拉奉注射液),观察组在对照组的基础上联合中医治疗(疏血通注射液),比较2组患者的治疗效果,及治疗前后神经功能缺损情况(NIHSS评分)、日常生活能力(Bathel评分)、血脂血液流变学及缺血区脑血流量。结果:观察组患者治疗总有效率为90. 6%(58/64),高于对照组的75%(48/64),2组比较差异有统计学意义(P <0. 05);治疗前,2组NIHSS评分、Bathel评分、血脂水平及血液流变学指标、缺血区脑血流量比较,差异均无统计学意义(P> 0. 05);治疗后,观察组NIHSS评分低于对照组、Bathel评分明显高于对照组(P <0. 05);治疗后观察组各项血脂水平及血液流变学指标均优于对照组,观察组缺血区脑血流量高于对照组(均P <0. 05)。结论:中西医结合治疗能有效提高脑梗死患者治疗效果,有利于提高患者神经功能及日常生活能力,改善患者血脂及血液流变学指标,有利于患者侧支循环的建立。
Objective: To explore the curative effects of Western medicine combined with traditional Chinese medicine on cerebral infarction and its influence on the establishment of collateral circulation in patients with cerebral infarction. Methods: A total of 128 patients with cerebral infarction admitted to Beijing Second Hospital from June 2017 to January 2019 were selected as research objects,and they were divided into an observation group and a control group according to the random number table method,with 64 cases in each group. Patients in the control group were treated with routine western medicine( edaravone injection),while patients in the observation group were treated with traditional Chinese medicine( Shuxuetong injection) on the basis of the control group.The therapeutic effect,neurological deficit( NIHSS score),daily living ability( Bathel score),blood lipid,hemorheology and cerebral blood flow in ischemic area before and after treatment were compared between the 2 groups. Results: The total effective rate of the observation group was 90. 6%( 58/64),higher than 75%( 48/64) of the control group. There was significant difference between 2 groups( P < 0. 05); before treatment,there was no significant difference in NIHSS score,Bathel score,blood lipid level,hemorheological index and cerebral blood flow in ischemic area between the 2 groups( P > 0. 05); after treatment,the NIHSS score of the observation group was lower than that of the control group,and the Bathel score was significantly higher than that of the control group( P < 0. 05). After treatment,the blood lipid level and hemorheological indexes in the observation group were better than those in the control group,and the cerebral blood flow in the ischemic area in the observation group was significantly higher than that of the control group( P < 0. 05). Conclusion: Integrated traditional Chinese and Western medicine can effectively improve the therapeutic effects of cerebral infarction patients,help to improve the neurological function and daily living ability of patients,improve blood lipid and hemorheological indicators,and is conducive to the establishment of collateral circulation.
Objective: To explore the curative effects of Western medicine combined with traditional Chinese medicine on cerebral infarction and its influence on the establishment of collateral circulation in patients with cerebral infarction. Methods: A total of 128 patients with cerebral infarction admitted to Beijing Second Hospital from June 2017 to January 2019 were selected as research objects,and they were divided into an observation group and a control group according to the random number table method,with 64 cases in each group. Patients in the control group were treated with routine western medicine( edaravone injection),while patients in the observation group were treated with traditional Chinese medicine( Shuxuetong injection) on the basis of the control group.The therapeutic effect,neurological deficit( NIHSS score),daily living ability( Bathel score),blood lipid,hemorheology and cerebral blood flow in ischemic area before and after treatment were compared between the 2 groups. Results: The total effective rate of the observation group was 90. 6%( 58/64),higher than 75%( 48/64) of the control group. There was significant difference between 2 groups( P < 0. 05); before treatment,there was no significant difference in NIHSS score,Bathel score,blood lipid level,hemorheological index and cerebral blood flow in ischemic area between the 2 groups( P > 0. 05); after treatment,the NIHSS score of the observation group was lower than that of the control group,and the Bathel score was significantly higher than that of the control group( P < 0. 05). After treatment,the blood lipid level and hemorheological indexes in the observation group were better than those in the control group,and the cerebral blood flow in the ischemic area in the observation group was significantly higher than that of the control group( P < 0. 05). Conclusion: Integrated traditional Chinese and Western medicine can effectively improve the therapeutic effects of cerebral infarction patients,help to improve the neurological function and daily living ability of patients,improve blood lipid and hemorheological indicators,and is conducive to the establishment of collateral circulation.
引文
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[11]Yu Z,Wenyan T,Xuewen S,et al.Immunological effects of the intraparenchymal administration of allogeneic and autologous adipose-derived mesenchymal stem cells after the acute phase of middle cerebral artery occlusion in rats[J].J Transl Med,2018,16(1):339.
[12]夏悦晖.疏血通与依达拉奉联用方案治疗急性脑梗塞的临床疗效评价[J].航空航天医学杂志,2016,27(12):1492-1494.
[13]靳丽丽.中西医结合治疗急性脑梗塞的疗效观察[J].中西医结合心血管病(连续型电子期刊),2015,8(13):54-55.
[14]薛莉娜,姬改梅.疏血通联合依达拉奉治疗急性脑梗塞的临床观察[J].内蒙古中医药,2014,33(14):101-102.
[15]罗晓静,白良,杨成蓉,等.依达拉奉注射液联合丹参多酚酸盐对脑梗死患者脑血流动力学的影响[J].实用临床医药杂志,2017,21(1):19-21,44.
[16]贺战海.疏血通注射液联合依达拉奉对老年进展性脑梗死患者凝血功能、血脂及血液流变学的影响[J].中国老年学杂志,2017,37(15):3752-3754.
[17]陶海军,周燕,丁仁平.疏血通注射液联合依达拉奉注射液治疗脑梗死的疗效及对患者日常生活能力的影响[J].中国医院用药评价与分析,2018,18(11):1487-1489.
[2]王少斌,王世霞,黄维星,等.丁苯酞软胶囊联合阿托伐他汀钙片治疗脑梗死的疗效及其对患者侧支循环建立的影响[J].中西医结合心血管病(连续型电子期刊),2017,7(3):753-2755.
[3]蒋孝宗.依达拉奉联合疏血通注射液在大面积脑梗死患者中的应用效果及对生活质量的影响研究[J].中国急救医学,2017,37(11):177-178.
[4]Bai J,Gao Y,Gao YH,et al.Effects of Peiyuan Tongnao Capsule on Working Memory and the Expression of Glutamic Acid and Receptor in Hippocampal Area in Rats with Cerebral Ischemia[J].World JTradit Chin Med 2019,5(1):36-41.
[5]王慧娟,刘运平,曹妍,等.疏血通氯化钠联合依达拉奉治疗急性期脑梗死患者对神经功能缺损评分和日常生活活动能力的影响[J].河北医药,2015,37(21):3255-3258.
[6]康梅娟,张旖旎,张保朝,等.依达拉奉注射液联合血栓通冻干粉治疗老年性脑梗死的临床研究[J].中国临床药理学杂志,2016,32(21):1930-1933.
[7]全国第四届脑血管病学术会议.各类脑血管疾病诊断要点及临床功能缺损程度评分标准(1995)[J].中华神经科杂志,1996,29(6):379-383.
[8]Yaghi S,Herber C,Boehme AK,et al.The Association between Diffusion MRI-Defined Infarct Volume and NIHSS Score in Patients with Minor Acute Stroke[J].J Neuroimaging,2017,27(4):388-391.
[9]张世洪,吴波,谈颂.卒中登记研究中Bathel指数和改良的Rankin量表的实用性与相关性研究[J].中国循证医学杂志,2004,4(12):871-874.
[10]Ueno T,Nakamura T,Hikichi H,et al.Rectus Sheath Hematoma Following Intravenous Thrombolysis With Recombinant Tissue Plasminogen Activator for Cerebral Infarction:A Case Report[J].JStroke Cerebrovasc Dis,2018,27(12):237-238.
[11]Yu Z,Wenyan T,Xuewen S,et al.Immunological effects of the intraparenchymal administration of allogeneic and autologous adipose-derived mesenchymal stem cells after the acute phase of middle cerebral artery occlusion in rats[J].J Transl Med,2018,16(1):339.
[12]夏悦晖.疏血通与依达拉奉联用方案治疗急性脑梗塞的临床疗效评价[J].航空航天医学杂志,2016,27(12):1492-1494.
[13]靳丽丽.中西医结合治疗急性脑梗塞的疗效观察[J].中西医结合心血管病(连续型电子期刊),2015,8(13):54-55.
[14]薛莉娜,姬改梅.疏血通联合依达拉奉治疗急性脑梗塞的临床观察[J].内蒙古中医药,2014,33(14):101-102.
[15]罗晓静,白良,杨成蓉,等.依达拉奉注射液联合丹参多酚酸盐对脑梗死患者脑血流动力学的影响[J].实用临床医药杂志,2017,21(1):19-21,44.
[16]贺战海.疏血通注射液联合依达拉奉对老年进展性脑梗死患者凝血功能、血脂及血液流变学的影响[J].中国老年学杂志,2017,37(15):3752-3754.
[17]陶海军,周燕,丁仁平.疏血通注射液联合依达拉奉注射液治疗脑梗死的疗效及对患者日常生活能力的影响[J].中国医院用药评价与分析,2018,18(11):1487-1489.