高压氧疗联合注射用丹参多酚酸治疗脑梗死的疗效分析及对患者血液流变学的影响
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摘要
目的探讨高压氧疗联合注射用丹参多酚酸治疗脑梗死的疗效及对患者血液流变学的影响。方法选取2016年1月—2018年2月周口市中心医院收治的脑梗死患者80例,随机分为两组,两组患者均给予降血脂、降血压、改善微循环、降低颅内压、抗凝、抗血小板聚集及脑神经保护药等常规治疗。对照组应用注射用丹参多酚酸,将100 mg注射用丹参多酚酸与250 mL 0.9%的Na Cl注射液混合后为患者静脉滴注,1次/d;观察组应用高压氧疗(氧疗压力为0.25～0.30 MPa,时间为3min;氧浓度为80%～90%,温度为18～25℃)联合注射用丹参多酚酸;1个疗程为14 d,连续治疗4个疗程。比较两组患者血细胞比容、全血低切黏度、全血高切黏度、血浆黏度、治疗疗效、巴塞尔(Barthel)指数、神经功能(CSS)分值、神经功能缺损(NIHSS)分值以及血清肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、神经生长因子(NGF)浓度。结果治疗后两组患者血细胞比容、全血低切黏度、全血高切黏度、血浆黏度均显著降低,同组治疗前后比较差异有统计学意义(P<0.05);且观察组各指标均显著低于对照组(P<0.05)。观察组治疗疗效显著优于对照组(P<0.05)。治疗后两组患者Barthel指数明显升高,同组治疗前后比较差异有统计学意义(P<0.05);且观察组显著高于对照组(P<0.05)。治疗后两组患者CSS分值、NIHSS分值明显降低,同组治疗前后比较差异有统计学意义(P<0.05);且观察组显著低于对照组(P<0.05)。治疗后两组患者血清TNF-α、IL-6浓度均明显降低,同组治疗前后比较差异有统计学意义(P<0.05);且观察组显著低于对照组(P<0.05)。治疗后两组患者血清NGF浓度均明显升高,同组治疗前后比较差异有统计学意义(P<0.05);且观察组显著高于对照组(P<0.05)。结论高压氧疗联合注射用丹参多酚酸治疗脑梗死疗效确切。
Objective To explore the efficacy of hyperbaric oxygen therapy combined with Salvianolic Acids for Injection in the treatment of cerebral infarction and its effect on the hemorheology of patients. Methods Tatolly 80 cases of cerebral infarction patients admitted to our hospital from January 2016 to February 2018 were selected and randomly divided into two groups. Patients in control group were treated with Salvianolic Acids for Injection, Salvianolic Acids for Injection was mixed with 250 mL 0.9% Na Cl injection for intravenous drip once a day. One course of treatment was 14 days, and four consecutive courses of treatment were given. Patients in research group was treated with hyperbaric oxygen therapy combined with Salvianolic Acids for Injection. Compare two groups of patients with hematocrit, whole blood low shear viscosity, whole blood high shear viscosity, plasma viscosity, treatment efficacy, Barthel index, neurological(CSS) score, nerve function defect(NIHSS) score, serum tumor necrosis factor-α(TNF-α), interleukin-6(IL-6), the nerve growth factor(NGF) concentration. Results The blood cell volume, total blood viscosity, total blood viscosity and plasma viscosity of study group were lower than those of control group(P < 0.05). The curative effect of study group was better than that of control group(P < 0.05). The Barthel index of study group was higher than that of control group(P < 0.05). The CSS and NIHSS score of study group was lower than that of control group(P < 0.05). TNF-α and IL-6 concentrations in study group were lower than those in control group(P <0.05). NGF concentration in study group was higher than that in control group(P < 0.05). Conclusion Hyperbaric oxygen therapycombined with Salvianolic Acids for Injection is effective in the treatment of cerebral infarction.
Objective To explore the efficacy of hyperbaric oxygen therapy combined with Salvianolic Acids for Injection in the treatment of cerebral infarction and its effect on the hemorheology of patients. Methods Tatolly 80 cases of cerebral infarction patients admitted to our hospital from January 2016 to February 2018 were selected and randomly divided into two groups. Patients in control group were treated with Salvianolic Acids for Injection, Salvianolic Acids for Injection was mixed with 250 mL 0.9% Na Cl injection for intravenous drip once a day. One course of treatment was 14 days, and four consecutive courses of treatment were given. Patients in research group was treated with hyperbaric oxygen therapy combined with Salvianolic Acids for Injection. Compare two groups of patients with hematocrit, whole blood low shear viscosity, whole blood high shear viscosity, plasma viscosity, treatment efficacy, Barthel index, neurological(CSS) score, nerve function defect(NIHSS) score, serum tumor necrosis factor-α(TNF-α), interleukin-6(IL-6), the nerve growth factor(NGF) concentration. Results The blood cell volume, total blood viscosity, total blood viscosity and plasma viscosity of study group were lower than those of control group(P < 0.05). The curative effect of study group was better than that of control group(P < 0.05). The Barthel index of study group was higher than that of control group(P < 0.05). The CSS and NIHSS score of study group was lower than that of control group(P < 0.05). TNF-α and IL-6 concentrations in study group were lower than those in control group(P <0.05). NGF concentration in study group was higher than that in control group(P < 0.05). Conclusion Hyperbaric oxygen therapycombined with Salvianolic Acids for Injection is effective in the treatment of cerebral infarction.
引文
[1]吕晓侠,刘红旗,王靖东,等.丹参多酚酸盐联合甲钴胺对2型糖尿病伴糖尿病周围神经病变患者肌电图及血液流变学的影响[J].中国老年学杂志, 2016, 36(3):615-616.
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[5]刘晓宇.补阳还五汤加减联合丹红注射液对脑梗塞恢复期偏瘫患者血液流变学的影响[J].辽宁中医杂志,2017, 44(7):1421-1424.
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[7]刘施,吴嘉瑞,蔺梦娟,等.基于Meta分析的注射用丹参多酚酸治疗急性脑梗死临床评价[J].中国实验方剂学杂志, 2017, 89(8):210-215.
[8]董桂英.高压氧治疗急性脑梗死的疗效以及对患者血清血管内皮生长因子、促血管生成素Ⅱ的影响[J].中国现代医学杂志, 2016, 26(14):52-57.
[9] Yahara K, Ohguri T, Udono H, et al. Radiotherapy using IMRT boosts after hyperbaric oxygen therapy with chemotherapy for glioblastoma[J]. J Radiat Res, 2017, 58(3):351-356.
[10]李树铁,汪业铭,李媛莉,等.丹参多酚酸盐治疗慢性阻塞性肺疾病急性加重期的临床观察[J].中国药房,2016, 27(17):2402-2404.
[11]曾宪忠,刘氜,李毅.高压氧治疗糖尿病足的疗效评价及对患者血清VEGF、b FGF水平的影响[J].中国现代医学杂志, 2016, 26(19):110-113.
[12]贺亚龙,高焱,郭晓贤.丹参多酚酸治疗急性脑梗死的临床研究[J].现代药物与临床, 2016, 31(9):1354-1359.
[13] Thews O, Vaupel P. Temporal changes in tumor oxygenation and perfusion upon normo-and hyperbaric inspiratory hyperoxia[J]. Strahlenther Onkol, 2016, 192(3):174-181.
[14]孙锡波,于国庆,潘海英,等.通窍活血汤联合高压氧和依达拉奉对一氧化碳中毒后迟发性脑病患者的治疗作用[J].中国中西医结合急救杂志, 2016, 23(4):427-428.
[15] Li M, Xie Z H, Yu A Y, et al. Increased efficacy of antivenom combined with hyperbaric oxygen on deinagkistrodon acutus envenomation in adult rats[J].Chin Med J, 2018, 131(3):323-329.
[2]展翔,李坤彬,王东伟.丹参多酚酸盐联合灯盏生脉胶囊对缺血性脑卒中神经功能缺损程度及血液流变学的影响[J].广东医学, 2017, 38(16):2555-2557.
[3] Neves A, Abrantes A, Pires A, et al. Hyperbaric oxygen therapy combined with photodynamic therapy as a new therapeutic approach against retinoblastoma[J]. Eur J Cancer Care, 2016, 61(1):S144.
[4]李娇红,李小刚.注射用丹参多酚酸盐治疗急性脑梗死患者的临床疗效[J].辽宁中医杂志, 2017, 44(6):1222-1225.
[5]刘晓宇.补阳还五汤加减联合丹红注射液对脑梗塞恢复期偏瘫患者血液流变学的影响[J].辽宁中医杂志,2017, 44(7):1421-1424.
[6] Oxford University Press. PT732. Successful treatment with a combination of thyrotropin-releasing hormone(TRH)and hyperbaric oxygen(HBO)for an interval form of carbon monoxide(CO)poisoning[J]. Int J Neuropsychoph, 2016, 19(Suppl 1):66-67.
[7]刘施,吴嘉瑞,蔺梦娟,等.基于Meta分析的注射用丹参多酚酸治疗急性脑梗死临床评价[J].中国实验方剂学杂志, 2017, 89(8):210-215.
[8]董桂英.高压氧治疗急性脑梗死的疗效以及对患者血清血管内皮生长因子、促血管生成素Ⅱ的影响[J].中国现代医学杂志, 2016, 26(14):52-57.
[9] Yahara K, Ohguri T, Udono H, et al. Radiotherapy using IMRT boosts after hyperbaric oxygen therapy with chemotherapy for glioblastoma[J]. J Radiat Res, 2017, 58(3):351-356.
[10]李树铁,汪业铭,李媛莉,等.丹参多酚酸盐治疗慢性阻塞性肺疾病急性加重期的临床观察[J].中国药房,2016, 27(17):2402-2404.
[11]曾宪忠,刘氜,李毅.高压氧治疗糖尿病足的疗效评价及对患者血清VEGF、b FGF水平的影响[J].中国现代医学杂志, 2016, 26(19):110-113.
[12]贺亚龙,高焱,郭晓贤.丹参多酚酸治疗急性脑梗死的临床研究[J].现代药物与临床, 2016, 31(9):1354-1359.
[13] Thews O, Vaupel P. Temporal changes in tumor oxygenation and perfusion upon normo-and hyperbaric inspiratory hyperoxia[J]. Strahlenther Onkol, 2016, 192(3):174-181.
[14]孙锡波,于国庆,潘海英,等.通窍活血汤联合高压氧和依达拉奉对一氧化碳中毒后迟发性脑病患者的治疗作用[J].中国中西医结合急救杂志, 2016, 23(4):427-428.
[15] Li M, Xie Z H, Yu A Y, et al. Increased efficacy of antivenom combined with hyperbaric oxygen on deinagkistrodon acutus envenomation in adult rats[J].Chin Med J, 2018, 131(3):323-329.