脑心通胶囊与阿司匹林治疗急性脑梗死临床疗效及其对认知功能、凝血功能影响的对比研究
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摘要
目的比较脑心通胶囊与阿司匹林治疗急性脑梗死的临床疗效及其对认知功能、凝血功能的影响。方法选取2015年1月—2018年7月深圳市龙华区人民医院收治的急性脑梗死患者120例,采用随机数字表法分为对照组和研究组,每组60例。在常规治疗基础上,对照组患者给予阿司匹林治疗,研究组患者给予脑心通胶囊治疗;两组患者均连续治疗1个月。比较两组患者临床疗效,治疗前后美国国立卫生研究院卒中量表(NIHSS)评分、Barthel指数评分、老年快速认知筛查量表(QCST-E)结果及凝血功能指标〔包括纤维蛋白原(FIB)、血浆黏度(PV)及D-二聚体〕。结果 (1)研究组患者临床疗效优于对照组(P<0.05)。(2)两组患者治疗前NIHSS评分、Barthel指数评分比较,差异无统计学意义(P>0.05);研究组患者治疗后NIHSS评分低于对照组,Barthel指数评分高于对照组(P<0.05)。(3)两组患者治疗前时间定向、延迟记忆、即刻记忆、动作指令、简单计算、言语流畅性评分比较,差异无统计学意义(P>0.05);研究组患者治疗后时间定向、延迟记忆、即刻记忆、动作指令、简单计算、言语流畅性评分高于对照组(P<0.05)。(4)两组患者治疗前FIB、PV及D-二聚体水平比较,差异无统计学意义(P>0.05);研究组患者治疗后FIB、PV及D-二聚体水平低于对照组(P<0.05)。结论与阿司匹林相比,脑心通胶囊能更有效地提高急性脑梗死患者临床疗效,减轻神经功能缺损程度,改善日常活动能力、认知功能及凝血功能。
Objective To compare the clinical effect on acute cerebral infarction and the impact on cognitive function and coagulation function between Naoxintong capsule and aspirin. Methods From January 2015 to July 2018,a total of 120 patients with acute cerebral infarction were selected in the People's Hospital of Longhua District,Shenzhen,and they were evenly divided into control group and research group by using random number table method. Based on conventional treatment,patients in control group received aspirin,while patients in research group received Naoxintong capsule;both groups continuously treated for 1 month. Comparisons were made between the two groups in terms of clinical effect,pre-and posttreatment NIHSS score,Barthel index,Quick Cognitive Screening Test for Elderly results and coagulation function parameters(including FIB,plasma viscosity and D-dimer). Results(1)Clinical effect in research group was statistically significantly better than that in control group(P<0.05).(2)No statistically significant difference of NIHSS score or Barthel index was found between the two groups before treatment(P>0.05);after treatment,NIHSS score in research group was statistically significantly lower than that in control group,while Barthel index in research group was statistically significantly higher than that in control group(P<0.05).(3)No statistically significant difference of time orientation score,delayed recall score,shortterm memory score,executive function score,simple calculation score or verbal fluency score was found between the two groups before treatment(P>0.05),while time orientation score,delayed recall score,short-term memory score,executive function score,simple calculation score and verbal fluency score in research group were statistically significantly higher than those incontrol group after treatment(P<0.05).(4)No statistically significant difference of FIB,plasma viscosity or D-dimer was found between the two groups before treatment(P>0.05),while FIB,plasma viscosity and D-dimer in research group were statistically significantly lower than those in control group after treatment(P<0.05). Conclusion Compared with aspirin,Naoxintong capsule can more effectively improve the clinical effect,ability of daily activities,cognitive function and coagulation function in patients with acute cerebral infarction,and is more helpful to reduce the degree of nervous functional defects.
Objective To compare the clinical effect on acute cerebral infarction and the impact on cognitive function and coagulation function between Naoxintong capsule and aspirin. Methods From January 2015 to July 2018,a total of 120 patients with acute cerebral infarction were selected in the People's Hospital of Longhua District,Shenzhen,and they were evenly divided into control group and research group by using random number table method. Based on conventional treatment,patients in control group received aspirin,while patients in research group received Naoxintong capsule;both groups continuously treated for 1 month. Comparisons were made between the two groups in terms of clinical effect,pre-and posttreatment NIHSS score,Barthel index,Quick Cognitive Screening Test for Elderly results and coagulation function parameters(including FIB,plasma viscosity and D-dimer). Results(1)Clinical effect in research group was statistically significantly better than that in control group(P<0.05).(2)No statistically significant difference of NIHSS score or Barthel index was found between the two groups before treatment(P>0.05);after treatment,NIHSS score in research group was statistically significantly lower than that in control group,while Barthel index in research group was statistically significantly higher than that in control group(P<0.05).(3)No statistically significant difference of time orientation score,delayed recall score,shortterm memory score,executive function score,simple calculation score or verbal fluency score was found between the two groups before treatment(P>0.05),while time orientation score,delayed recall score,short-term memory score,executive function score,simple calculation score and verbal fluency score in research group were statistically significantly higher than those incontrol group after treatment(P<0.05).(4)No statistically significant difference of FIB,plasma viscosity or D-dimer was found between the two groups before treatment(P>0.05),while FIB,plasma viscosity and D-dimer in research group were statistically significantly lower than those in control group after treatment(P<0.05). Conclusion Compared with aspirin,Naoxintong capsule can more effectively improve the clinical effect,ability of daily activities,cognitive function and coagulation function in patients with acute cerebral infarction,and is more helpful to reduce the degree of nervous functional defects.
引文
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[8]王素艳,李艳琴,李伟,等.脑心通胶囊联合依达拉奉对大面积脑梗死老年患者血清IL-17、hs-CRP及MMP-3水平的影响[J].现代中西医结合杂志,2016,25(14):1499-1501,1505.DOI:10.3969/j.issn.1008-8849.2016.14.006.
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[10]吴正国,王萍.脑心通对急性脑梗死患者神经功能及VEGF、TNF-α、IL-6水平的影响[J].陕西中医,2017,38(3):280-281.DOI:10.3969/j.issn.1000-7369.2017.03.003.
[11]朵杰.脑心通胶囊治疗慢性心力衰竭疗效及对患者生活质量的影响[J].现代中西医结合杂志,2016,25(31):3490-3492.DOI:10.3969/j.issn.1008-8849.2016.31.027.
[12]杨廷海,张洪伟,殷建保,等.脑心通胶囊联合尿激酶溶栓治疗急性脑梗死的临床疗效及其对血清中VEGF、Ang-2的影响[J].世界中西医结合杂志,2017,12(10):1405-1407.DOI:10.13935/j.cnki.sjzx.171019.
[13]YANG N,HAO J,ZHANG D.Antithrombin III and D-dimer levels as indicators of disease severity in patients with hyperlipidaemic or biliary acute pancreatitis[J].J Int Med Res,2017,45(1):147-158.DOI:10.1177/0300060516677929.
[14]杨凡.丁苯酞氯化钠注射液联合脑心通胶囊对急性脑卒中患者血清炎性因子水平及生活质量的影响[J].实用心脑肺血管病杂志,2016,24(6):85-88.DOI:10.3969/j.issn.1008-5971.2016.06.022.
[15]陶黎,李花.丁苯酞联合阿托伐他汀对急性脑梗死患者血清NSE、ANGⅡ、Hcy、炎性因子及凝血功能指标水平的影响[J].海南医学院学报,2016,22(21):2609-2612.DOI:10.13210/j.cnki.jhmu.20160814.001.
[16]武胜涛,张羽,李富慧.脑心通胶囊联合依达拉奉治疗急性脑梗死的疗效分析[J].中国药房,2017,28(9):1184-1187.DOI:10.6039/j.issn.1001-0408.2017.09.09.
[17]葛晓航,牛智领,张盼盼.康复训练联合步长脑心通胶囊在脑梗死患者康复期的应用研究[J].重庆医学,2017,46(26):3704-3706.DOI:10.3969/j.issn.1671-8348.2017.26.038.
[2]李宁,徐琴,黄勇华.脑心通胶囊治疗脑梗死合并心肌缺血的多中心非随机临床对照试验[J].河北医药,2016,38(16):2405-2408.DOI:10.3969/j.issn.1002-7386.2016.16.001.
[3]高长玉,吴成翰,赵建国,等.中国脑梗死中西医结合诊治指南(2017)[J].中国中西医结合杂志,2018,38(2):136-144.
[4]杨梅,蒲晓,张倩,等.丁苯酞氯化钠、脑心通胶囊联合丹参酮ⅡA磺酸钠治疗急性缺血性脑卒中的临床效果及对炎性因子的影响[J].临床和实验医学杂志,2018,17(2):148-151.DOI:10.3969/j.issn.1671-4695.2018.02.012.
[5]WANG Z W,YE P J.Clinical analysis of acute cerebral infarction accompanied with lung cancer[J].急性病杂志(英文版),2016,5(4):307-310.DOI:10.1016/j.joad.2016.06.003.
[6]孙树成.脑心通胶囊治疗急性脑梗死的临床疗效[J].中西医结合心脑血管病杂志,2017,15(2):235-237.DOI:10.3969/j.issn.1672-1349.2017.02.036.
[7]吴越,程灶火,季庆,等.老年快速认知筛查量表应用于轻度认知功能障碍筛查的分界值研究[J].临床精神医学杂志,2017,27(5):303-306.DOI:10.3969/j.issn.1005-3220.2017.05.005.
[8]王素艳,李艳琴,李伟,等.脑心通胶囊联合依达拉奉对大面积脑梗死老年患者血清IL-17、hs-CRP及MMP-3水平的影响[J].现代中西医结合杂志,2016,25(14):1499-1501,1505.DOI:10.3969/j.issn.1008-8849.2016.14.006.
[9]ZANG R,ZHANG H,XU Y,et al.Serum C-reactive protein,fibrinogen and D-dimer in patients with progressive cerebral infarction[J].Transl Neurosci,2016,7(1):84-88.DOI:10.1515/tnsci-2016-0013.
[10]吴正国,王萍.脑心通对急性脑梗死患者神经功能及VEGF、TNF-α、IL-6水平的影响[J].陕西中医,2017,38(3):280-281.DOI:10.3969/j.issn.1000-7369.2017.03.003.
[11]朵杰.脑心通胶囊治疗慢性心力衰竭疗效及对患者生活质量的影响[J].现代中西医结合杂志,2016,25(31):3490-3492.DOI:10.3969/j.issn.1008-8849.2016.31.027.
[12]杨廷海,张洪伟,殷建保,等.脑心通胶囊联合尿激酶溶栓治疗急性脑梗死的临床疗效及其对血清中VEGF、Ang-2的影响[J].世界中西医结合杂志,2017,12(10):1405-1407.DOI:10.13935/j.cnki.sjzx.171019.
[13]YANG N,HAO J,ZHANG D.Antithrombin III and D-dimer levels as indicators of disease severity in patients with hyperlipidaemic or biliary acute pancreatitis[J].J Int Med Res,2017,45(1):147-158.DOI:10.1177/0300060516677929.
[14]杨凡.丁苯酞氯化钠注射液联合脑心通胶囊对急性脑卒中患者血清炎性因子水平及生活质量的影响[J].实用心脑肺血管病杂志,2016,24(6):85-88.DOI:10.3969/j.issn.1008-5971.2016.06.022.
[15]陶黎,李花.丁苯酞联合阿托伐他汀对急性脑梗死患者血清NSE、ANGⅡ、Hcy、炎性因子及凝血功能指标水平的影响[J].海南医学院学报,2016,22(21):2609-2612.DOI:10.13210/j.cnki.jhmu.20160814.001.
[16]武胜涛,张羽,李富慧.脑心通胶囊联合依达拉奉治疗急性脑梗死的疗效分析[J].中国药房,2017,28(9):1184-1187.DOI:10.6039/j.issn.1001-0408.2017.09.09.
[17]葛晓航,牛智领,张盼盼.康复训练联合步长脑心通胶囊在脑梗死患者康复期的应用研究[J].重庆医学,2017,46(26):3704-3706.DOI:10.3969/j.issn.1671-8348.2017.26.038.