刺五加注射液联合藻酸双酯钠治疗短暂性脑缺血发作的临床研究
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摘要
目的探讨刺五加注射液联合藻酸双酯钠片治疗短暂性脑缺血发作的临床疗效。方法选取2017年2月—2018年2月延安大学咸阳医院收治的161例短暂性脑缺血发作患者进行临床研究,所有患者根据入院顺序分成对照组(80例)和治疗组(81例)。对照组患者口服藻酸双酯钠片,50mg/次,3次/d;治疗组患者在对照组治疗的基础上静脉滴注刺五加注射液,60m L加入到生理盐水250m L中,1次/d。两组患者均连续治疗14d。观察两组的临床疗效,比较两组的大脑动脉血流速度、ABCD评分、血清学生化指标。结果治疗后,对照组和治疗组的总有效率分别为80.00%、92.59%,两组比较差异有统计学意义(P<0.05)。治疗后,两组患者大脑动脉平均流速、峰流速均较治疗前显著加快,ABCD评分均较治疗前显著降低,同组治疗前后比较差异有统计学意义(P<0.05);且治疗组大脑动脉平均流速、峰流速和ABCD评分显著优于对照组,两组比较差异具有统计学意义(P<0.05)。治疗后,两组患者血清神经元特异性烯醇化酶(NSE)、同型半胱氨酸(Hcy)、转化生长因子-β1(TGF-β1)水平均较治疗前显著降低,同组治疗前后比较差异有统计学意义(P<0.05);且治疗组血清NSE、Hcy以及TGF-β1水平显著低于对照组,两组比较差异具有统计学意义(P<0.05)。结论刺五加注射液联合藻酸双酯钠片治疗短暂性脑缺血发作具有较好的临床疗效,可改善大脑动脉血流速度,调节血清生化指标,安全性较好,具有一定的临床推广应用价值。
Objective To investigate the clinical effect of Ciwujia Injection combined with Alginic Sodium Diester Tablets in treatment of transient ischemic attack. Methods Patients(161 cases) with transient ischemic attack in Xianyang Hospital of Yan'an University from February 2017 to February 2018 were randomly divided into the control group(80 cases) and treatment group(81 cases). Patients in the control group were po administered with Alginic Sodium Diester Tablets, 50 mg/time, three times daily. Patients in the treatment group were iv administered with Ciwujia Injection on the basis of the control group, 60 mL added into normal saline 250 mL, once daily. Patients in two groups were treated for 14 d. After treatment, the clinical efficacies were evaluated, and cerebral arterial blood flow velocity, ABCD scores, and the serum levels of NSE, Hcy and TGF-β1 in two groups were compared. Results After treatment, the clinical efficacies in the control and treatment groups were 80.00% and 92.59%, respectively, and there was difference between two groups(P < 0.05). After treatment, the average velocity and the peak velocity of cerebral artery in two groups were significantly increased, but ABCD scores in two groups were significantly decreased, and the difference was statistically significant in the same group(P < 0.05). And the observational indexes in the treatment group were significantly better than those in the control group, with significant difference between two groups(P < 0.05). After treatment, the serum levels of NSE, Hcy, and TGF-β1 in two groups were significantly decreased, and the difference was statistically significant in the same group(P < 0.05). And the observational indexes in the treatment group were significantly lower than those in the control group, with significant difference between two groups(P < 0.05). Conclusion Ciwujia Injection combined with Alginic Sodium Diester Tablets has clinical curative effect in treatment of transient ischemic attack, can improve blood flow velocity of cerebral artery, and regulate serum biochemical indicators, with good safety, which has a certain clinical application value.
Objective To investigate the clinical effect of Ciwujia Injection combined with Alginic Sodium Diester Tablets in treatment of transient ischemic attack. Methods Patients(161 cases) with transient ischemic attack in Xianyang Hospital of Yan'an University from February 2017 to February 2018 were randomly divided into the control group(80 cases) and treatment group(81 cases). Patients in the control group were po administered with Alginic Sodium Diester Tablets, 50 mg/time, three times daily. Patients in the treatment group were iv administered with Ciwujia Injection on the basis of the control group, 60 mL added into normal saline 250 mL, once daily. Patients in two groups were treated for 14 d. After treatment, the clinical efficacies were evaluated, and cerebral arterial blood flow velocity, ABCD scores, and the serum levels of NSE, Hcy and TGF-β1 in two groups were compared. Results After treatment, the clinical efficacies in the control and treatment groups were 80.00% and 92.59%, respectively, and there was difference between two groups(P < 0.05). After treatment, the average velocity and the peak velocity of cerebral artery in two groups were significantly increased, but ABCD scores in two groups were significantly decreased, and the difference was statistically significant in the same group(P < 0.05). And the observational indexes in the treatment group were significantly better than those in the control group, with significant difference between two groups(P < 0.05). After treatment, the serum levels of NSE, Hcy, and TGF-β1 in two groups were significantly decreased, and the difference was statistically significant in the same group(P < 0.05). And the observational indexes in the treatment group were significantly lower than those in the control group, with significant difference between two groups(P < 0.05). Conclusion Ciwujia Injection combined with Alginic Sodium Diester Tablets has clinical curative effect in treatment of transient ischemic attack, can improve blood flow velocity of cerebral artery, and regulate serum biochemical indicators, with good safety, which has a certain clinical application value.
引文
[1]付银娜.短暂性脑缺血发作概念及其内涵的研究进展[J].临床医药文献电子杂志, 2015, 2(17):3602-3603.
[2]柴英娟,邓兰兰,张燕,等.中老年短暂性脑缺血发作的危险因素分析[J].中国社会医学杂志, 2011,28(4):259-261.
[3]王丽娜,胡松,毛拥军.藻酸双酯钠临床应用进展及不良反应[J].中国海洋药物, 2015, 34(1):67-72.
[4]陈继美.刺五加注射液的药理及临床应用[J].中国新医药, 2003, 2(12):77-78.
[5]中华医学会神经病学分会.中国缺血性脑卒中和短暂性脑缺血发作二级预防指南2014[J].中华神经科杂志, 2015, 48(4):258-273.
[6]郑筱萸.中药新药临床研究指导原则(试行)[M].北京:中国医药科技出版社, 2002:99-104.
[7] Rothwell P M, Giles M F, Flossmann E, et al. A simple score(ABCD)to identify individuals at high early risk of stroke after transient ischaemic attack[J]. Lancet, 2005,366(9479):29-36.
[8]李晓智.短暂性脑缺血发作的病因与发病机制[J].大家健康:中旬版, 2011, 27(4):58-59.
[9]王伊龙,王拥军.短暂性脑缺血发作概念、风险评价与治疗新进展[J].中国医学前沿杂志:电子版, 2010,2(4):1-6.
[10]郭燕飞.短暂性脑缺血发作危险因素分析及防治措施[J].实用心脑肺血管病杂志, 2012, 20(10):1605-1607.
[11]李春霞,孙杨,管华诗.海洋药物藻酸双酯钠研究进展及启示[J].生命科学, 2012, 24(9):1019-1025.
[12]肖海英,邱友红,刘莹.刺五加注射液的临床应用[J].黑龙江医学, 2007, 20(3):257-258.
[13]黄志东,顾承志,李新玲.短暂性脑缺血发作患者血清NSE的测定及临床意义[J].卒中与神经疾病, 2003,10(6):364-365.
[14]辛永飞,王珩.血清同型半胱氨酸与短暂性脑缺血发作及预后的相关性研究[J].中国中西医结合急救杂志, 2016, 23(2):172-174.
[15]陈蓉,胡治平,陈志斌,等.短暂性脑缺血发作患者血清转化生长因子-β1的浓度变化及临床意义[J].中国现代医学杂志, 2007, 17(16):1931-1933.
[2]柴英娟,邓兰兰,张燕,等.中老年短暂性脑缺血发作的危险因素分析[J].中国社会医学杂志, 2011,28(4):259-261.
[3]王丽娜,胡松,毛拥军.藻酸双酯钠临床应用进展及不良反应[J].中国海洋药物, 2015, 34(1):67-72.
[4]陈继美.刺五加注射液的药理及临床应用[J].中国新医药, 2003, 2(12):77-78.
[5]中华医学会神经病学分会.中国缺血性脑卒中和短暂性脑缺血发作二级预防指南2014[J].中华神经科杂志, 2015, 48(4):258-273.
[6]郑筱萸.中药新药临床研究指导原则(试行)[M].北京:中国医药科技出版社, 2002:99-104.
[7] Rothwell P M, Giles M F, Flossmann E, et al. A simple score(ABCD)to identify individuals at high early risk of stroke after transient ischaemic attack[J]. Lancet, 2005,366(9479):29-36.
[8]李晓智.短暂性脑缺血发作的病因与发病机制[J].大家健康:中旬版, 2011, 27(4):58-59.
[9]王伊龙,王拥军.短暂性脑缺血发作概念、风险评价与治疗新进展[J].中国医学前沿杂志:电子版, 2010,2(4):1-6.
[10]郭燕飞.短暂性脑缺血发作危险因素分析及防治措施[J].实用心脑肺血管病杂志, 2012, 20(10):1605-1607.
[11]李春霞,孙杨,管华诗.海洋药物藻酸双酯钠研究进展及启示[J].生命科学, 2012, 24(9):1019-1025.
[12]肖海英,邱友红,刘莹.刺五加注射液的临床应用[J].黑龙江医学, 2007, 20(3):257-258.
[13]黄志东,顾承志,李新玲.短暂性脑缺血发作患者血清NSE的测定及临床意义[J].卒中与神经疾病, 2003,10(6):364-365.
[14]辛永飞,王珩.血清同型半胱氨酸与短暂性脑缺血发作及预后的相关性研究[J].中国中西医结合急救杂志, 2016, 23(2):172-174.
[15]陈蓉,胡治平,陈志斌,等.短暂性脑缺血发作患者血清转化生长因子-β1的浓度变化及临床意义[J].中国现代医学杂志, 2007, 17(16):1931-1933.