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[摘要]
目的 探讨苦碟子注射液联合脑苷肌肽治疗急性脑梗死的临床效果。方法 选取2015年9月-2017年9月皖南医学院第二附属医院收治的86例急性脑梗死患者,随机分为对照组和治疗组,每组各43例。对照组静脉滴注脑苷肌肽注射液,20 mL加入生理盐水250 mL充分稀释后给药,缓慢滴注,1次/d。治疗组在对照组基础上静脉滴注苦碟子注射液,40 mL加入生理盐水250 mL均匀混合后给药,1次/d。两组均连续治疗14 d。观察两组的临床疗效,比较两组治疗前后国立卫生研究院卒中量表(NIHSS)评分、日常生活能力量表(ADL)评分、颈总动脉内径(CCAD)、颈动脉内-中膜厚度(CIMT)、椎动脉收缩期峰值(Vs)、舒张末期血流速度(Vd)、血清低/高密度脂蛋白胆固醇比值(LDL-C/HDL-C)、超敏C反应蛋白(hs-CRP)、降钙素原(PCT)、胱抑素C(Cys-C)、同型半胱氨酸(Hcy)的变化情况。结果 治疗后,对照组和治疗组的总有效率分别为72.09%、90.70%,两组比较差异有统计学意义(P<0.05)。治疗后,两组NIHSS、ADL评分、LDL-C/HDL-C值、hs-CRP、PCT、Cys-C、Hcy较治疗前均显著降低,两组双侧椎动脉Vs、Vd值均显著增加,同组治疗前后比较差异具有统计学意义(P<0.05);治疗后,治疗组NIHSS、ADL评分、双侧CCAD、CIMT值、LDL-C/HDL-C值、hs-CRP、PCT、Cys-C、Hcy均显著低于对照组,治疗组双侧椎动脉Vs、Vd值显著高于对照组,两组比较差异有统计学意义(P<0.05)。结论 苦碟子注射液联合脑苷肌肽治疗急性脑梗死具有较好的临床疗效,可有效改善患者脑血流状态,减轻组织损伤与颈动脉粥样硬化病变,促进神经功能恢复,提高生活质量,具有一定的临床推广应用价值。
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[Abstract]
Objective To investigate the clinical effect of Kudiezi Injection combined with cattle encephalon glycoside and ignotin in treatment of acute cerebral infarction. Methods Patients (86 cases) with acute cerebral infarction in the Second Affiliated Hospital of Wannan Medical College from September 2015 to September 2017 were randomly divided into control (43 cases) and treatment (43 cases) groups. Patients in the control group were iv administered with Cattle Encephalon Glycoside and Ignotin Injection, 20 mL was added with normal saline solution 250 mL, once daily. Patients in the treatment group were iv administered with Kudiezi Injection on the basis of the control group, 40 mL was added with normal saline solution 250 mL, once daily. Patients in two groups were treated for 14 d. After treatment, the clinical efficacy was evaluated, and the changes of NIHSS score, ADL score, CCAD, CIMT, Vs, Vd, LDL-C/HDL-C, hs-CRP, PCT, Cys-C, and Hcy in two groups were compared. Results After treatment, the clinical efficacy in the control and treatment groups were 72.09% and 90.70%, respectively, and there was difference between two groups (P < 0.05). After treatment, NIHSS score, ADL score, LDL-C/HDL-C, hs-CRP, PCT, Cys-C, and Hcy in two groups were significantly reduced, butVs and Vd of both bilateral vertebral artery were significantly increased, and the difference was statistically significant in the same group (P < 0.05). After treatment, NIHSS score, ADL score, CCAD and CIMT of both sides, LDL-C/HDL-C, hs-CRP, PCT, Cys-C, and Hcy in the treatment group were lower than those in the control group, but Vs and Vd of both bilateral vertebral artery were higher than those in the control group, and there was difference between two groups (P < 0.05). Conclusion Kudiezi Injection combined with cattle encephalon glycoside and ignotin has remarkable clinical effect in treatment of acute cerebral infarction, and can effectively improve the blood flow state, reduce tissue damage and carotid atherosclerosis, promote the recovery of nerve function and improve the life quality, which has a certain clinical application value.
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