目的 探讨曲克芦丁脑蛋白水解物注射液联合阿司匹林肠溶片治疗烟雾病的临床疗效.方法 新疆医科大学第一附属医院、新疆医科大学第二附属医院、新疆自治区人民医院2012年9月—2014年7月收治的烟雾病患者121例,随机分为治疗组(61例)和对照组(60例).对照组在常规治疗的基础上口服阿司匹林肠溶片,0.1 g/次,1次/d.治疗组给予曲克芦丁脑蛋白水解物注射液10 mL加入250 mL生理盐水后缓慢静脉点滴,1次/d.两组均连续治疗30 d.评价两组的临床疗效,同时比较两组神经功能缺损(NIHSS)评分、颅内供血、双侧平均肌力、凝血酶原时间和血小板计数的变化情况.结果 治疗组和对照组的总有效率分别为83.61%、56.67%,两组比较差异有统计学意义(P<0.05).治疗10 d、治疗后,两组NIHSS评分均较治疗前显著降低,同组比较差异有统计学意义(P<0.05、0.01);且治疗10 d、治疗后治疗组NIHSS评分显著低于对照组,两组比较差异有统计学意义(P<0.05、0.01).治疗10 d、治疗后,两组颅内供血均较治疗前显著增加,同时,患者双侧平均肌力均显著升高,同组比较差异有统计学意义(P<0.01);且治疗组这些观察指标的改善程度优于对照组,两组比较差异有统计学意义(P<0.05、0.01).结论 曲克芦丁脑蛋白水解物注射液联合阿司匹林肠溶片对烟雾病有较好的临床疗效,能够促进患者神经功能缺损恢复,且不良反应少,值得临床推广.
Objective To explore the effect of Troxerutin Cerebroprotein Hydrolysate Injection combined with Aspirin Enteric-coated Tablets in the treatment of moyamoya disease. Methods Patients (121 cases) with moyamoya disease who came to the First and Second Affiliated Hospitals of Xinjiang Medical University, and People's Hospital of Xinjiang Autonomous Region from September 2012 to July 2014 were randomly divided into control (60 cases) and treatment (61 cases) groups. The patients in the control group were po administered with Aspirin Enteric-coated Tablets on the basis of conventional treatment, 0.1 g/time, once daily. The patients in the treatment group were iv administered with 250 mL Troxerutin Cerebroprotein Hydrolysate Injection (10 mL adding into 0.9% saline solution), once daily. The patients in the two groups were treated for 30 d. After treatment, the treatment efficacy was evaluated, while the changes of NIHSS score, intracranial blood flow, average strength on both sides, prothrombin time, and platelet count in two groups were compared. Results The efficacies in the treatment and control groups were 83.61% and 56.67%, respectively, and there were differences between the two groups (P < 0.05). After 10 d treatment, NIHSS scores in the two groups were significantly reduced, and the difference was statistically significant in the same group (P < 0.05, 0.01). NIHSS score in the treatment group was significantly lower than that in the control group, with significant difference between two groups (P < 0.05, 0.01). After 10 d treatment, intracranial blood flow in two groups were significantly increased, while the average muscle was significantly higher, and the difference was statistically significant in the same group (P < 0.01). These observational indexes in the treatment group improved more obviously than those in the control group in the same time of treatment, with the significant difference between two groups (P < 0.05, 0.01). Conclusion Troxerutin Cerebroprotein Hydrolysate Injection combined with Aspirin Enteric-coated Tablets has good clinical effect in the treatment of moyamoya disease, and can promote the neurologic deficits recovery with less adverse reaction, which is worthy of clinical application.