目的 探讨银杏酮酯滴丸联合阿托伐他汀钙治疗缺血性脑梗死的临床疗效。方法 选取2012年8月—2015年1月上海市奉贤区中心医院收治的急性缺血性脑梗死患者120例,随机分为对照组和治疗组,每组各60例。对照组口服阿托伐他汀钙片,1片/次,1次/d。治疗组在对照组治疗基础上口服银杏酮酯滴丸,5丸/次,3次/d。两组患者均治疗2周,出院后坚持服药12周。观察两组的临床疗效,比较两组治疗前后神经功能缺损(NIHSS)评分、巴特尔日常生活能力指数(BI)、颈动脉内膜-中膜厚度值(IMT)、斑块面积和个数、细胞间黏附分子-1(ICAM-1)和血管细胞黏附分子-1(VCAM-1)的变化。结果 治疗后,对照组和治疗组的总有效率分别为76.67%、91.67%,两组总有效率比较差异有统计学意义(P< 0.05)。治疗2周、出院12周时,两组NIHSS评分、IMT、斑块面积、斑块个数、sICAM-1、sVCAM-1均显著降低,BI指数显著升高,同组治疗前后差异有统计学意义(P< 0.05);且治疗组的改善程度优于对照组,两组比较差异具有统计学意义(P< 0.05)。结论 银杏酮酯滴丸联合阿托伐他汀钙治疗缺血性脑梗死具有较好的临床疗效,可改善患者的神经功能和生活质量,能够显著降低黏附分子的表达,具有一定的临床推广应用价值。

Objective To observe the clinical effect of Yinxing Guttate Dropping Pills combined with atorvastatin calcium in treatment of ischemic cerebral infarction. Methods Patients (120 cases) with ischemic cerebral infarction in Shanghai Fengxian District Central Hospital from August 2012 to January 2015 were randomly divided into control and treatment groups, and each group had 60 cases. The patients in the control group were po administered with Atorvastatin Calcium Tablets, 1 tablet/time, once daily. The patients in the treatment group were po administered with Yinxing Guttate Dropping Pills on the basis of the control group, 5 pills/time, three times daily. The patients in two groups were hospitalized for 2 weeks, and they took drugs for 12 weeks after discharge. After treatment, the efficacy was evaluated, and the changes of NIHSS scores, BI, IMT, plaque area and numbers, ICAM-1, and VCAM-1 in two groups before and after treatment were compared. Results After treatment, the efficacies in the control and treatment groups were 76.67% and 91.67%, respectively, and there were differences between two groups (P < 0.05). After 2 weeks in hospital and 12 weeks after discharge, the NIHSS scores, IMT, plaque area and numbers, ICAM-1, and VCAM-1 in two groups were significantly decreased, BI was significantly increased, and the difference was statistically significant in the same group (P < 0.05). These observational indexes in the treatment group were better than those in the control group, with significant difference between two groups (P < 0.05).Conclusions Yinxing Guttate Dropping Pills combined with atorvastatin calcium has clinical curative effect in treatment of ischemic cerebral infarction, and can improve nerve function and quality of life, also can significantly reduce the expression of adhesion molecules, which has a certain clinical application value.