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[摘要]
目的 探讨养血清脑颗粒联合硫酸氢氯吡格雷片治疗急性脑梗死的临床疗效。方法 选取2017年5月-2018年5月青海省心脑血管病专科医院收治的108例急性脑梗死患者作为研究对象,所有患者随机分为对照组和治疗组,每组各54例。对照组口服硫酸氢氯吡格雷片,75 mg/次,1次/d。治疗组在对照组基础上口服养血清脑颗粒,1袋/次,3次/d。两组患者均治疗14 d。观察两组的临床疗效,比较两组的美国国立卫生研究院卒中量表(NIHSS)评分、the Barthelindex of ADL(Barthel指数)、凝血功能指标、血清细胞因子。结果 治疗后,对照组和治疗组的总有效率分别为75.9%、90.7%,两组比较差异有统计学意义(P<0.05)。治疗后,两组NIHSS评分显著下降,Barthel指数显著升高,同组治疗前后比较差异有统计学意义(P<0.05);且治疗组NIHSS评分和Barthel指数明显优于对照组,两组比较差异有统计学意义(P<0.05)。治疗后,两组全血高切黏度(HBV)、全血低切黏度(LBV)、血浆黏度(PRV)、血细胞比容(HCT)水平均显著下降,同组治疗前后比较差异有统计学意义(P<0.05);且治疗组HBV、LBV、PRV、HCT水平均显著低于对照组,两组比较差异有统计学意义(P<0.05)。治疗后,两组血清同型半胱氨酸(Hcy)、肿瘤坏死因子-α(TNF-α)、白细胞介素-8(IL-8)水平均明显下降,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Hcy、TNF-α、IL-8水平均显著低于对照组,两组比较差异有统计学意义(P<0.05)。结论 养血清脑颗粒联合硫酸氢氯吡格雷片治疗急性脑梗死具有较好的临床疗效,可改善患者神经功能缺损及血液流变学,降低炎性反应,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 Yangxue Qingnao Granules combined with Clopidogrel Bisulfate Tablets in treatment of acute cerebral infarction. Methods Patients (108 cases) with acute cerebral infarction in Qinghai Province Cardiovascular and Cerebrovascular Disease Specialist Hospital from May 2017 to May 2018 were randomly divided into control and treatment groups, and each group had 54 cases. Patients in the control group were po administered with Clopidogrel Bisulfate Tablets, 75 mg/time, once daily. Patients in the treatment group were po administered with Yangxue Qingnao Granules on the basis of the control group, 1 bag/time, three times daily. Patients in two groups were treated for 14 d. After treatment, the clinical efficacies were evaluated, and NIHSS scores, Barthel Indexes, coagulation function indexes, and serum cytokines in two groups were compared. Results After treatment, the clinical efficacies in the control and treatment groups were 75.9% and 90.7%, respectively, and there was difference between two groups (P<0.05). After treatment, NIHSS scores in two groups were significantly decreased, but Barthel Indexes in two groups were significantly increased, and the difference was statistically significant in the same group (P<0.05). And the NIHSS scores and Barthel 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 levels of HBV, LBV, PRV, and HCT in two groups were significantly decreased, and the difference was statistically significant in the same group (P<0.05). And the coagulation function indexes in the treatment group were significantly lower than those in the control group, with significant difference between two groups (P<0.05). After treatment, the levels of Hcy, TNF-α, and IL-8 in two groups were significantly decreased, and the difference was statistically significant in the same group (P<0.05). And the serum cytokines levels in the treatment group were significantly lower than those in the control group, with significant difference between two groups (P<0.05). Conclusion Yangxue Qingnao Granules combined with Clopidogrel Bisulfate Tablets has clinical effect in treatment of acute cerebral infarction, can improve the neurologic function defect and hemorheology, reduce the inflammatory reaction, and improve the quality of life, which has a certain clinical application value.
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