脑心通胶囊联合西药治疗急性脑梗死合并心肌缺血291例临床观察

Clinical Study on 291 Cases of Acute Cerebral Infarction with Myocardial Ischemia Treated by Naoxintong Capsule(脑心通胶囊) Combined with Western Medicine

目的观察脑心通胶囊治疗急性脑梗死合并心肌缺血患者的临床疗效及疗效的影响因素。方法将528例急性脑梗死伴心肌缺血患者分为治疗组291例和对照组237例。对照组给予西药常规治疗,治疗组在常规治疗的基础上加用脑心通胶囊,每次4粒(每粒0.4 g),每日3次。两组均治疗12周。采用美国国立卫生研究院卒中量表(NIHSS)和改良Rankin评分比较两组治疗前后神经功能,治疗后比较两组心肌缺血疗效和神经功能缺损疗效,并采用Logistic回归分析方法探讨疗效影响因素。结果治疗第8周、12周时,治疗组心肌缺血疗效有效率分别为27.7%和31.3%,对照组分别为13.9%和16.9%,治疗组心肌缺血有效率均明显高于对照组(P<0.01)。根据NIHSS评分、改良Rankin评分,治疗组神经功能缺损有效率均明显高于对照组(P<0.05)。多因素分析显示心肌缺血改善的影响因素包括脑心通治疗(P=0.005)和第12周时门冬氨酸氨基转移酶(AST)水平(P=0.047);神经功能改善的影响因素包括脑心通治疗、基线收缩压和肌酐水平、既往心脏病或高脂血症病史。结论脑心通胶囊治疗急性脑梗死合并心肌缺血临床疗效确切,既往相关病史及症状对疗效可能产生影响。

Objective To observe clinical effects and its influencing factors of acute cerebral infarction with myo- cardial ischemia treated by Naoxintong Capsule. Methods Totally 528 patients with acute cerebral infarction with myocardial ischemia were divided into 291 cases in treatment group and 237 cases in control group. The control group was given western medicine to conventional treatment. The treatment group, on the basis of conventional treatment, took Naoxintong Capsule, 4 tablets each time （0. 4g each tablet）, three times a day for 12 weeks. The researchers used the national institutes of health stroke scale （NIHSS） and modified Rankin to compare neurological function of both groups before and after the treatment, as well as compared curative effect in myocardial ischemia and neurological function of two groups after the treatment, and used Logistic regression analysis method to explore influencing factors of curative effect. Results After treatment for 8 weeks and 12 weeks, in the treatment group curative effect of myo- cardial ischemia took effect accounting for 27.7% and 31.3% respectively, that in the control group accounting for 13.9% and 16.9% respectively. Effective rate of myocardial ischemia in the treatment group were significantly higher than in the control group （P 〈 0. 01 ）. According to the score of NIHSS and modified Rankin, effective rate of neuro- logical deficit in the treatment group were significantly higher than in the control group （P 〈 0. 05 ）. Multi-factor anal- ysis showed that the influencing factors of myocardial ischemia improved involved the therapy of Naoxintong （P = 0. 005） and the level of aspartate transaminase （AST） at the 12th weeks （P = 0. 047 ）. The influencing factors of neurological function improvement involved the treatment of Naoxintong, baseline systolic pressure and the level of creatinine, past heart disease or hyperlipidemia history. Conclusion Clinical effects of Naoxintong Capsule to treat acute cerebral infarction with myocardial ischemia is definite and can be impacted by past correlative medical history and symptoms.