脑心通胶囊联合丹红注射液治疗急性脑梗死的临床疗效及其机制探讨

Clinical Efficacy of Naoxintong Capsule Combined with Danhong Injection in the Treatment of Acute Cerebral Infarction

目的观察脑心通胶囊联合丹红注射液治疗急性脑梗死的临床疗效,探讨其作用机制。方法选取2013年10月~2014年12月在武汉市中心医院神经内科住院的急性脑梗死患者90例,随机分为3组：对照组单纯应用抗血小板聚集、降脂、护脑及对症等常规治疗;治疗组在常规治疗同时给予脑心通胶囊治疗;联合用药组在常规治疗基础上加用脑心通胶囊和丹红注射液治疗。观察治疗前后三组患者的临床疗效、血液流变学、血脂代谢指标、炎症因子的变化。结果治疗组治疗前后神经功能缺损评分明显改善,且优于对照组（均P〈0.05）,联合用药组改善更明显（均P〈0.05）,治疗组和联合用药组总有效率均高于对照组（均P〈0.05）,联合用药组与治疗组总有效率差异无统计学意义（P〉0.05）,治疗组对降低脑梗死患者纤维蛋白原、血浆粘度、肿瘤坏死因子α（TNF-α）及白介素1β（IL-1β）作用明显强于对照组（均P〈0.05）;联合用药组降低纤维蛋白原、血浆粘度、TNF-α及IL-1β作用较治疗组更强（均P〈0.05）。血脂代谢方面,联合用药组与治疗组降总胆固醇及三酰甘油的作用相当,两者均高于对照组（均P〈0.05）。结论脑心通胶囊对急性脑梗死患者有较好的疗效,联用丹红注射液的疗效更佳,其可能作用机制为脑心通联合丹红注射液能降低患者血液纤维蛋白原、血浆粘度,降低TNF-α、IL-1β炎症因子的水平。

Objective To observe the clinical efficacy of Naoxintong capsule combined with Danhong injection in the treatment of acute cerebral infarction and the mechanism of action.Methods A total of 90 patients with acute cerebral infarction who were treated in the Department of Neurology of Wuhan Central Hospital from October 2013 to December 2014 were enrolled in the study and randomly divided into 3groups：control group,in which patients received conventional medicines with antiplatelet aggregation,lipid-lowering,brain-protecting and symptom-treating effects;treatment group,in which patients were given both conventional treatment and Naoxintong capsule;combination group,in which patients were treated with Naoxintong capsule and Danhong injection on the basis of the conventional treatment.Changes of clinical effect,hemodynamics,indexes for high lipid metabolism and inflammatory factors were observed before and after treatment in the three groups.Results The neurological deficit score was significantly improved in the treatment group when compared with that in the control group（P〈0.05）,and the improvement was most obvious in the combination group（P〈0.05）.The total effective rate in both treatment group and combination group was higher than that in the control group（P〈0.05）,and it was not statistically different between the treatment group and combination group（P〈0.05）.The fibrinogen,plasma viscosity,tumor necrosis factor-α（TNF-α）and interleukin-1β（IL-1β）were significantly decreased in the treatment group as compared with those in the control group（P〈0.05）,and the decrease in these indexes was strongest in the combination group（P〉0.05）.The total cholesterol and triglyceride were significantly reduced in both combination group and treatment group when compared with those in the control group（P〈0.05）.Conclusion Naoxintong capsule has good curative effects on the patients with acute cerebral infarction,which is better when combined with Danhong injection.The mechanism possibly involves the decrease in the plasma viscosity,the levels of fibrinogen and inflammatory factors,like TNF-αand IL-1β.