银杏叶提取物注射液联合依达拉奉治疗急性脑出血的临床研究

Clinical study on Extract of Ginkgo biloba Leaves Injection combined with edaravone in treatment of intracerebral hemorrhage

目的观察银杏叶提取物注射液联合依达拉奉注射液治疗急性脑出血的临床疗效。方法收集上海市浦东新区周浦医院2013年7月—2015年7月住院急诊脑出血患者82例,随机分为对照组和治疗组,每组各41例。对照组静脉滴注依达拉奉注射液,30 mg加入生理盐水250 m L中,2次/d。治疗组在对照组治疗基础上静脉滴注银杏叶提取物注射液,17.5 mg加入0.9%氯化钠注射液500 m L中,1次/d。两组患者均连续治疗14 d。观察两组的临床疗效,并在治疗前及治疗7、14 d,检测NO和SOD水平,计算水肿体积和血肿体积,比较治疗前及治疗后1个月两组的中国脑卒中临床神经功能缺损程度评分量表(CSS)评分。结果治疗后,对照组总有效率为90.24%,治疗组总有效率为95.12%,两组总有效率比较差异具有统计学意义(P<0.05)。治疗后,两组血清NO水平、SOD水平、水肿体积、血肿体积均得到改善,同组治疗前后差异具有统计学意义(P<0.05)。经过7、14 d治疗后,治疗组患者血清NO水平均显著低于对照组(P<0.05);经过7 d治疗后,治疗组患者血清SOD水平显著低于对照组(P<0.05),而经过14 d治疗后,治疗组患者血清SOD水平与对照组无统计学差异。治疗后,治疗组患者水肿的治疗效果显著优于对照组(P<0.05),血肿体积迅速减少,治疗效果显著优于对照组(P<0.05)。治疗后,两组患者CSS评分均较治疗前显著降低,同组治疗前后差异具有统计学意义(P<0.05);且治疗组CSS评分降低程度优于对照组,两组比较差异具有统计学意义(P<0.05)。结论银杏叶提取物注射液联合依达拉奉注射液治疗急性脑出血具有较好的临床疗效,清除自由基,改善微循环,有利于患者神经功能的恢复,具有一定的临床推广应用价值。

Objective To observe the effect of Extract of Ginkgo biloba Leaves Injection combined with Edaravone Injection in treatment of intracerebral hemorrhage. Methods Patients（82 cases） with intracerebral hemorrhage in Shanghai Pudong New District Zhoupu Hospital from July 2013 to July 2015 were randomly divided into control and treatment groups, and each group had 41 cases. The patients in the control group were iv administered with Edaravone Injection, 30 mg added into normal saline 250 m L, twice daily. The patients in the treatment group were iv administered with Extract of Ginkgo biloba Leaves Injection on the basis of control group, 17.5 mg added into 0.9% Na Cl Injection 500 m L, once daily. The patients in two groups were treated for 14 d. After treatment, the clinical efficacies were evaluated, and the levels of NO and SOD in two groups were determined before treatment and 7 and 14 d after treatment. The volumes of edema and the volume of hematoma were calculated. CSS scores in two groups before treatment and one month after treatment were compared. Results After treatment, the clinical efficacies in the control and treatment groups were 90.24% and 95.12%, respectively, and there were differences between two groups（P〈0.05）. After treatment, the levels of NO and SOD, and the volumes of edema and the volume of hematoma in two groups were significantly improved, and the difference was statistically significant in the same group（P〈0.05）. After treatment for 7 and 14 d, the levels of NO in the control group were significantly lower than those of the treatment group（P〈0.05）. After treatment for 7 d, the levels of SOD in the control group were significantly lower than those of the treatment group（P〈0.05）, but there was no statistically significant difference between the control group and the treatment group after treatment for 14 d. After treatment, the volumes of edema and the volume of hematoma in the treatment group were significantly lower than those in the control group（P〈0.05）. After treatment, CSS scores in two groups were significantly decreased, and the difference was statistically significant in the same group（P〈0.05）. After treatment, the observational indexes in the treatment group were significantly better than those in the control group, with significant difference between two groups（P〈0.05）. Conclusion Extract of Ginkgo biloba Leaves Injection combined with Edaravone Injection has clinical curative effect in treatment of intracerebral hemorrhage, and can scavenge free radicals, improve microcirculation, and be beneficial for the recovery of neurological function in patients, which has a certain clinical application value.