丁苯酞联合依达拉奉治疗急性脑梗死60例临床研究

Clinical Research of Butylphthalide Combined with Edaravone in Treatment of 60 Patients with Acute Cerebral Infarction

目的丁苯酞联合依达拉奉治疗急性脑梗死的临床疗效和对神经功能的影响。方法选取2013年1月—2015年12月梧州市工人医院收治的急性脑梗死240例,根据治疗方法不同分为对照组、丁苯酞组、依达拉奉组及联合组,每组各60例,对照组给予临床常规治疗,其他组在此基础上给予相应治疗,丁苯酞组口服丁苯酞治疗,依达拉奉组静脉滴注依达拉奉治疗,联合组联合口服丁苯酞与静脉滴注依达拉奉治疗,观察比较4组治疗前及治疗后7、14、30、90 d神经功能缺损程度评分(NIHSS)、Barthel-ADL指数变化,治疗后疗效及药物不良反应情况。结果治疗前4组NIHSS评分比较差异无统计学意义(P>0.05),治疗后7、14、30、90 d明显低于治疗前(P<0.01),联合组治疗后7、14、30、90 d明显低于对照组、丁苯酞组及依达拉奉组(P<0.05),丁苯酞组及依达拉奉组在治疗后14、30、90 d明显低于对照组(P<0.05)。治疗前4组Barthel-ADL指数比较差异无统计学意义(P>0.05),治疗后7、14、30、90 d明显高于治疗前(P<0.01),联合组治疗后14、30、90 d明显高于对照组、丁苯酞组及依达拉奉组(P<0.01)。治疗后14 d联合组总有效率明显高于对照组、丁苯酞组及依达拉奉组(P<0.01)。4组不良反应发生率比较差异无统计学意义(P>0.05)。结论丁苯酞联合依达拉奉治疗急性脑梗死能显著提高疗效,明显改善神经功能,提高日常生活质量,同时药物不良反应没有增加,治疗安全性高,值得在临床应用推广。

Objective To investigate clinical efficacy and effect on neurological function of Butylphthalide combined with Edaravone in treatment of acute cerebral infarction. Methods A total of 240 patients with acute cerebral infarction admitted during January 2013 and December 2015 were divided into control group,Butylphthalide group,Edaravone group and combination group（ n = 60 for each group） according to different treatment methods. Control group was given routine treatment. On the basis of routine treatment,other groups received corresponding treatments. Butylphthalide group was treated with Butylphthalide orally; Edaravone group was treated with Edaravone by intravenous infusion; combination group was treated with Butylphthalide orally combined with Edaravone by intravenous infusion. Neurologic impairment degree（ NIHSS） scores,Barthel-ADL index changes and clinical efficacy before and 7,14,30 and 90 days after treatment and incidence rates of adverse drug reactions were observed and compared in 4 groups. Results There were no significant differences in NIHSS scores before treatment（ P〉0. 05）,while the scores 7,14,30 and 90 days after treatment were significantly lower than those before treatment in 4 groups（ P〈0. 01）; the scores 7,14,30 and 90 days after treatment in combination group were significantly lower than those in other three group（ P〈0. 05）; the scores 14,30 and 90 days after treatment in Butylphthalide and Edaravone groups were significantly lower than those in control group（ P〈0. 05）. There were no significant differences in Barthel-ADL indexes before treatment（ P〉0. 05）,while the levels7,14,30 and 90 days after treatment were significantly higher than those before treatment in 4 groups（ P〈0. 01）; the levels 14,30 and 90 days after treatment in combination group were significantly higher than those in control,Butylphthalide and Edaravone groups（ P〈0. 01）. The total effective rate in combination group was significantly higher than those in other three groups（ P〈0. 01）. There were no significant differences in incidence rates of adverse reaction among4 groups（ P〉0. 05）. Conclusion Butylphthalide combined with Edaravone in treatment of patients with acute cerebral infarction can significantly improve curative effect,neurological function and quality of daily life without increasing adverse drug reactions,and it has good safety.