丁苯酞软胶囊联合依达拉奉治疗脑梗死的临床研究

Clinical study on Butylphthalide Soft Capsules combined with edaravone in treatment of cerebral infarction

目的研究丁苯酞软胶囊联合依达拉奉注射液治疗脑梗死的临床疗效。方法选取2015年8月—2016年7月常德市第一人民医院收治的脑梗死患者86例,按照治疗方案不同分为对照组和治疗组,每组各43例。对照组静脉滴注依达拉奉注射液,30 mg加入到生理盐水150 mL中,2次/d。治疗组在对照组基础上口服丁苯酞软胶囊,0.2 g/次,3次/d。两组患者均连续治疗14 d。观察两组的临床疗效,比较两组的血清神经营养因子、炎症反应、神经功能评分和日常生活能力(ADL)评分情况。结果治疗后,对照组和治疗组的总有效率分别为74.42%、93.02%,两组比较差异有统计学意义(P<0.05)。治疗后,两组神经元特异性烯醇化酶(NSE)水平显著降低,神经生长因子(NGF)和脑源性神经营养因子(BDNF)水平显著升高,同组治疗前后比较差异有统计学意义(P<0.05);且治疗组这些观察指标的改善程度明显优于对照组,两组比较差异具有统计学意义(P<0.05)。治疗后,两组白细胞介素-8(IL-8)、白细胞介素-10(IL-10)和C反应蛋白(CRP)水平明显降低,同组治疗前后比较差异有统计学意义(P<0.05);且治疗组这些观察指标的下降程度明显优于对照组,两组比较差异具有统计学意义(P<0.05)。治疗后,两组神经功能评分明显降低,ADL评分明显升高,同组治疗前后比较差异有统计学意义(P<0.05);且治疗组这些观察指标的改善程度明显优于对照组,两组比较差异有统计学意义(P<0.05)。结论丁苯酞软胶囊联合依达拉奉注射液治疗脑梗死具有较好的临床疗效,能改善神经功能和日常生活能力,调节血清神经营养因子和炎症反应,安全性较好,具有一定的临床推广应用价值。

Objective To study the effect of Butylphthalide Soft Capsules combined with Edaravone Injection in treatment of cerebral infarction. Methods Patients（86 cases） with cerebral infarction in the First People＇s Hospital of Changde from August 2015 to July 2016 were enrolled in this study. According to the difference treatment plan, patients were randomly divided into control and treatment groups, and each group had 43 cases. Patients in the control group were iv administered with Edaravone Injection, 30 mg added into normal saline 150 mL, twice daily. Patients in the treatment group were po administered with Butylphthalide Soft Capsules on the basis of the control group, 0.2 g/time, three times daily. Patients in two groups were treated for 14 d. After treatment, the clinical efficacies were evaluated, andserum neurotrophic factors, inflammatory response factors, neurological function scores, and ADL scores in two groups were compared. Results After treatment, the clinical efficacies in the control and treatment groups were 74.42% and 93.02%, respectively, and there was difference between two groups（P〈0.05）. After treatment, the levels of NSE in two groups were significantly decreased, but the levels of NGF and BDNF in two groups were significantly increased, and the difference was statistically significant in the same group（P〈0.05）. And 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）. After treatment, the levels of IL-8, IL-10, and CRP in two groups were significantly decreased, and the difference was statistically significant in the same group（P〈0.05）. And the observational 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 neurological function scores in two groups were significantly decreased, but the ADL scores in two groups were significantly increased, and the difference was statistically significant in the same group（P〈0.05）. 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 Butylphthalide Soft Capsules combined with Edaravone Injection has clinical curative effect in treatment of cerebral infarction, can improve neurological function and daily living ability, and regulate serum neurotrophic factors and inflammatory responses, with good safety, which has a certain clinical application value.