苦碟子注射液联合瑞舒伐他汀治疗急性脑梗死临床研究

Effect ofKudiezi injection combined with rosuvastatin on patients with acute cerebral infarction

目的 评价苦碟子注射液联合瑞舒伐他汀治疗急性脑梗死（acute cerebral infarction,ACI）的疗效.方法 将符合入选标准的90例ACI患者按随机数字表法将患者分为3组,每组30例.对照组口服阿托伐他汀,治疗I组口服瑞舒伐他汀,治疗Ⅱ组在治疗I组基础上联用苦碟子注射液.3组均治疗2周.采用生化分析仪检测血清TC、TG、LDL-C含量,采用全自动血凝分析仪检测纤维蛋白原、血小板计数和凝血酶原时间,采用Barthel指数评价患者日常生活能力,采用美国国立卫生研究院卒中量表（National Institute of Health Stroke Scale,NIHSS）评价患者神经功能,比较临床疗效.结果 治疗Ⅱ组总有效率为96.7%（29/30）、治疗I组为76.7%（23/30）、对照组为73.3%（22/30）,3组比较差异有统计学意义（χ2=6.537,P=0.018）.治疗后,治疗Ⅱ组血清TC[（4.03＆#177;0.83）mmol/L比（4.61＆#177;0.89）mmol/L、（5.42＆#177;0.75）mmol/L,F=21.538]、TG[（1.68＆#177;0.46）mmol/L比（2.02＆#177;0.81）mmol/L、（2.38＆#177;0.67）mmol/L,F=8.585]、LDL-C[（2.37＆#177;0.48）mmol/L比（2.74＆#177;0.68）mmol/L、（3.11＆#177;0.81）mmol/L,F=9.092]水平低于治疗I组和对照组（P〈0.01）;治疗Ⅱ组纤维蛋白原[（2.48＆#177;0.37）g/L比（2.81＆#177;0.46）g/L、（2.95＆#177;0.51）g/L,F=8.592]、血小板[（125.27＆#177;11.88）＆#215;109比（132.13＆#177;13.55）＆#215;109、（133.83＆#177;13.91）＆#215;109,F=3.571]低于治疗I组和对照组（P〈0.05）,凝血酶原时间[（17.52＆#177;1.94）s比（16.14＆#177;1.62）s、（15.34＆#177;1.18）s,F=14.139]高于治疗I组和对照组（P〈0.05）.治疗II组Barthel指数[（85.63＆#177;4.10）分比（81.83＆#177;3.92）分、（79.23＆#177;4.81）分,F=16.873]高于治疗Ⅰ组和对照组（P〈0.01）、NIHSS评分[（3.57＆#177;1.17）分比（4.63＆#177;1.22）分、（5.57＆#177;1.33）分,F=19.550]低于治疗I组和对照组（P〈0.01）.结论 苦碟子注射液联合瑞舒伐他汀可有效降低ACI患者血脂水平,改善凝血功能,提高生活质量,促进神经功能恢复.

Objective To investigate the clinical effect ofKudiezi injection combined with rosuvastatin on patients with acute cerebral infarction（ACI）.Methods A total of 90 patients with ACI patients of Department of Neurology of our hospital, from March 2015 to June 2016, were randomly divided into treatment group Ⅰ, treatment group Ⅱ and the control group, 30 in each group. The control group was given atorvastatin, the treatment group Ⅰ received rosuvastatin, and the treatment group Ⅱ was adopted Kudiezi injection combined with rosuvastatin. The curative effect was observed, and blood lipid and coagulation function were compared, and daily life ability and nerve function were recorded.Results The curative ratein treatment group Ⅱ （96.7%）was significantly better than that in treatment group Ⅰ （76.7%） and the control group （73.3%） （χ2=6.537,P〈0.05）. Total cholesterol,three acyl glycerin,low density lipoprotein in treatment group Ⅱ （4.03 ± 0.83 mmol/L, 1.68 ± 0.46 mmol/L, 2.37 ± 0.48 mmol/Lvs. 4.61 ± 0.89 mmol/L, 2.02 ± 0.81 mmol/L, 2.74 ± 0.68 mmol/L and 5.42 ± 0.75 mmol/L, 2.38 ± 0.67 mmol/L, 3.11 ± 0.81 mmol/L） were significantly lower than those in treatment group Ⅰ and the control group （F=21.538, 8.585, 9.092,P〈0.05）, and those in treatment group Ⅰ was significantly lower than those in the control group （P〈0.05）.The fibrinogen （2.48 ± 0.37 g/Lvs.2.81 ± 0.46 g/L, 2.95 ± 0.51 g/L）, platelet counts[（125.27 ± 11.88）＆#215;109vs.（132.13 ± 13.55）＆#215;109 and （133.83 ± 13.91）＆#215;109] and prothrombin time （17.52 ± 1.94 svs.（16.14 ± 1.62 s, 15.34 ± 1.18 s） in treatment group Ⅱ were significantly lower and higher than those in treatment group Ⅰ and control group （F=8.592, 3.571, 14.139,P〈0.05）. The scores of Barthel index （85.63 ± 4.10 vs.81.83 ± 3.92, 79.23 ± 4.81） and NIHSS （3.57 ± 1.17 vs. 4.63 ± 1.22, 5.57 ± 1.33） intreatment group Ⅱ were significantly higher and lower than those in treatment group Ⅰand the control group （F=16.873, 19.550,P〈0.05）, those in treatment group Ⅰ was significantly higher and lower than those in the control group （P〈0.05）.ConclusionsKudiezi injection combined with rosuvastatin could improve curative effect ,reduce blood lipid, improve coagulation function, improve quality of life and promote recovery of nerve function in patients with acute cerebral infarction.