丁苯酞氯化钠注射液治疗急性缺血性脑梗死的疗效观察

Clinical observation of Butylphthalide and Sodium Chloride Injection in treatment of acute ischemic cerebral infarction

目的探讨丁苯酞氯化钠注射液治疗急性缺血性脑梗死的临床疗效。方法选取2015年3月—2017年3月湖北省中医院神经内科收治的急性缺血性脑梗死患者100例为研究对象,所有患者随机分为对照组和治疗组,每组各50例。对照组第1天口服阿司匹林肠溶片300 mg、阿托伐他汀钙片40 mg、硫酸氢氯吡格雷片300 mg;从第2天起剂量调整为:阿司匹林肠溶片100 mg,1次/d,阿托伐他汀钙片40 mg,1次/晚,硫酸氢氯吡格雷片75 mg,1次/d。治疗组在对照组基础上静脉滴注丁苯酞氯化钠注射液,在发病后48 h内开始给药,25 mg/次,2次/d,滴注时间不少于50 min,两次用药间隔时间控制在6 h左右。两组患者均连续治疗14 d。观察两组的临床疗效,比较两组的美国国立卫生研究院卒中量表(NIHSS)评分和梗死灶体积。对出院患者进行病情跟踪随访3个月,比较两组的不良反应发生率。结果治疗后,对照组和治疗组的总有效率分别为78.00%、92.00%,两组比较差异有统计学意义(P<0.05)。治疗8、14 d后,两组NIHSS评分均显著降低,同组治疗前后比较差异有统计学意义(P<0.05);且治疗组NIHSS评分明显低于对照组,两组比较差异有统计学意义(P<0.05)。治疗8、14 d后,两组梗死灶体积均显著减小,同组治疗前后比较差异有统计学意义(P<0.05);且治疗组梗死灶体积明显小于对照组,两组比较差异具有统计学意义(P<0.05)。对照组、治疗组不良反应发生率分别为18.00%、6.00%,两组不良反应发生率比较差异有统计学意义(P<0.05)。结论丁苯酞氯化钠注射液治疗急性缺血性脑梗死具有较好的临床疗效,可降低NIHSS评分,减小梗死灶体积,安全性较好,具有一定的临床推广应用价值。

Objective To investigate the clinical effect of Butylphthalide and Sodium Chloride Injection in treatment of acute ischemic cerebral infarction.Methods Patients （100 cases） with acute ischemic cerebral infarction in Department of Neurology of Hubei Provincial Hospital of Traditional Chinese Medicine from March 2015 to March 2017 were randomly divided into control and treatment groups, and each group had 50 cases. Patients in the control group werepo administered with Aspirin Enteric-coated Tablets （300 mg）, Atorvastatin Calcium Tablets （40 mg）, and Clopidogrel Hydrogen Sulphate Tablets （300 mg） on day 1; and from the second day, the dose was adjusted to Aspirin Enteric-coated Tablets 100 mg, once daily, Atorvastatin Calcium Tablets 40 mg, once every night, and Clopidogrel Hydrogen Sulphate Tablets 75 mg, once daily. Patients in the treatment group were iv administered with Butylphthalide and Sodium Chloride Injection on the basis of the control group, 25 mg/time, twice daily, infusion time not less than 50 min, dosing interval about 2 h. Patients in two groups were treated for 14 d. After treatment, the clinical efficacies were evaluated, and NIHSS scores and infarction volume in two groups were compared. The patients were followed up for 3 months, and the incidences of adverse reactions in two groups were compared.Results After treatment, the clinical efficacies in the control and treatment groups were 78.00% and 92.00%, respectively, and there was difference between two groups （P 〈 0.05）. After treatment for 8 and 14 d, the NIHSS scores in two groups were significantly decreased, and the difference was statistically significant in the same group （P〈0.05）. And the NIHSS score in the treatment group was significantly lower than those in the control group, with significant difference between two groups （P〈0.05）. After treatment for 8 and 14 d, the infarction volumes in two groups were significantly decreased, and the difference was statistically significant in the same group （P〈0.05）. And the infarction volume in the treatment group was significantly smaller than those in the control group, with significant difference between two groups （P〈0.05）. The incidences of adverse reactions in the control and treatment groups were 18.00% and 6.00%, respectively, and there was difference between two groups （P 〈 0.05）. Conclusion Butylphthalide and Sodium Chloride Injection has clinical curative effect in treatment of acute ischemic cerebral infarction, can decrease NIHSS score, reduce infarction volume, with good safety, which has a certain clinical application value.