养血清脑颗粒联合尿激酶治疗急性缺血性脑血管病的临床研究

Clinical study on Yangxue Qingnao Granules combined with urokinase in treatment of acute ischemic cerebrovascular disease

目的探究养血清脑颗粒联合注射用尿激酶治疗急性缺血性脑血管病的临床疗效。方法选择2014年5月—2017年5月上海市同仁医院收治急性缺血性脑血管病的患者128例,将所有患者采用随机数字表法分为对照组和治疗组,每组各64例。对照组静脉滴注注射用尿激酶,100万U(发病时间>3 h:剂量为150万U)加入到0.9%氯化钠溶液100 mL中,滴注30 min内完成。治疗组在对照组基础上口服养血清脑颗粒,4 g/次,3次/d。两组患者均治疗2周。观察两组的临床疗效,比较两组的血液流变学、凝血功能和血管内皮功能。结果治疗后,对照组和治疗组的总有效率分别为75.00%、92.19%,两组比较差异有统计学意义(P<0.05)。治疗后,两组全血黏度(WBV)、血浆黏度(PV)、血细胞比容(HCT)、红细胞沉降率(ESR)、红细胞聚集指数(RF)水平均显著降低,同组治疗前后比较差异有统计学意义(P<0.05);且治疗组这些观察指标明显低于对照组,两组比较差异具有统计学意义(P<0.05)。治疗后,两组凝血酶原时间(PT)、部分凝血活酶时间(APTT)、凝血酶时间(TT)水平均显著升高,纤维蛋白原(FIB)水平显著下降,同组治疗前后比较差异具有统计学意义(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,两组血管内皮生长因子(VEGF)、一氧化氮(NO)水平均显著升高,内皮素-1(ET-1)水平显著降低,同组治疗前后比较差异具有统计学意义(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)。结论养血清脑颗粒联合注射用尿激酶治疗急性缺血性脑血管病具有较好的临床疗效,可改善患者的血液流变学、凝血功能及血管内皮细胞功能,具有一定的临床推广使用价值。

Objective To investigate the clinical efficacy of Yangxue Qingnao Granules combined with Urokinase for injection in treatment of acute ischemic cerebrovascular disease. Methods Patients（128 cases） with acute ischemic cerebrovascular disease in Shanghai Tongren Hospital from May 2014 to May 2017 were randomly divided into control and treatment groups, and each group had 64 cases. Patients in the control group were iv administered with Urokinase for injection, 1 million U（When the time of onset was more than 3 h, the dose was 1 million 500 thousand U） added into normal saline 100 mL, complete infusion within 30 min. Patients in the treatment group were po administered with Yangxue Qingnao Granules on the basis of the control group, 4 g/time, three times daily. Patients in two groups were treated for 2 weeks. After treatment, the clinical efficacies were evaluated, and hemorheology, coagulation function, and vascular endothelial cell function in two groups were compared. Results After treatment, the clinical efficacies in the control and treatment groups were 75.00% and 92.19%, respectively, and there was difference between two groups（P〈0.05）. After treatment, the levels of WBV, PV, HCT, ESR, and RF 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 levels of PT, APTT, and TT in two groups were significantly increased, but the levels of FIB 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 better than those in the control group, with significant difference between two groups（P〈0.05）. After treatment, the levels of VEGF and NO in two groups were significantly increased, but the levels of ET-1 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 better than those in the control group, with significant difference between two groups（P〈0.05）. Conclusion Yangxue Qingnao Granules combined with Urokinase for injection has clinical curative effect in treatment of acute ischemic cerebrovascular disease, can improve hemorheology, coagulation function, and vascular endothelial cell function, which has a certain clinical application value.