脑血疏口服液联合神经节苷脂治疗老年急性脑梗死的临床研究

Clinical study on Naoxueshu Oral Liquid combined with ganglioside in treatment of acute cerebral infarction in the elderly

目的探讨脑血疏口服液联合注射用单唾液酸四己糖神经节苷脂钠治疗老年急性脑梗死的临床疗效。方法选取2016年3月—2017年10月中国人民解放军第二五四医院收治的老年急性脑梗死患者92例为研究对象,按照随机数字表法将所有患者分为对照组和治疗组,每组各46例。对照组静脉滴注注射用单唾液酸四己糖神经节苷脂钠,100 mg加入到生理盐水100 m L,1次/d。治疗组在对照组治疗的基础上口服脑血疏口服液,10 m L/次,3次/d。两组均连续治疗2周。观察两组的临床疗效,比较两组的血清因子、神经功能、日常生活能力。结果治疗后,对照组和治疗组的总有效率分别为71.74%、89.13%,两组比较差异有统计学意义(P<0.05)。治疗后,两组丙二醛(MDA)、超敏C反应蛋白(hs-CRP)、白细胞介素-6(IL-6)水平显著降低,超氧化物歧化酶(SOD)水平明显升高,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,两组比较差异具有统计学意义(P<0.05)。治疗后,两组神经元特异性烯醇化酶(NSE)、S-100β蛋白水平显著降低,脑源性神经营养因子(BDNF)、神经生长因子(NGF)水平明显升高,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)。治疗后,两组美国国立卫生研究院卒中量表(NIHSS)评分显著降低,改良Barthel指数(MBI)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,两组比较差异具有统计学意义(P<0.05)。结论脑血疏口服液联合注射用单唾液酸四己糖神经节苷脂钠治疗老年急性脑梗死具有较好的临床疗效,可改善神经功能和日常生活能力,减轻氧化应激反应及炎症反应,促进脑神经细胞恢复,具有一定的临床推广应用价值。

Objective To investigate the effect of Naoxueshu Oral Liquid combined with Monosialotetrahexosylganglioside Sodium for injection in treatment of acute cerebral infarction in the elderly. Methods Elderly patients（92 cases） with acute cerebral infarction in the No. 254 Hospital of PLA from March 2016 to October 2017 were randomly divided into control and treatment groups, and each group had 46 cases. Patients in the control group were iv administered with Monosialotetrahexosylganglioside Sodium for injection, 100 mg added into normal saline 100 m L, once daily. Patients in the treatment group were po administered with Naoxueshu Oral Liquid on the basis of the control group, 10 m L/time, three times daily. Patients in two groups were treated for 2 weeks. After treatment, the clinical efficacies were evaluated, and serum factors, neurological function, and daily life ability in two groups were compared. Results After treatment, the clinical efficacies in the control and treatment groups were 71.74% and 89.13%, respectively, and there was difference between two groups（P〈0.05）. After treatment, the levels of MDA, hs-CRP and IL-6 in two groups were significantly decreased, but the levels of SOD 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 NSE and S-100β protein in two groups were significantly decreased, but the levels of BDNF and NGF 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 NIHSS scores in two groups were significantly decreased, but the MBI scores 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）. Conclusion Naoxueshu Oral Liquid combined with Monosialotetrahexosylganglioside Sodium for injection has clinical curative effect in treatment of acute cerebral infarction in the elderly, can neurological function and daily life ability, relieve oxidative stress and inflammatory reaction, and promote recovery of brain neurons, which has a certain clinical application value.