补阳还五汤联合重组人组织纤维蛋白溶酶原激活剂治疗急性脑梗死的临床疗效及预后分析

Clinical effects and prognosis of Buyang Huanwu decoction combined with recombinant human tissue plasminogen activator on acute cerebral infarction

目的观察补阳还五汤联合重组人组织纤维蛋白溶酶原激活剂(rt-PA)治疗急性脑梗死(ACI)的临床疗效及预后。方法将62例ACI患者随机分为2组。对照组31例予rt-PA溶栓治疗;治疗组31例在对照组治疗基础上加服补阳还五汤治疗,中药连服3周。比较2组治疗前及治疗后7、14、21 d美国国立卫生研究院卒中量表(NIHSS)评分,2组治疗前及治疗后14、21 d Barthel指数(BI)评分,并统计2组疗效及治疗后继发性脑出血率、死亡率、血管再闭塞率情况。结果治疗组总有效率93.55%,对照组总有效率77.42%,治疗组疗效优于对照组(P<0.05)。治疗7、14、21 d后2组NIHSS评分与本组治疗前比较均降低(P<0.05);治疗14、21 d后治疗组NIHSS评分低于对照组(P<0.05)。治疗14 d后2组BI指数评分比较差异无统计学意义(P>0.05);治疗21 d后治疗组BI指数评分高于对照组(P<0.05)。2组继发性脑出血率、死亡率及血管再闭塞率比较差异均无统计学意义(P>0.05)。结论对ACI患者早期在rt-PA溶栓治疗的基础上联合应用补阳还五汤治疗,能有效提高ACI患者临床疗效,改善其预后。

Objective To observe the clinical effects and prognosis of Buyang Huanwu decoction combined with recombinant human tissue plasminogen activator（rt-PA） on acute cerebral infarction（ACI）.Methods 62 cases of patients with ACI were randomly divided into two groups.31 patients in control group were treated by rt-PA thrombolytic therapy.31 patients in treatment group were treated by Buyang Huanwu decoction on the basis of control group,and the Chinese medicine was given for 3 weeks.The National Institutes of Health Stroke Scale（NIHSS）scores were compared before treatment and at 7,14 and 21 d after treatment.The Barthel index（BI） scores of the two groups before treatment and 14 and 21 d after treatment,and the efficacy and the rate of secondary cerebral hemorrhage,mortality and revascularization after treatment were counted.Results The total effective rate was 93.55%in treatment group and 77.42% in control group.The clinical effects of the treatment group was better than that of the control group（P〈 0.05）.After treatment of 7,14,21 d,the 2 groups of NIHSS scores were lower than those before treatment（P〈 0.05）,and after treatment of 14 and 21 d,the NIHSS scores in treatment group was lower than that of the control group（P〈 0.05）.After 14 d treatment,there was no significant difference in the BI index scores between the 2 groups（P〉 0.05）.After treatment for 21 d,the BI index scores in treatment group was higher than that of the control group（P〈 0.05）.There was no significant difference between the two groups in the incidence of secondary cerebral hemorrhage,mortality and revascularization rate（P〉 0.05）.Conclusion The combination of Buyang Huanwu decoction on the basis of rt-PA thrombolytic therapy in patients with ACI can effectively improve the clinical efficacy and improve the prognosis of patients with ACI.