参蛇偏瘫胶囊联合依达拉奉治疗急性脑梗死的临床研究

Clinical study on Shenshe Piantan Capsules combined with edaravone in treatment of acute cerebral infarction

目的探讨参蛇偏瘫胶囊联合依达拉奉注射液治疗急性脑梗死的临床疗效。方法选取2017年2月—2017年11月在赤峰学院附属医院治疗的急性脑梗死患者106例,根据用药的差别分为对照组(53例)和治疗组(53例)。对照组静脉滴注依达拉奉注射液,30 mg加入100 m L生理盐水,2次/d;治疗组在对照组基础上口服参蛇偏瘫胶囊,1.6 g/次,3次/d。两组均治疗2周。观察两组患者临床疗效,同时比较治疗前后两组患者NIHSS、ADL和SF-36评分及血流流变学指标和血清学指标。结果治疗后,对照组和治疗组临床有效率分别为81.13%和96.23%,两组比较差异具有统计学意义(P<0.05)。治疗后,两组NIHSS评分显著降低,ADL和SF-36评分显著升高,同组治疗前后比较差异具有统计学意义(P<0.05),且治疗后治疗组NIHSS、ADL和SF-36评分明显优于对照组(P<0.05)。治疗后,两组红细胞压积(HCT)、全血黏度(WBV)、纤维蛋白原(FIB)和血浆黏度(PV)均显著降低(P<0.05),且治疗组上述血流流变学指标水平明显低于对照组(P<0.05)。治疗后,两组血清酪蛋白磷酸肽(CPP)、血红素加氧酶1(HO1)、胱抑素C(Cys C)水平均显著下降,转化生长因子β1(TGF-β1)水平显著升高,同组治疗前后比较差异具有统计学意义(P<0.05),且治疗后治疗组上述血清学指标水平明显优于对照组(P<0.05)。结论参蛇偏瘫胶囊联合依达拉奉治疗急性脑梗死可有效改善机体血液流变学指标,降低机体炎症反应、促进神经功能恢复,有利于提高患者日常活动能力和改善生活质量。

Objective To explore the clinical efficacy of Shenshe Piantan Capsules combined with edaravone in treatment of acute cerebral infarction. Methods Patients（106 cases） with acute cerebral infarction in Affiliated Hospital of Chifeng University from February 2017 to November 2017 were randomly divided into control（53 cases） and treatment（53 cases） groups. Patients in the control group were iv administered with Edaravone Injection, 30 mg added into normal saline 100 m L, twice daily. Patients in the treatment group were po administered with Shenshe Piantan Capsules on the basis of the control group, 1.6 g/time, three times daily. Patients in two groups were treated for 2 weeks. After treatment, the clinical efficacy was evaluated, and the NIHSS, ADL and SF-36 scores, the hemorheology and serological indexes in two groups before and after treatment were compared. Results After treatment, the clinical efficacy in the control and treatment groups was 81.13% and 96.23% respectively, and there were differences between two groups（P 〈 0.05）. After treatment, the NIHSS scores in two groups were significantly decreased（P 〈 0.05）, but ADL and SF-36 scores were significantly increased（P 〈 0.05）, and these scores in the treatment group after treatment were significantly better than those in the control group（P 〈 0.05）. After treatment, the HCT, WBV, FIB and PV levels in two groups were significantly decreased（P 〈 0.05）, and the hemorheology indexes in the treatment group after treatment were significantly lower than those in the control group（P 〈 0.05）. After treatment, the serum CPP, HO1 and Cys C levels in two groups were significantly decreased（P 〈 0.05）, but TGF-β1 levels were significantly increased（P 〈 0.05）, and the serological indexes in the treatment group after treatment were significantly better than those in the control group（P 〈 0.05）. Conclusion Shenshe Piantan Capsules combined with edaravone in treatment of acute cerebral infarction can effectively improve hemorheology indexes, reduce inflammation, promote the recovery of neurological function and improve the quality of life and the ability of daily activities.