散风活络丸联合阿替普酶治疗急性脑梗死的临床研究

Clinical study on Sanfeng Huoluo Pills combined with alteplase in treatment of acute cerebral infarction

目的探讨散风活络丸联合阿替普酶治疗急性脑梗死的临床疗效。方法选取2017年5月-2018年5月来巴中市中医院就诊并治疗的急性脑梗死患者151例,根据就诊顺序随机分成对照组(75例)和治疗组(76例)。对照组患者给予注射用阿替普酶,用量为0.9mg/kg,先取10%直接静脉注射,剩余90%于1h内静脉滴注完毕。治疗组患者在对照组基础上口服散风活络丸,15丸/次,2次/d。两组患者均治疗7d。观察两组的临床疗效,比较两组治疗前后ABCD^2评分、NIHSS评分、EuroQOL评分、C反应蛋白、可溶性细胞间黏附分子1(sICAM-1)及神经烯醇化酶的变化情况。结果治疗后,对照组和治疗组的总有效率分别是82.67%、94.74%,两组比较差异具有统计学意义(P<0.05)。治疗后,两组患者的ABCD^2评分、NIHSS评分及EuroQOL评分均较治疗前显著降低,同组治疗前后比较差异有统计学意义(P<0.05);治疗后,治疗组这些评分均显著低于对照组,两组比较差异具有统计学意义(P<0.05)。治疗后,两组血清C反应蛋白、sICAM-1及神经烯醇化酶水平均较治疗前显著降低,同组治疗前后比较差异有统计学意义(P<0.05);治疗后,治疗组C反应蛋白、sICAM-1及神经烯醇化酶水平显著低于对照组,两组比较差异具有统计学意义(P<0.05)。结论散风活络丸联合阿替普酶溶栓治疗急性脑梗死具有较好的临床疗效,可显著改善患者各相关评分,具有一定的临床推广应用价值。

Objective To investigate the clinical efficacy of Sanfeng Huoluo Pills combined with alteplase in treatment of acute cerebral infarction. Methods Patients(151 cases) with acute cerebral infarction in Bazhong Hospital of Traditional Chinese Medicine from May 2017 to May 2018 were divided into control(75 cases) and treatment(76 cases) groups according to the order of treatment. Patients in the control group were given Alteplase for injection, the dosage was 0.9 mg/kg, 10% was taken and injected directly into the vein, and the remaining 90% was finished within 1 h. Patients in the treatment group were po administered with Sanfeng Huoluo Pills, 15 pill/time, twice daily. Patients in two groups were treated for 7 d. After treatment, the clinical efficacy was evaluated, and the changes of ABCD^2 score, NIHSS score, EuroQOL score, CRP, sICAM-1 and neuroenolase in two groups were compared. Results After treatment, the clinical efficacy in the control and treatment groups were 82.67% and 94.74%, respectively, and there were differences between two groups(P < 0.05). After treatment, ABCD^2 score, NIHSS score, EuroQOL score in two groups were significantly decreased, and there were differences in the same group(P < 0.05). After treatment, those related scores in the treatment group were significantly lower than those in the control group, and there were differences between two groups(P < 0.05). After treatment, CRP, sICAM-1 and neuroenolase in two groups were significantly decreased, and there were differences in the same group(P < 0.05). After treatment, CRP, sICAM-1, and neuroenolase in the treatment group were significantly lower than those in the control group, and there were differences between two groups(P < 0.05). Conclusion Sanfeng Huoluo Pills combined with alteplase has significant effect in treatment of acute cerebral infarction, and can significantly improve the relevant scores, which has a certain clinical application value.