通脉颗粒联合长春西汀治疗脑梗死恢复期的临床研究

Clinical study on Tongmai Granules combined with vinpocetine in treatment of convalescent stage of cerebral infarction

目的探讨通脉颗粒联合长春西汀片治疗脑梗死恢复期的临床疗效。方法选取2016年2月-2018年12月连云港市第一人民医院收治的78例脑梗死恢复期患者为研究对象,根据治疗方案的差异将所有患者分为对照组和治疗组,每组各39例。对照组口服长春西汀片,1片/次,3次/d;治疗组在对照组治疗的基础上口服给予通脉颗粒,1袋/次,3次/d。两组患者均连续治疗6个月。观察两组的临床疗效,比较两组的美国国立卫生研究院卒中量表(NIHSS)评分、Barthel评分、Fugl-Meyer评分、血液流变学指标。结果治疗后,对照组和治疗组的总有效率分别为79.5%、94.9%,两组比较差异有统计学意义(P<0.05)。治疗后,两组NIHSS评分明显降低,Barthel评分、Fugl-Meyer评分均显著升高,同组治疗前后比较差异有统计学意义(P<0.05);且治疗组上述评分明显优于对照组,两组比较差异有统计学意义(P<0.05)。治疗后,两组全血高切黏度、血小板黏附率、血浆黏度、全血低切黏度、红细胞压积均显著降低,同组治疗前后比较差异具有统计学意义(P<0.05);且治疗组血液流变学相关指标明显低于对照组,两组比较差异有统计学意义(P<0.05)。结论通脉颗粒联合长春西汀片治疗脑梗死恢复期具有较好的临床疗效,可改善脑神经功能缺损,提高患者日常生活能力、运动功能,改善血流动力学参数,具有一定的临床推广应用价值。

Objective To study the clinical efficacy of Tongmai Granules combined with Vinpocetine Tablets in treatment of convalescent stage of cerebral infarction. Methods Patients(78 cases) with convalescent stage of cerebral infarction in the First People’s Hospital of Lianyungang from February 2016 to December 2018 were randomly divided into control and treatment groups, and each group had 39 cases. Patients in the control group were po administered with Vinpocetine Tablets, 1 tablet/time, three times daily. Patients in the treatment group were po administered with Tongmai Granules on the basis of the control group, 1 bag/time, three times daily. Patients in two groups were treated for 6 months. After treatment, the clinical efficacies were evaluated, and NIHSS scores, Barthel scores, Fugl-Meyer scores, and hemorheological indexes in two groups were compared. Results After treatment, the clinical efficacies in the control and treatment groups were 79.5% and 94.9%, respectively, and there was difference between two groups(P < 0.05). After treatment, NIHSS scores in two groups were significantly decreased, but Barthel scores and Fugl-Meyer 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). After treatment, whole blood high shear viscosity, platelet adhesion rate, plasma viscosity, whole blood low shear viscosity, and hematocrit in two groups were significantly decreased, and the difference was statistically significant in the same group(P < 0.05). And the hemorheological indexes in the treatment group were significantly lower than those in the control group, with significant difference between two groups(P < 0.05). Conclusion Tongmai Granules combined with Vinpocetine Tablets has clinical curative effect in treatment of convalescent stage of cerebral infarction, can improve cerebral nerve function defect, daily living ability, motor function, and hemodynamic parameters of patients, which has a certain clinical application value.