通心络胶囊联合阿加曲班治疗轻中度急性脑梗死的疗效观察

Clinical observation of Tongxinluo Capules combined with argatroban in treatment of mild to moderate acute cerebral infarction

目的研究通心络胶囊联合阿加曲班注射液治疗轻中度急性脑梗死的临床疗效。方法选取2017年3月-2019年9月在天津市滨海新区大港医院治疗的80例轻中度急性脑梗死患者,随机分为对照组和治疗组,每组各40例。对照组静脉滴注阿加曲班注射液,60 mg加入生理盐水250 mL中静滴24 h,持续2 d,第3天开始剂量调整为60 mg加到生理盐水100mL,静滴3 h,2次/d,持续5 d。治疗组在对照组的基础上口服通心络胶囊,4粒/次,3次/d,连续治疗14 d。观察两组患者临床疗效,同时比较治疗前后两组患者血凝功能指标和美国国立卫生研究院卒中量表(NIHSS)评分。结果治疗后,对照组和治疗组临床有效率分别为77.50%和95.00%,两组比较差异具有统计学意义(P<0.05)。治疗后,两组患者凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)水平明显升高(P<0.05),而D-D二聚体(D-D)、纤维蛋白原(FIB)水平明显降低(P<0.05),且治疗组的血凝功能指标明显好于对照组(P<0.05)。治疗后,两组NIHSS评分均显著降低(P<0.05),且治疗组评分明显低于对照组(P<0.05)。结论通心络胶囊联合阿加曲班注射液治疗轻中度急性脑梗死有较明显的临床疗效,具有一定的临床推广应用价值。

Objective To study the clinical effect of Tongxinluo Capules combined with Argatroban Injection in treatment of mild to moderate acute cerebral infarction. Methods Patients(80 cases) with moderate acute cerebral infarction in Dagang Hospital of Tianjin Binhai New Area from March 2017 to September 2019 were randomly divided into control and treatment groups, and each had 40 cases. Patients in the control group iv administered with Argatroban Injection, 60 mg added into normal saline 250 mL, and intravenous drip for 24 h for 2 d, the dose was adjusted to 60 mg added into normal saline 100 mL for 3 h from day 3, twice daily, and they were treated for 5 d. Patients in the treatment group were po administered with Tongxinluo Capsules on the basis of the control group, 4 grains/time, three times daily. Patients in two groups were treated for 14 d. After treatment, the clinical efficacy was evaluated, and the coagulation function indexes and NIHSS score in two groups before and after treatment were compared. Results After treatment, the clinical efficacy and in the control and treatment groups was 77.50% and 95.00%, respectively, and there were differences between two groups(P < 0.05). After treatment, the PT and APTT level in two groups was significantly increased(P < 0.05), but the FIB and D-D level was significantly decreased(P < 0.05), and the coagulation function indexes in the treatment group were significantly better than those in the control group(P < 0.05). After treatment, the NIHSS score in two groups was significantly decreased(P < 0.05), and the score in the treatment group was significantly lower than that in the control group(P < 0.05). Conclusion Tongxinluo Capules combined with Argatroban Injection has obvious clinical effect in treatment of mild to moderate acute cerebral infarction, and which has a certain clinical application value.