黄连素联合脑苷肌肽治疗急性脑梗死疗效研究

Effect of berberine combined with cerebroside carnosine on acute cerebral infarction

目的探讨黄连素联合脑苷肌肽治疗急性脑梗死的疗效及安全性。方法选取自2017年7月至2019年12月上海市浦东新区人民医院收治的94例急性脑梗死患者为研究对象。将患者随机分为常规治疗组与联合治疗组,每组各47例。连续治疗2周,比较两组患者的临床疗效、安全性、治疗后脑水肿的发生情况及治疗前后神经功能缺损程度、日常生活活动能力(BI)指数、Toll样受体4(TLR4)/核转录因子(NF-κB)信号通路相关蛋白表达、基质金属蛋白酶(MMP)-7、MMP-8、MMP-9水平等。结果联合治疗组的总有效率为91.5%(43/47),显著高于常规治疗组的74.5%(35/47),两组间比较,差异有统计学意义(P<0.05)。治疗后,两组患者的美国国立卫生研究院卒中量表(NIHSS)评分、BI指数较治疗前显著改善,且联合治疗组NIHSS评分明显低于常规治疗组,BI指数明显高于常规治疗组,差异均有统计学意义(P<0.05)。治疗后,两组患者TLR4、NF-κB水平较治疗前显著降低,且联合治疗组TLR4、NF-κB水平明显低于常规治疗组,差异均有统计学意义(P<0.05)。治疗后,两组患者MMP-7、MMP-8、MMP-9水平较治疗前显著降低,且联合治疗组MMP-7、MMP-8、MMP-9水平明显低于常规治疗组,差异均有统计学意义(P<0.05)。联合治疗组患者脑水肿发生率为8.5%(4/47),明显低于常规治疗组的23.4%(11/47),两组间比较,差异有统计学意义(P<0.05)。结论黄连素联合脑苷肌肽治疗急性脑梗死,可有效抑制炎性反应,改善血脑屏障通透性,降低脑水肿的发生率,促进神经功能及日常生活活动能力恢复,临床效果显著。

Objective To investigate the efficacy and safety of berberine combined with cerebroside carnosine in the treatment of acute cerebral infarction.Methods A retrospective study was performed on 94 cases of patients with acute cerebral infarction who were admitted from July 2017 to December 2019.The patients were randomly divided into the conventional treatment group and the combined treatment group,with 47 cases in each group.After two weeks of continuous treatment,the clinical efficacy,safety,the occurrence of brain edema,the degree of National Institute of Health stroke scale(NIHSS)score,Barthel index(BI),Toll-like receptor 4(TLR4)/nuclear transcription factor(NF-κB)signal pathway related protein expression,matrix metalloproteinase(MMP)-7,MMP-8 and MMP-9 levels were compared between the two groups.Results The total effective rate of the combined treatment group was 91.5%(43/47),significantly higher than that of the conventional treatment group(74.5%,35/47),and the difference between the two groups was statistically significant(P<0.05).After treatment,NIHSS score and BI of patients in the two groups were significantly improved compared with those before treatment,and NIHSS score in the combined treatment group was significantly lower than that in the conventional treatment group,and BI was significantly higher than that in the conventional treatment group(P<0.05).After treatment,the levels of TLR4 and NF-κB in the two groups were significantly lower than those before treatment,and the levels of TLR4 and NF-κB in the combined treatment group were significantly lower than those in the conventional treatment group(P<0.05).After treatment,the levels of MMP-7,MMP-8 and MMP-9 in the two groups were significantly lower than those before treatment,and the levels of MMP-7,MMP-8 and MMP-9 in the combined treatment group were significantly lower than those in the conventional treatment group(P<0.05).The incidence of cerebral edema in the combined treatment group was 8.5%(4/47),which was significantly lower than the 23.4%(11/47)in the conventional treatment group(P<0.05).Conclusion Berberine combined with cerebroside carnosine in the treatment of acute cerebral infarction can effectively inhibit the inflammatory response,improve the permeability of blood-brain barrier,reduce the incidence of brain edema,promote the recovery of nerve function and ability of daily living activities,and clinical effect is remarkable.