注射用阿替普酶静脉溶栓协同化痰通络汤口服对脑梗死溶栓成功率的影响及出血风险评估

The effect of rt-PA intravenous injection plus the Huatan Tongluo decoction on thrombolysis ofter cerebral infarction and the bleeding risk assess

目的:探索注射用阿替普酶(rt-PA)静脉溶栓协同化痰通络汤口服对脑梗死溶栓成功率的影响及出血风险评估。方法:收集我院脑梗死证属痰瘀阻络患者80例,随机分为两组,治疗组40例,给予rt-PA静脉溶栓协同化痰通络汤口服,并给予双抗、调脂、依达拉奉静滴基本治疗;对照组40例,给予rt-PA静脉溶栓,并给予双抗、调脂、依达拉奉静滴基本治疗。结果:两组总体疗效评价有显著性差异(P<0.05),两组日常生活能力评定方面有非常显著性差异(P<0.01),两组美国国立卫生研究院卒中量表(National Institutes of Health Stroke Scale,NIHSS)评分评定方面有显著性差异(P<0.05),两组出血风险评估、凝血功能方面无显著性差异(P>0.05),两组不良反应无显著性差异(P>0.05),治疗组再发率低,卒中后抑郁发病率低。结论:rt-PA静脉溶栓协同化痰通络汤口服提高了脑梗死溶栓成功率,改善了临床症状,提高了日常生活能力;在规范治疗量的情况下,具有不增加出血风险、再发率低、卒中后抑郁发病率低、患者依从性好的特点。

Objective:To explore the effect of rt-PA intravenous injection plus the Huatan Tongluo decoction(化痰通络汤)on thrombolysis after cerebral infarction and assess the bleeding risk.Methods:80 cases in our hospital were randomly divided into two groups.40 cases in the treatment group received rt-PA intravenous injection plus the Huatan Tongluo decoction orally,and received basic treatment,such as double antibodies,lipid regulating and edaravone intravenous drip.40 cases in the control group were given rt-PA intravenous injection,and received basic treatment,such as double antibodies,lipid regulating and edaravone intravenous drip.Results:There was a significant difference in the overall efficacy between the groups(P<0.05).There was a very significant difference in ability of daily living between the groups(P<0.01).NIHSS score between the groups showed a significant difference(P<0.05).There was no significant difference in bleeding risk assessment,coagulation function and adverse reactions between the groups(P>0.05).The recurrence rate and incidence rate of post-stroke depression in the treatment group were lower.Conclusion:The thrombolysis success of cerebral infarction was improved by rt-PA intravenous injection plus the Huatan Tongluo decoction.The therapy can improve clinical symptoms and the ability of daily living.Under the condition of standard treatment,the therapy does not increase the risk of bleeding,with low recurrence rate,low incidence of post-stroke depression,and good patients’compliance.