丁苯酞软胶囊联合阿司匹林治疗急性脑梗死的临床效果及其机制研究

Clinical effect and mechanism of butylphthalide soft capsule combined with aspirin in the treatment of patients with acute cerebral infarction

目的探讨丁苯酞软胶囊联合阿司匹林治疗急性脑梗死的临床效果及其作用机制。方法选取湖南中医药高等专科学校附属第一医院2018年8月至2020年4月收治的急性脑梗死患者120例,应用随机数字表法分为对照组和观察组,各60例。对照组在常规对症治疗基础上口服阿司匹林治疗,观察组在对照组治疗基础上联合丁苯酞软胶囊口服治疗,2组均持续治疗1个月。比较2组患者临床疗效,治疗前后美国国立卫生研究院卒中量表(NIHSS)评分、血流灌注指标水平和血清炎症因子水平,以及治疗期间不良反应发生率。结果治疗1个月后,观察组临床总有效率高于对照组[96.7%(58/60)比81.7%(49/60)](χ^(2)=21.714,P<0.001)。治疗前,2组NIHSS评分、血流灌注指标水平和血清炎症因子水平比较差异均无统计学意义(均P>0.05);治疗1个月后,2组NIHSS评分和血清白细胞介素6(IL-6)、IL-8、IL-10、C反应蛋白水平均低于治疗前、且观察组均低于对照组,CT灌注成像造影剂平均通过时间较治疗前缩短、且观察组短于对照组,脑血流量和脑血容量均高于治疗前、且观察组高于对照组(均P<0.05)。治疗期间观察组患者不良反应发生率与对照组比较差异无统计学意义(P=0.613)。结论丁苯酞软胶囊联合阿司匹林治疗急性脑梗死安全有效,患者神经功能缺损状况明显改善,其机制可能与改善血流灌注情况和降低炎症因子水平有关。

Objective To investigate the clinical effect and mechanism of butylphthalide soft capsule combined with aspirin in the treatment of patients with acute cerebral infarction.Methods Totally 120 patients with acute cerebral infarction admitted to the First Affiliated Hospital of Hunan College of Traditional Chinese Medicine from August 2018 to April 2020 were selected and randomly divided into control group and observation group,with 60 cases in each group.The control group was treated with aspirin orally on the basis of conventional symptomatic treatment;the observation group was treated with butylphthalide soft capsule orally on the basis of control group;both groups were treated for 1 month.The clinical efficacy,National Institutes of Health Stroke Scale(NIHSS)score,blood flow perfusion index level and serum inflammatory factor level were campared between the two groups before and after treatment.The incidence of adverse reactions during treatment were compared between the two groups.Results After 1 month of treatment,the total clinical effective rate of the observation group was higher than that of the control group[96.7%(58/60)vs 81.7%(49/60)](χ^(2)=21.714,P<0.001).Before treatment,there were no significant differences in NIHSS score,blood flow perfusion index level and serum inflammatory factor level between the two groups(all P>0.05).After 1 month of treatment,the NIHSS score,serum levels of interleukin(IL)-6,IL-8,IL-10 and C-reactive protein in the two groups were lower than those before treatment,and those in the observation group were lower than those in the control group;the mean pass time of contrast agent for CT perfusion imaging in the two groups were lower than those before treatment,and that in the observation group was shorter than that in the control group;the cerebral blood flow and cerebral blood volume were higher than those before treatment,and those in the observation group were higher than those in the control group(all P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P=0.613).Conclusions Butylphthalide soft capsule combined with aspirin is safe and effective in the treatment of patients with acute cerebral infarction,and the neurological deficit is improved significantly.The possible mechanism is related to the improvement of blood perfusion and the reduction of inflammatory factors.