麝香四黄颗粒联合阿替普酶治疗痰热腑实型急性脑梗死的临床研究

Clinical study of Shexiang Sihuang Granules combined with alteplase in treatment of phlegm-heat abdominal solid type acute cerebral infarction

目的探讨麝香四黄颗粒联合注射用阿替普酶治疗痰热腑实型急性缺血性脑梗死患者的疗效。方法选取2019年7月—2020年12月潍坊市中医院急诊收入的80例痰热腑实型急性缺血性脑梗死患者,按照治疗方法将患者分为对照组和观察组,每组各40例。对照组予以注射用阿替普酶,其中所需总量的10%在1 min内静脉推注,剩余90%静脉泵入60 min;观察组在对照组的基础上冲服麝香四黄颗粒,1剂/d,分早晚2次服,疗程为14 d。观察两组患者的临床疗效和中医疗效,比较两组的美国国立卫生研究院脑梗死量表评分(NIHSS)、Barthel指数、低密度脂蛋白(LDL-C)水平及中医临床证候积分指标。结果治疗后,观察组总有效率为87.5%,显著高于对照组的77.5%,两组比较差异有统计学意义(P<0.05)。治疗后,观察组中医症候疗效明显优于对照组,差异有统计学意义(P<0.05)。治疗后,两组中医症候积分明显降低(P<0.05);治疗后,观察组中医症候积分显著低于同期对照组(P<0.05)。治疗后7、14 d,两组NIHSS评分均显著降低,Barthel指数显著升高(P<0.05);且观察组患者NIHSS评分显著低于同期对照组,Barthel指数显著高于同期对照组(P<0.05)。治疗后7、14 d,两组LDL-C水平均显著降低(P<0.05);且观察组LDL-C水平显著低于同期对照组(P<0.05)。结论麝香四黄颗粒联合阿替普酶治疗痰热腑实型急性缺血性脑梗死具有较好的临床疗效,可显著改善患者的预后,安全有效。

Objective To explore the clinical effect of Shexiang Sihuang Granules combined with alteplase in treatment of phlegmheat abdominal solid type acute cerebral infarction.Methods Eighty patients with acute ischemic cerebral infarction of phlegm-heat abdominal and real type who were admitted to the emergency department of Weifang Hospital of Traditional Chinese Medicine from July 2019 to December 2020 were selected.According to the treatment methods,the patients were divided into control group and observation group,with 40 cases in each group.Patients in the control group were received Alteplase for injection,in which 10% of the total amount needed was injected intravenously within 1 min,and the remaining 90% was pumped intravenously for 60 min.Patients in the observation group were po administered with Shexiang Sihuang Granules,1 dose/d,twice in the morning and evening,for a course of 14 days.The clinical efficacy of two groups was observed,and the NIHSS score,Barthel index,LDL-C levels and TCM clinical syndrome score were compared between two groups.Results After treatment,the total effective rate of the observation group was 87.5%,significantly higher than 77.5% of the control group,and the difference between two groups was statistically significant(P<0.05).After treatment,the curative effect of TCM syndrome in the observation group was significantly better than that in the control group,and the difference was statistically significant(P<0.05).After treatment,the scores of TCM symptoms in two groups were significantly decreased(P<0.05).After treatment,the scores of TCM symptoms in the observation group were significantly lower than those in the control group(P<0.05).On day 7 and 14 after treatment,NIHSS score was significantly decreased,and Barthel index was significantly increased in two groups(P<0.05).The NIHSS score of observation group was significantly lower than that of control group,and Barthel index was significantly higher than that of control group(P<0.05).On day 7 and 14 after treatment,the LDL-C level in two groups was significantly decreased(P<0.05);the level of LDL-C in observation group was significantly lower than that in control group(P<0.05).Conclusion Shexiang Sihuang Granules combined with alteplase in treatment of acute ischemic cerebral infarction of phlegm-heat abdominal compact type has good clinical efficacy,which can significantly improve the prognosis of patients,and is safe and effective.