丁苯酞联合脑苷肌肽对急性脑梗死神经功能缺损、日常生活活动能力的改善作用

The effect of butyphthalide combined with brain-carnosine on the improvement of neurological deficit and activity of daily living in patients with acute cerebral infarction

目的:探讨丁苯酞联合脑苷肌肽对急性脑梗死(acute cerebral infarct,ACI)的临床效果以及神经功能缺损、日常生活活动能力的改善作用。方法:选取2016年5月~2019年3月在我院接受治疗的86例急性脑梗死患者为研究对象,采用随机数字表法分为对照组和观察组,每组各43例。所有患者入院后均予溶栓、吸氧、控制血压和血糖、降低颅内压、维持水和电解质平衡等常规治疗。在常规治疗基础上,对照组患者给予丁苯酞治疗,观察组患者给予丁苯酞联合脑苷肌肽治疗,两组均连续治疗14d。应用脑卒中患者临床神经功能缺损程度评分标准(CSS)和美国国立卫生院神经功能缺损评分(NIHSS)评价患者神经功能,采用Barthel指数评价患者日常生活活动能力,并对评分进行评定。比较两组治疗前、治疗后7、14d神经功能缺损评分以及日常生活活动能力评分,观察两组临床疗效及不良反应发生情况。结果:①观察组总有效率大于对照组(88.37%vs67.44%);②治疗前两组神经功能缺损评分(CSS、NIHSS)比较无统计学意义,治疗后7、14d两组CSS、NIHSS评分与入院时比较显著降低,差异有统计学意义,且治疗后观察组CSS和NIHSS评分明显优于同期对照组,两组入院14d与入院7d比较,差异有统计学意义。③治疗前两组Barthel指数评分比较无统计学意义,治疗后7、14d两组Barthel指数评分与入院时比较显著降低,差异有统计学意义,且治疗后观察组Barthel指数评分明显优于同期对照组,两组入院14d与入院7d比较,差异有统计学意义;④两组治疗期间不良反应发生率比较无统计学意义。结论:丁苯酞联合脑苷肌肽治疗急性期脑梗死效果确切,可以使患者神经功能得到良好恢复,改善患者日常生活活动能力,从而提高患者的生活质量。

Objective To investigate the clinical effect of butyphthalide combined with brain-carnosine on acute cerebral infarction(acute cerebral infarct,ACI)and the effect of improving the ability of daily living and nerve function.Methods 86 patients with acute cerebral infarction who were treated in our hospital from May 2016 to March 2019 were randomly divided into control group(n=43)and observation group(n=43).All patients were treated with thrombolytic therapy,oxygen inhalation,control of blood pressure and blood glucose,reduction of intracranial pressure and maintenance of water and electrolyte balance.On the basis of conventional therapy,control The patients in the observation group were treated with butyphthalide and the patients in the observation group were treated with butyphthalide combined with cerebral glycoside carnosine for 14 days.(CSS)and(NIHSS)were used to evaluate the neurological function,and the Barthel index was used to evaluate the activity of daily living(ADL).The score was evaluated.The neurological deficit score and activity of daily living(ADL)score were compared between the two groups before and 7 days after treatment,and the clinical efficacy and adverse reactions were observed.Results①The total effective rate in the observation group was higher than that in the control group(88.37%vs 67.44%).②There was no significant difference in CSS,NIHSS between the two groups before treatment.The CSS,NIHSS score of the two groups was significantly lower than that at admission on day 7 and 14 after treatment.The scores of CSS and NIHSS in the observation group were significantly better than those in the control group after treatment,and there was a significant difference between the two groups on the 14th day of admission and the 7 day of admission.③There was no significant difference in Barthel index score between the two groups before and after treatment.The Barthel index score of the two groups was significantly lower than that at admission on the 7th and 14th day after treatment.The Barthel index score of the observation group was significantly better than that of the control group after treatment,and there was a significant difference between the two groups on the 14th day and the 7th day.④There was no significant difference in the incidence of adverse reactions between the two groups during treatment.Conclusion Butylphthalide combined with cerebroside and carnosine is effective in the treatment of acute cerebral infarction,which can restore the patient’s neurological function well,improve the patient’s activities of daily living,thereby improving the patient’s quality of life.