脑心通胶囊联合丁苯酞治疗急性脑梗死患者的临床观察

Effect of Naoxintong Capsule Combined with Butyphthalide on Neurological Function,Cerebral Hemodynamic Parameters and H-FABP Level in Patients with Acute Cerebral Infarction

目的探讨脑心通胶囊联合丁苯酞对急性脑梗死(Acute cerebral infarct,ACI)患者神经功能、脑血流动力学参数及心型脂肪酸结合蛋白(H-FABP)水平的影响。方法选取2018年1月—2020年10月期间江苏省常州市中医院收治的ACI患者120例,按随机数字表法分为对照组(60例)和研究组(60例)。两组患者均给予对症治疗,在此基础上对照组采用丁苯酞氯化钠注射液治疗,观察组采用脑心通胶囊联合丁苯酞氯化钠注射液治疗。治疗2周后,对两组患者临床疗效、不良反应发生情况、治疗前后神经功能缺损程度、脑血流动力学参数[左侧颈动脉的平均血流速度(Vm)、平均血流量(Qm)、动态阻力(DR)、外周阻力(Rv)]及血清胰岛素样生长因子-1(IGF-1)、心型脂肪酸结合蛋白(H-FABP)水平进行比较。结果与对照组比较,研究组总有效率明显升高,差异有统计学意义(P<0.05)。治疗1周、2周后研究组国家卫生研究卒中量表评分均明显低于对照组,差异有统计学意义(P<0.05)。治疗2周后,研究组Vm和Qm明显高于对照组,DR和Rv明显低于对照组,差异有统计学意义(P<0.05);研究组血清IGF-1水平明显高于对照组,H-FABP水平明显低于对照组,差异有统计学意义(P<0.05)。治疗期间研究组和对照组不良反应发生率比较,差异无统计学意义(P>0.05)。结论脑心通胶囊联合丁苯酞治疗ACI的临床效果较好,可明显改善患者脑血流动力学指标,降低H-FABP水平,促进神经功能恢复,且安全可靠。

Objective To investigate the effects of Naoxintong capsule combined with butyphthalide on neurological function,cerebral hemodynamic parameters and the level of heart type fatty acid binding protein(H-FABP)in patients with acute cerebral infarction(ACI)patients.Methods From January 2018 to October 2020,120 patients with acute cerebral infarction were selected,they were divided into control group 60 and study group 60.Both groups were given symptomatic treatment.On this basis,the control group was treated with butyphthalide sodium chloride injection,and the observation group was treated with Dingnaoxintong capsule combined with phthalide sodium chloride injection.The clinical efficacy,occurrence of adverse reactions,degree of neurological deficit,cerebral hemodynamic parameters[mean blood flow velocity(Vm),mean blood flow(Qm),dynamic resistance(DR),peripheral resistance(Rv)]and the level of serum insulin-like growth factor-1(IGF-1),H-FABP before and after treatment were analyzed and compared.Results Compared with the control group,the total effective rate of the study group was significantly higher,and the difference was statistically significant(P<0.05).After 1 week and 2 weeks of treatment,the NIHSS score of the study group was significantly lower than that of the control group,and the difference was statistically significant(P<0.05).After 2 weeks of treatment,the Vm and Qm of the study group were significantly higher than those of the control group,and the DR and Rv were significantly lower than those of the control group.The difference was statistically significant(P<0.05).The serum IGF-1 level of the study group was significantly higher than that of the control group,and the level of H-FABP was significantly lower than that of the control group,the difference was statistically significant(P<0.05).During the treatment period,there was no significantdifference in the incidence of adverse reactions between the study group and the control group(P>0.05).Conclusions Naoxintong capsule combined with butyphthalide has a remarkable effect on ACI,which can obviously improve the cerebral hemodynamics index,reduce the level of H-FABP,promote the recovery of nerve function,and is safe and reliable.It is worthy of clinical application.