超早期脑梗死痰瘀阻络证患者经活血化瘀法联合静脉溶栓治疗的疗效与安全性

Efficacy and Safety of Therapy of Activating Blood and Resolving Stasis Combined with Intravenous Thrombolysis for Ultra-early Cerebral Infarction and Syndrome of Phlegm and Blood Stasis Blocking Collaterals

目的分析超早期脑梗死(CI)痰瘀阻络证患者经活血化瘀法联合静脉溶栓治疗的临床疗效与安全性。方法选取2019年1月—2021年1月期间山东颐养健康集团新泰协庄医院收治的74例超早期脑梗死痰瘀阻络证患者,应用随机数字表法分为对照组(37例)和观察组(37例)。对照组采用静脉溶栓治疗,观察组采用活血化瘀法联合静脉溶栓治疗,两组均连续用药4周。比较两组患者的美国国立卫生研究院卒中量表(NIHSS)评分、临床疗效及不良反应发生率。结果治疗后,两组患者NIHSS评分均较治疗前显著降低(P<0.01),且观察组NIHSS评分显著低于对照组(P<0.01);观察组临床总有效率(94.59%)显著高于对照组(70.27%,P<0.01);观察组不良反应发生率(8.11%)与对照组(5.41%)比较,差异无统计学意义(P>0.05)。结论采用活血化瘀法联合静脉溶栓治疗,可以有效减轻超早期脑梗死痰瘀阻络证患者的神经功能受损程度及炎症反应,提升疗效,临床使用安全性较高,建议临床推广与应用。

Objective To analyze the clinical efficacy and safety of the therapy of activating blood and resolving stasis+intravenous thrombolysis in patients with ultra-early cerebral infarction(CI)and syndrome of phlegm and blood stasis blocking collaterals.Methods A total of 74 patients with ultra-early CI and syndrome of phlegm and blood stasis blocking collaterals admitted to Xintai Xiezhuang Hospital of Shandong Yiyang Health Group from January 2019 to January 2021 were randomly assigned into a control group(37 patients)and an observation group(37 patients).The control group was treated with intravenous thrombolysis,and the observation group with the therapy of activating blood and resolving stasis combined with intravenous thrombolysis.Both groups were treated for 4 weeks.The National Institutes of Health Stroke Scale(NIHSS)score,clinical efficacy,and incidence of adverse reactions were compared between the two groups.Results After treatment,the NIHSS scores of both groups declined compared with those before treatment(P<0.01).Moreover,the NIHSS score of the observation group was lower than that of the control group(P<0.01).The observation group had higher total effective rate than the control group(94.59%vs.70.27%,P<0.01).The incidence of adverse reactions showed no significant difference between the observation group and the control group(8.11%vs.5.41%,P>0.05).Conclusion The therapy of activating blood and resolving stasis combined with intravenous thrombolysis reduced the neurological damage and inflammatory reaction in patients with ultra-early CI and syndrome of phlegm and blood stasis blocking collaterals,improved the curative effect,and had high safety.It is recommended to be popularized in clinical practice.