银杏内酯注射液联合尼莫地平治疗高血压脑出血的临床疗效及其对神经功能的影响

Clinical effect of ginkgolide injection combined with nimodipine in the treatment of hypertensive cerebral hemorrhage and its influence on neurological function

目的观察银杏内酯注射液联合尼莫地平治疗高血压脑出血的临床疗效及其对神经功能的影响。方法选取2018年7月—2020年7月武穴市中医医院收治的高血压脑出血患者100例,采用随机数字表法分为对照组与观察组,各50例。对照组予以尼莫地平,观察组在对照组基础上联合银杏内酯注射液。2组均需要持续治疗2周。比较2组治疗前、治疗2周后血—脑脊液屏障功能指标(血清白蛋白、脑脊液白蛋白、血—脑屏障指数)、脑血流量(包括中心区、周边近区、周边远区、额顶叶区)、美国国立卫生研究院卒中量表(NIHSS)评分、格拉斯哥昏迷量表(GCS)评分、简易Fugl-Meyer运动功能评价表(FMA)评分,不良反应。结果观察组总有效率为88.0%,高于对照组的66.0%(χ^(2)=6.832,P=0.009)。治疗2周后,2组脑脊液白蛋白、血—脑屏障指数低于治疗前,观察组血清白蛋白高于治疗前,且观察组脑脊液白蛋白、血—脑屏障指数低于对照组,血清白蛋白高于对照组(P<0.05)。治疗2周后,2组周边近区、周边远区血流量及观察组中心区、额顶叶区血流量快于治疗前,且观察组中心区、周边近区、周边远区、额顶叶区血流量快于对照组(P<0.01)。治疗2周后,2组NIHSS评分低于治疗前,GCS评分、FMA评分高于治疗前,且观察组NIHSS评分低于对照组,GCS评分、FMA评分高于对照组(P<0.01)。观察组不良反应总发生率为8.0%,与对照组的4.0%比较,差异无统计学意义(χ^(2)=0.709,P=0.400)。结论银杏内酯注射液联合尼莫地平治疗高血压脑出血可提高临床疗效,可有效改善患者神经功能、血—脑脊液屏障功能,提高脑血流量,且安全性较高。

Objective To observe clinical effect of ginkgolide injection combined with nimodipine on treating hypertensive cerebral hemorrhage and its influence on neurological function.Methods A total of 100 cases of patients with hypertensive cerebral hemorrhage were selected from July 2018 to July 2020 in Traditional Chinese Medicine Hospital of Wuxue City,which were divided into the control group and the observation group by random number table method,50 cases in each group.The control group was given nimodipine,and the observation group was given ginkgolide injection on the basis of the control group.Both groups need continuous treatment for 2 weeks.Blood-brain barrier function index(serum albumin,cerebrospinal fluid albumin,blood-brain barrier index),cerebral blood flow(including central area,peripheral near area,peripheral far area,frontal parietal area),NIHSS score,GCS score,FMA score before treatment and after 2 weeks of treatment were compared between the two groups,and the incidence of adverse reactions were observed.Results The total effective rate in the observation group was 88.0%,was higher than 66.0%in the control group(χ^(2)=6.832,P=0.009).After 2 weeks of treatment,the cerebrospinal fluid albumin and blood-brain barrier index of the two groups were lower than those before treatment,while the serum albumin of the observation group was higher than that before treatment,and the cerebrospinal fluid albumin and blood-brain barrier index of the observation group were lower than those of the control group,but the serum albumin was higher than that of the control group(P<0.05).After 2 weeks of treatment,the blood flow in the peripheral near and far areas of the two groups,the blood flow in the central area and frontal parietal area of the observation group were faster than those before treatment,and the blood flow in the central area,peripheral near area,peripheral far area and frontal parietal area of the observation group were faster than those in the control group(P<0.01).After two weeks of treatment,the NIHSS score of the two groups was lower than that before treatment,while the GCS scores and FMA scores were higher than those before treatment,and the NIHSS score of the observation group was lower than that of the control group,while the GCS scores and FMA scores were higher than those of the control group(P<0.01).The total incidence of adverse reactions in the observation group was 8.0%,and there was no significant difference compared with 4.0%in the control group(χ^(2)=0.709,P=0.400).Conclusion Ginkgolide injection combined with nimodipine in the treatment of hypertensive intracerebral hemorrhage can promote the clinical efficacy,which can effectively improve patients’neurological function,blood-brain barrier function and improve cerebral blood flow,and with high safety.