丁苯酞联合血栓通治疗急性缺血性脑卒中的临床效果

Clinical effect of butylphthalide sodium chloride injection combined with Xueshuantong for injection in the treatment of acute ischemic stroke

目的观察丁苯酞联合血栓通治疗急性缺血性脑卒中的临床疗效。方法选取2017年1月—2020年12月南京医科大学附属泰州人民医院收治的急性缺血性脑卒中患者92例,依照随机数字表法分为观察组与对照组,各46例。对照组患者予注射用血栓通(冻干)治疗,观察组患者在对照组基础上加用丁苯酞氯化钠注射液治疗,2组均以1周为1个疗程,共治疗4个疗程。比较2组患者治疗效果,治疗前后美国国立卫生研究院卒中量表评分(NIHSS)、神经功能缺损评分(CSS)、日常生活活动能力量表评分(Barthel)、生活质量评价量表评分(SF-36)及血液流变学指标(血小板聚集率、纤维蛋白原、血浆黏度)。结果观察组患者治疗总有效率为91.30%,高于对照组的73.91%(χ^(2)=4.842,P=0.028);治疗4周后,2组患者NIHSS、CSS评分及血小板聚集率、纤维蛋白原与血浆黏度均较治疗前下降,Barthel、SF-36评分均较治疗前升高,且观察组下降或升高的程度大于对照组(P均<0.01)。结论丁苯酞联合血栓通治疗急性缺血性脑卒中的临床疗效肯定,能有效改善患者神经功能与血液流变学表现,同时可提高患者生活质量,值得临床推广应用。

Objective To observe the clinical effect of butylphthalide sodium chloride injection combined with Xueshuantong for injection in the treatment of acute ischemic stroke.Methods Select 92 patients with acute ischemic stroke admitted to the Affiliated Taizhou People′s Hospital of Nanjing Medical University from January 2016 to December 2019.According to the principle of randomization and control,they were divided into observation group and control group,with 46 cases each.The control group was treated with Xueshuantong injection(lyophilized),and the observation group was treated with butylphthalide sodium chloride injection on the basis of the control group.Both groups took one week as a course of treatment,with a total of four courses of treatment.The treatment effects of the two groups were compared,and the changes of NIHSS,CSS,Barthel,SF-36 and hemorheology indexes(platelet aggregation rate,fibrinogen,plasma viscosity,etc.)before and after treatment were compared.Results The total effective rate of treatment in the observation group was 91.30%,higher than 73.91%in the control group(χ^(2)=4.842,P=0.028).After treatment,the scores of NIHSS,CSS,platelet aggregation rate,fibrinogen and plasma viscosity in the two groups decreased compared with those before treatment,while the scores of Barthel and SF-36 increased compared with those before treatment,and the degree of decrease or increase in the observation group was greater than that in the control group(P<0.01).Conclusion The clinical effect of butylphthalide sodium chloride injection combined with Xueshuantong for injection in the treatment of acute ischemic stroke is positive.It can effectively improve the neurological function and hemorheology of patients,and improve the quality of life of patients,which is worthy of clinical application.