脑栓通胶囊联合依达拉奉治疗急性脑梗死患者疗效观察

Observation on the therapeutic effect of Naoshuantong capsule combined with edaravone on patients with acute cerebral infarction

目的:探讨脑栓通胶囊联合依达拉奉治疗急性脑梗死患者的疗效及对炎症因子、凝血功能和氧化应激影响。方法:选自2019年3月—2021年9月本院收治的急性脑梗死患者120例,按1∶1比较随机分为两组,各60例。两组入院后采取脑保护、抗凝、营养神经、抗血小板聚集、他汀类等常规治疗,对照组给予依达拉奉30 mg,加入氯化钠注射液100 ml中静脉滴注,2次/d;联合组在对照组基础上口服脑栓通胶囊3粒/次,3次/d。两组治疗周期14 d。比较两组治疗14 d疗效,治疗前与治疗14 d Barthel指数(BI)和神经功能缺损程度(NIHSS)评分、炎症因子、凝血功能和氧化应激影响。结果:联合组和对照组总有效率分别为95.00%和80.00(P<0.05);两组治疗前BI评分和NIHSS评分比较差异无统计学意义(P>0.05);两组治疗14 d BI评分高于治疗前,而NIHSS评分低于治疗前(P<0.05);联合组治疗14 d BI评分高于对照组,而NIHSS评分低于对照组(P<0.05)。两组治疗前血清TNF-α、IL-6和hs-CRP水平比较差异无统计学意义(P>0.05);两组治疗14 d血清TNF-α、IL-6和hs-CRP水平低于治疗前(P<0.05);联合组治疗14 d血清TNF-α、IL-6和hs-CRP水平低于对照组(P<0.05)。两组治疗前D-D、PT和APTT比较差异无统计学意义(P>0.05);两组治疗14 d D-D水平低于治疗前,而PT和APTT长于治疗前(P<0.05);联合组治疗14 d D-D水平低于对照组,而PT和APTT长于对照组(P<0.05)。两组治疗前MDA、GSH-Px和SOD水平比较差异无统计学意义(P>0.05);两组治疗14 d MDA水平低于治疗前,而GSH-Px和SOD水平高于治疗前(P<0.05);联合组治疗14 d MDA水平低于对照组,而GSH-Px和SOD水平高于对照组(P<0.05)。结论:脑栓通胶囊联合依达拉奉对急性脑梗死患者疗效显著,且可减轻患者炎症反应,改善患者凝血功能及氧化应激。

Objective:To investigate the effect of Naoshuantong capsule combined with edaravone on inflammatory factors,coagulation function,and oxidative stress in patients with acute cerebral infarction.Methods:A total of 120 patients with acute cerebral infarction admitted to our hospital from March 2019 to September 2021 were randomly divided into two groups,with 60 cases in each group.After admission,the two groups received conventional treatments,such as brain protection,anticoagulation,nutritional nerve,antiplatelet aggregation,and statins.The control group was given edaravone(30 mg added into 100 ml sodium chloride injection)intravenouslytwice a day.On the basis of the control group,the combined group was given Naoshuotong capsule 3 capsules/time,3 times a day.The treatment period of the two groups was 14 days.The effects of the Barthel index(BI),NIHSS score,inflammatory factors,coagulation function,and oxidative stress were compared between the two groups before treatment and 14 days after treatment.Results:The total effective rate ofthecombination group was higher than that of the control group(P<0.05).There was no significant difference in BI score and NIHSS score between the two groups before treatment(P>0.05).After 14 days of treatment,the BI score of both groups was higher than before treatment,while the NIHSS score was lower than before treatment(P<0.05).After 14 days of treatment,the BI score of the combination group was higher than that of the control group,while the NIHSS score was lower than that of the control group(P<0.05).There were no significant differences in serum levels of TNF-α,IL-6,and hs-CRP between the two groups before treatment(P>0.05).The serum levels of TNF-α,IL-6,and hs-CRP after14 days of treatment were lower than before treatment(P<0.05).The serum levels of TNF-α,IL-6,and hs-CRP in the combination group were lower than those in the control group after 14 days of treatment(P<0.05).There were no significant differences in D-D,PT,and APTT between the two groups before treatment(P>0.05).The D-D level of the two groups after 14 days of treatment was lower than before treatment,while PT and APTT were longer than before treatment(P<0.05).After 14 days of treatment,the D-D level in the combination group was lower than that in the control group,while PT and APTT were longer than those in the control group(P<0.05).There were no significant differences in MDA,GSH-Px,and SOD levels between the two groups before treatment(P>0.05).After 14 days of treatment,the MDA level was lower than before,while the GSH-Px and SOD levels in both groups were higher than before(P<0.05).The MDA level of the combined group was lower than that of the control group at 14 d,while the GSH-Px and SOD levels of the combined group were higher than those of the control group(P<0.05).Conclusion:Naoshuantong capsule combined with edaravone is effective in patients with acute cerebral infarction,and can reduce inflammatory reaction,and improve coagulation function and oxidative stress.