脉络宁口服液联合氯吡格雷治疗脑梗死恢复期的临床研究

Clinical study of Mailuoning Oral Liquid combined with clopidogrel in treatment of cerebral infarction convalescence period

目的 探讨脉络宁口服液联合氯吡格雷治疗脑梗死恢复期的临床疗效。方法 选取2019年3月—2022年3月太和县人民医院收治的82例脑梗死恢复期患者,按照随机数字表法分为对照组和治疗组,每组各41例。对照组口服硫酸氢氯吡格雷片,75 mg/次,1次/d。治疗组在对照组基础上口服脉络宁口服液,20 mL/次,3次/d。两组均连续治疗8周。观察两组临床疗效,比较治疗前后两组相关量表[脑卒中专门化生存质量量表(SS-QOL)、美国国立卫生研究院卒中量表(NIHSS)、改良Barthel指数(MBI)]评分,血栓前状态指标[纤维蛋白原(FIB)、血小板最大聚集率(MAR)、血小板激活复合物-1(PAC-1)],以及血清肿瘤坏死因子(TNF)-α、可溶性细胞间黏附分子-1(s ICAM-1)、血管内皮生长因子(VEGF)、神经元特异性烯醇化酶(NSE)水平。结果 治疗后,治疗组总有效率为92.7%,显著高于对照组的75.6%(P<0.05)。与治疗前相比,两组治疗后SS-QOL、MBI评分均显著增加,NIHSS评分则均显著降低(P<0.05);且治疗后,治疗组相关量表评分的改善效果均显著优于对照组(P<0.05)。治疗后,两组血浆FIB、PAC-1、MAR均显著低于治疗前(P<0.05),且均以治疗组血栓前状态指标(FIB、PAC-1、MAR)的降低更显著(P<0.05)。相比治疗前,两组治疗后血清TNF-α、s ICAM-1、NSE水平均显著下降,血清VEGF水平则均显著上升(P<0.05);且均以治疗组改善更显著(P<0.05)。结论 脉络宁口服液联合氯吡格雷治疗脑梗死恢复期的整体疗效确切,能有效促进患者神经功能和生活能力的恢复,提高生存质量,并可进一步纠正血栓前状态以及良性调控血中TNF-α、sICAM-1、VEGF水平,且安全性好。

Objective To investigate the clinical effect of Mailuoning Oral Liquid combined with clopidogrel in treatment of cerebral infarction convalescence period. Methods A total of 82 convalesce cerebral infarction patients admitted to Taihe County People’s Hospital from March 2019 to March 2022 were selected and divided into control group and treatment group according to random number table method, with 41 cases in each group. Patients in the control group were po administered with Clopidogrel Hydrogen Sulphate Tablets, 75 mg/time, once daily. Patients in the treatment group were po administered with Mailuoning Oral Liquid on the basis of the control group, 20 mL/time, three times daily. Patients in two groups were treated for 8 weeks. After treatment, the clinical efficacy was evaluated, the scores of related scales [Stroke Specialized Quality of Life(SS-QOL), National Institutes of Health Stroke Scale(NIHSS), Modified Barthel Index(MBI)] scores, prethrombotic state indicators [fiber Proprotein(FIB), maximum platelet aggregation rate(MAR), platelet activation complex-1(PAC-1)], and serum tumor necrosis factor-α(TNF-α), soluble intercellular adhesion molecule-1(sICAM-1), vascular endothelial growth factor(VEGF), neuron-specific enolase(NSE) levels in two groups before and after treatment were compared. Results After treatment, the total effective rate of the treatment group was 92.7%,significantly higher than that of the control group(75.6%)(P < 0.05). Compared with before treatment, SS-QOL and MBI scores were significantly increased after treatment, while NIHSS scores were significantly decreased in both groups(P < 0.05). After treatment, the improvement effect of relevant scale scores in the treatment group was significantly better than that in the control group(P < 0.05).After treatment, plasma FIB, PAC-1, and MAR in two groups were significantly lower than before treatment(P < 0.05), and the reduction of pre-thrombotic status indexes(FIB, PAC-1 and MAR) in the treatment group was more significant(P < 0.05). Compared with before treatment, the serum levels of TNF-α, sICAM-1, and NSE in two groups were significantly decreased after treatment, while the serum levels of VEGF were significantly increased(P < 0.05). The improvement was more significant in treatment group(P <0.05). Conclusion Mailuoning Oral Liquid combined with clopidogrel has a definite overall effect in treatment of convalescent cerebral infarction, and can effectively promote the recovery of neurological function and living ability, improve the quality of life, and can further correct the prethrombotic state and benign regulation of blood TNF-α, sICAM-1, VEGF expression with good safety.