卒中进展方联合阿加曲班治疗急性进展型脑梗死临床疗效观察

Efficacy of Cuzhong Jinzhan prescription combined with argatroban in treatment of acute progressive cerebral infarction

目的:观察卒中进展方联合阿加曲班治疗穿支动脉病变型急性进展型脑梗死痰瘀阻络证的疗效及安全性。方法:选取穿支动脉病变型急性进展型脑梗死痰瘀阻络证患者36例,按随机对照原则将其分为治疗组和对照组,每组各18例。2组均给予西医常规基础治疗,对照组加用阿加曲班静脉泵入治疗,治疗组在对照组基础上加服卒中进展方治疗,2组均治疗14 d。比较2组治疗前后美国国立卫生研究院卒中量表(NIHSS)评分、改良运动功能(mRS)评分、中医证候积分、超敏C反应蛋白(hs-CRP)及同型半胱氨酸(Hcy)水平变化,并观察综合疗效及不良事件发生率。结果:总有效率治疗组为94.44%(17/18),对照组为66.67%(12/18),差异有统计学意义(P<0.05)。2组治疗7 d、14 d后NIHSS评分,治疗后3个月的mRS评分,治疗后中医证候积分、hs-CRP及Hcy水平均较治疗前下降,且治疗组下降幅度较对照组更大(P<0.05)。治疗过程中,2组均未出现肝肾功能损害、出血等不良事件。结论:卒中进展方联合阿加曲班注射液治疗穿支动脉病变型急性进展型脑梗死痰瘀阻络证,可有效改善患者神经功能预后、减轻炎症反应,且安全性较好。

Objective:To investigate the efficacy and safety of Cuzhong Jinzhan prescription combined with argatroban in the treatment of acute progressive cerebral infarction with perforating arterial lesions with phlegm-stasis blocking collateral-collateral syndrome.Methods:A total of 36 patients with acute progressive cerebral infarction with perforating arterial lesions with phlegm-stasis blocking collaterals were selected and divided into treatment group and control group using a randomized controlled design,with 18 patients in each group.The patients in the control group were given conventional Western medicine basic treatment and intravenous pumping of argatroban,and those in the treatment group were given oral administration of Cuzhong Jinzhan prescription in addition to the treatment in the control group;the course of treatment was 14 days for both groups.The two groups were compared in terms of the changes in National Institutes of Health Stroke Scale(NIHSS)score,modified Rankin Scale(mRS)score,traditional Chinese medicine(TCM)syndrome score,high-sensitivity C-reactive protein(hs-CRP),and homocysteine(Hcy)after treatment,and overall response and the incidence rate of adverse events were also observed for both groups.Results:There was a significant difference in overall response rate between the treatment group and the control group[94.44%(17/18)vs 66.67%(12/18),P<0.05].Both groups had a significant reduction in NIHSS score on days 7 and 14 of treatment,a significant reduction in mRS score at 3 months after treatment,and significant reductions in TCM syndrome score,hs-CRP,and Hcy after treatment,and the treatment group had significantly greater reductions than the control group(P<0.05).No adverse events such as liver/renal dysfunction and hemorrhage were observed in either group during treatment.Conclusion:In the treatment of acute progressive cerebral infarction with perforating arterial lesions with phlegm stasis obstruction syndrome,Cuzhong Jinzhan prescription combined with argatroban can effectively improve the prognosis of neurological function and alleviate inflammatory response with relatively good safety.