丹参川芎嗪注射液联合溶栓治疗急性脑梗死临床研究

Clinical Study on Danshen Chuanxiongqin Injection Combined with Thrombosis for Acute Cerebral Infarction

目的:观察丹参川芎嗪注射液联合溶栓在急性脑梗死(ACI)患者中的疗效及其对血液流变学的影响。方法:采用优效性样本量估算方法,选取80例ACI患者并按随机数字表法分为2组,对照组40例实施溶栓治疗,治疗组40例在溶栓的基础上加用丹参川芎嗪注射液治疗。治疗4周后,判定2组临床疗效,记录2组中国卒中量表(CSS)评分、血流变学指标[血浆黏度、红细胞比容(Hct)、纤维蛋白原(Fib)、血小板聚集率]、血浆血栓素B2(TXB2)、降钙素基因相关肽(CGRP)、同型半胱氨酸(Hcy)、心钠素(ANP)变化并进行比较,比较2组不良反应发生率。结果:临床总有效率治疗组92.50%,对照组72.50%,2组比较,差异有统计学意义(P<0.05)。治疗1周、2周及治疗4周后,2组CSS评分均明显低于本组治疗前,差异均有统计学意义(P<0.05),且治疗组各时间点CSS评分均低于同期对照组,差异均有统计学意义(P<0.05)。治疗4周后,2组血浆CGRP均明显高于治疗前,差异均有统计学意义(P<0.05),血浆黏度、Fib、Hct、血小板聚集率及血浆TXB2、Hcy、ANP水平均明显低于治疗前,差异均有统计学意义(P<0.05),且治疗组血浆CGRP高于对照组,治疗组血浆黏度、Fib、Hct、血小板聚集率及血浆TXB2、Hcy、ANP水平均低于对照组,差异均有统计学意义(P<0.05);2组出血性不良反应总发生率比较,差异无统计学意义(P>0.05)。结论:丹参川芎嗪注射液联合溶栓治疗ACI,可明显减轻神经功能损伤,有效改善血液流变学指标及血浆TXB2、CGRP、Hcy、ANP。

Objective:To observe the curative effect of therapy of Danshen Chuanxiongqin Injection combined with thrombosis on patients with acute cerebral infarction(ACI)and its effect on hemorheology.Methods:Using the estimation method of superiority sample size,a total of 80 ACI patients were selected and divided into the control group and the treatment group according to the random number table method,with 40 cases in each group.The control group was given thrombosis for treatment,and the treatment group was additionally treated with Danshen Chuanxiongqin Injection based on the treatment of the control group.After four weeks of treatment,the clinical effects in the two groups were determined;the changes of scores of Chinese Stroke Scale(CSS),indexes of hemorheology,including plasma viscosity,levels of hematocrit(Hct)and fibrinogen(Fib)and platelet aggregation rates,thromboxane B_2(TXB_2),and levels of calcitonin generated peptide(CGRP),homocysteine(Hcy)and atrial natriuretic polypeptide(ANP)in both groups were recorded and compared;the incidence of adverse reactions(AR)were compared between the two groups.Results:The total clinical effective rate was 92.50%in the treatment group and 72.50%in the control group,the difference being significant(P<0.05).After 1 week,2 and 4 weeks of treatment,the CSS scores in both groups were obviously lower than those before treatment,differences being significant(P<0.05),and the CSS score in the treatment group at each time point was lower than those in the control group,differences being significant(P<0.05).After 4 weeks of treatment,the CGRP levels in plasma in the two groups were significantly higher than those before treatment,differences being significant(P<0.05),and the plasma viscosity,levels of Fib and Hct,platelet aggregation rates and levels of TXB_2,Hcy and ANP in plasma were obviously lower than those before treatment,differences being significant(P<0.05);the CGRP level in plasma in the treatment group was higher than that in the control group,and the plasma viscosity,levels of Fib and Hct,platelet aggregation rate and levels of TXB_2,Hcy and ANP in plasma were lower than those in the control group,differences being significant(P<0.05);there was no significant difference being found in the comparison of total incidence of adverse reactions between the two groups(P>0.05).Conclusion:The therapy of Danshen Chuanxiongqin Injection combined with thrombosis for ACI can significantly reduce the injuries of nerve function,and effectively improve the indexes of hemorheology and levels of TXB_2,CGRP,Hcy and ANP.