脑清喷鼻微乳治疗急性缺血性卒中疗效及对基质金属蛋白酶-9的影响

Efficacy of Naoqing nasal microemulsion on acute ischemic stroke and its effect on matrix metalloproteinase-9

目的观察脑清喷鼻微乳治疗急性缺血性卒中患者的疗效及对基质金属蛋白酶-9(MMP-9)水平的影响。方法采用随机、双盲的试验设计,将2022年1—10月于广州医科大学附属中医医院神经科治疗的60例急性缺血性卒中患者随机分为脑清喷鼻微乳组(30例)和空白微乳剂组(30例),2组患者均接受常规治疗,脑清喷鼻微乳组同时给予脑清喷鼻微乳喷鼻,空白微乳剂组给予空白微乳剂喷鼻,均3次/d,3喷/次,疗程为10 d。观察2组患者治疗前后血清MMP-9水平、血液流变学指标、美国国立卫生研究院卒中量表(NIHSS)评分、日常生活能力Barthel指数评分及中医证候积分的变化,比较2组临床疗效。结果治疗10 d后,脑清喷鼻微乳组血清MMP-9水平、全血高切黏度、全血中切黏度、全血低切黏度、血浆黏度、NIHSS评分、中医证候积分均明显低于治疗前及空白微乳剂组(P均<0.05);脑清喷鼻微乳组Barthel指数评分明显高于治疗前及空白微乳剂组(P均<0.05)。治疗10 d后脑清喷鼻微乳组总有效率为83.3%(25/30),空白微乳剂组为60.0%(18/30),脑清喷鼻微乳组明显高于空白微乳剂组(P<0.05)。结论脑清喷鼻微乳治疗急性缺血性卒中患者疗效更好,能显著降低患者血清MMP-9水平,保护血脑屏障,改善神经功能及临床症状,提高患者日常生活能力。

Objective It is to observe the clinical efficacy of Naoqing nasal microemulsion in patients with acute ischemic stroke(AIS)and its effect on matrix metalloproteinase-9(MMP-9).Methods Using a randomized,double-blind trial design,60 patients with AIS admitted to the Affiliated TCM Hospital of Guangzhou Medical University from January 2022 to October 2022 were randomly divided into a Naoqing nasal microemulsion group(n=30)and a blank placebo group(n=30),both groups received conventional therapy,the Naoqing nasal microemulsion group was treated with Naoqing nasal microemulsion and the control group was treated with blank microemulsion at the same time,both 3 times/day,3 sprays/time,continuously treated for 10 days.The changes in the level of serum MMP-9,indicators of blood rheology,scores of National Institutes of Health Stroke Scale(NIHSS),Barthel index of daily living ability and Chinese medicine syndrome were observed before and after treatment in both groups,and the clinical efficacy of the two groups was compared.Results After 10 dyas of treatment,the level of serum MMP-9,whole blood high cut viscosity,whole blood medium cut viscosity,whole blood low cut viscosity,plasma viscosity,NIHSS score,and the scores of Chinese medicine syndrome in the Naoqing nasal microemulsion group were significantly lower than those before treatment and in the blank microemulsion group(all P<0.05);the Barthel index score in the Naoqing nasal microemulsion group was significantly higher than that before treatment and in the blank microemulsion group(all P<0.05).After 10 days of treatment,the total effective rate was 83.3%(25/30)in the Naoqing nasal microemulsion group,which was significantly higher than that 60.0%(18/30)in the blank microemulsion group(P<0.05).Conclusion The efficacy of Naoqing nasal microemulsion in treating AIS patients is clear,and it can significantly reduce serum MMP-9 concentration,protect the blood-brain barrier,improve neurological functional status and clinical symptoms,and improve patients'daily living ability.