银星养脑片联合阿替普酶治疗急性缺血性脑卒中的临床观察

Clinical Observation of Yinxing Yangnao Tablet Combined with Alteplase in the Treatment of Acute Ischemic Stroke

目的观察银星养脑片治疗急性缺血性脑卒中的临床疗效,并探讨其作用机制。方法80例患者采用随机数字表法随机分为研究组与对照组各40例。两组均予阿替普酶静脉溶栓治疗,研究组在对照组治疗基础上加用银星养脑片治疗。比较两组入院时、治疗后1周及2周血清丙二醛(MDA)及超氧化物歧化酶(SOD)、神经功能缺损评分(NIHSS)及日常生活能力(ADL)的水平,记录两组不良反应及临床疗效。结果两组治疗后2周、治疗后1周与入院时比较,血清MDA水平下降、SOD水平则上升(均P<0.01),且研究组治疗后1周、治疗后2周血清MDA水平低于同期对照组,而SOD水平则高于同期对照组(均P<0.01)。两组治疗后NIHSS评分呈下降趋势、ADL评分呈上升趋势,组内比较,差异均有统计学意义(均P<0.01);研究组治疗后1周、治疗后2周NIHSS评分低于同期对照组、ADL评分高于同期对照组(均P<0.01)。研究组总有效率为95.00%,高于对照组的80.00%(P<0.05)。对照组溶栓后脑出血2例(5.00%),研究组1例(2.50%),脑出血仅微量,未特殊干预,组间比较差异无统计学意义(P>0.05)。结论阿替普酶静脉溶栓后联合银星养脑片治疗急性缺血性脑卒中安全有效,可改善患者缺损神经功能、恢复日常生活能力,其机制可能与抗氧化应激、抗炎等相关。

Objective:To observe the clinical efficacy of Yinxing Yangnao Tablet in the treatment of acute ischemic stroke,and to investigate its mechanism of action.Methods:A total of 80 patients were divided into a study group and a control group using a random number table method,with 40 cases in each group.Both groups received intravenous thrombolytic therapy with alteplase,while the study group received further treatment with Yinx-ing Yangnao Tablet.The levels of serum malondialdehyde(MDA)and superoxide dismutase(SOD),neurological deficit score(NIHSS)and daily living ability(ADL)between the two groups at admission and 1 and 2 weeks after treatment were compared,and the adverse reactions and clinical efficacy of the two groups were recorded.Results:Compared with the data of the two groups at the time of admission,the serum MDA level decreased,and the SOD level increased(all P<0.01),and the serum MDA levels in the study group were lower than those in the control group at 1 week and 2 weeks after treatment,while the SOD level was higher than that in the control group(all P<0.01).The NIHSS score of the two groups showed a downward trend and an upward trend after treatment,and the differences between the two groups were statistically significant(all P<0.01),and the NIHSS scores of the study group were lower than those of the control group at 1 week and 2 weeks after treatment,and the ADL scores were higher than those of the control group(all P<0.01).The total effective rate of the study group was 95.00%,which was higher than 80.00%of the control group(P<0.05).There were 2 cases(5.00%)of intracerebral hemor-rhage after thrombolysis in the control group and 1 case(2.50%)in the study group.There was no significant difference in intracerebral hemorrhage between the two groups(P>0.05).Conclusion:After intravenous thrombolysis with alteplase for acute ischemic stroke,the combination with Yinxing Yangnao Tablet is safe and effective,which can further improve defective neurological function and restore daily living ability.Its mechanism may be related to antioxidant stress,antiinflammatory,and other factors.