川芎嗪注射液联合丁苯酞治疗短暂性脑缺血发作的疗效观察

Efficacy of tetramethylpyrazine injection combined with butylphthalidein treatment of transient ischemic attack

目的观察川芎嗪注射液联合丁苯酞治疗短暂性脑缺血发作(TIA)的疗效及对患者脑葡萄糖代谢、血小板活化程度及免疫炎性反应的影响。方法选取100例TIA患者,随机分为对照A组(n=33)、对照B组(n=33)和观察组(n=34)。对照A组给予丁苯酞治疗,对照B组给予川芎嗪注射液治疗,观察组给予川芎嗪注射液联合丁苯酞治疗,3组连续治疗2周。比较3组临床疗效、卒中风险(ABCD^(2)评分)、神经功能[美国国立卫生研究院卒中量表(NIHSS)评分]、脑葡萄糖代谢(K_(E)值、T_(max)值)、血小板活化[α颗粒膜蛋白-140(GMP-140)、P选择素(CD62p)、血小板活化因子(PAF)]、免疫炎性指标[白细胞介素(IL)-17、IL-23、高迁移率族蛋白B1(HMGB1)]及安全性。结果观察组临床总有效率为97.06%,高于对照A组的75.76%和对照B组的72.73%,差异有统计学意义(P<0.05)。治疗1、2周后,3组ABCD^(2)、NIHSS评分以及K_(E)值、T_(max)值低于治疗前,且观察组低于对照A组、对照B组,差异有统计学意义(P<0.05);3组的CD62p、PAF、GMP-140和IL-17、IL-23及HMGB1低于治疗前,且观察组低于对照A组、对照B组,差异有统计学意义(P<0.05)。3组治疗期间均未出现明显不良反应。结论川芎嗪注射液联合丁苯酞治疗TIA,可改善患者脑葡萄糖代谢及神经功能,降低卒中风险,且安全性较高,疗效显著,这可能与抑制血小板活化及免疫炎性反应有关。

Objective To observe the efficacy of ligustrazine injection combined with butylphthalein in treatment of transient ischemic attack(TIA)and the its effects on cerebral glucose metabolism,platelet activation and immune inflammation reaction.Methods A total of 100 patients with TIA were selected and randomly divided into control group A(n=33),control group B(n=33)and observation group(n=34).The control group A was given butylphthalide treatment,the control group B was given tetramethylpyrazine injection treatment,and observation group was given tetramethylpyrazine injection combined with butylphthalide treatment,three groups were treated for two weeks.The clinical efficacy,stroke risk(ABCD^(2) score),neurological function[National Institutes of Health Stroke Scale(NIHSS)score],cerebral glucose metabolism(K_(E) value and T_(max) value),platelet activation[α-granular membrane protein-140(GMP-140),P-selectin(CD62p)and platelet activating factor(PAF)],immunoinflammatory indexes[interleukin(IL)-17,IL-23 and high mobility group protein B1(HMGB1)]and safety were compared among the three groups.Results The total clinical effective rate of the observation group was 97.06%,which was significantly higher than 75.76%of the control group A and 72.73%of the control group B(P<0.05).After one week and two weeks of treatment,ABCD^(2),NIHSS scores,K_(E) values and T_(max) values in the three groups were significantly lower than before treatment,and the observation group was significantly lower than the control group A and control group B(P<0.05);the levels of CD62p,PAF,GMP-140,IL-17,IL-23 and HMGB1 in the three groups were significantly lower than before treatment,and the observation group was significantly lower than the control group A and control group B(P<0.05).Conclusion Ligustrazine injection combined with butylphthalein in treatment of TIA can improve the cerebral glucose metabolism and nervous function of patients,reduce the risk of stroke,with high safety and significant efficacy,which may be related to the inhibition of platelet activation and immune inflammatory response.