川蛭通络胶囊联合替罗非班治疗急性脑梗死的临床研究

Clinical study on Chuanzhi Tongluo Capsules combined with tirofiban in treatment of acute cerebral infarction

目的 探究川蛭通络胶囊联合替罗非班对48 h内脑梗死急性期患者的治疗效果。方法 选取2022年6月—2023年6月在淄博市中心医院治疗的急性脑梗死患者103例,根据患者治疗方案分成对照组(51例)和治疗组(52例)。对照组静脉滴注盐酸替罗非班注射液,初始滴注速度0.4μg/(kg·min),滴注30 min,随后按0.1μg/(kg·min)的速度连续给药;治疗组在对照组基础上口服川蛭通络胶囊,2粒/次,3次/d。两组患者治疗14 d。观察两组患者临床疗效,比较治疗前后两组患者中医证候评分、巴氏指数(Barthel)评分和美国国立卫生研究院卒中量表(NIHSS)评分及血清超氧化物歧化酶(SOD)、谷胱甘肽过氧化酶(GSH-Px)、过氧化氢酶(CAT)、CX3C基序趋化因子配体1(CX3CL1)、碱性成纤维细胞生长因子(bFGF)和分拣蛋白(Sortilin)水平。结果 治疗后,对照组和治疗组临床总有效率分别为78.43%和94.23%,两组比较差异具有统计学意义(P<0.05)。治疗后,两组患者中医证候和NIHSS评分显著下降,而Barthel指数评分则显著升高(P<0.05),且治疗组评分明显好于对照组(P<0.05)。治疗后,两组患者氧化应激指标SOD、GSH-Px、CAT和bFGF水平显著升高,而CX3CL1和Sortilin水平显著降低(P<0.05),且治疗组在所有指标的改善上表现尤为突出(P<0.05)。结论 川蛭通络胶囊联合替罗非班治疗48 h内脑梗死急性期患者疗效显著,不仅能够显著改善患者神经功能和独立生活能力,同时还能够促进血清学指标的恢复并有效改善氧化应激损害。

Objective To explore the therapeutic effect of Chuanzhi Tongluo Capsules combined with tirofiban in treatment of acute cerebral infarction within 48 h. Methods Patients (103 cases) with acute cerebral infarction in Zibo Central Hospital from June 2022 to June 2023 were divided into control (51 cases) and treatment (52 cases) group based on different treatments. Patients in the control group were administered with Tirofiban Hydrochloride Injection, the initial drip speed was 0.4 µg/(kg∙min) for 30 min, then the drug was administered continuously at a rate of 0.1 µg/(kg∙min). Patients in the treatment group were po administered with Chuanzhi Tongluo Capsules on the basis of the control group, 2 grains/time, three times daily. Patients in two groups were treated for 14 d. After treatment, the clinical evaluations were evaluated, the scores of TCM syndrome, Barthel index, and NIHSS, the levels of serum SOD, GSH-Px, CAT, CX3CL1, bFGF and Sortilin in two groups before and after treatment were compared. Results After treatment, the total clinical effective rate of the control group and the treatment group was 78.43% and 94.23% respectively, and the difference between the two groups was statistically significant (P < 0.05). After treatment, the TCM syndrome and NIHSS score in two groups were significantly decreased, while the Barthel index score was significantly increased (P < 0.05), and the scores of the treatment group was significantly better than that of the control group (P < 0.05). After treatment, the levels of oxidative stress indexes SOD,GSH-Px, CAT and bFGF in two groups were significantly increased, while the levels of CX3CL1 and Sortilin were significantly decreased (P < 0.05), and the improvement of all indexes in the treatment group was particularly prominent (P < 0.05). Conclusion The combination of Chuanzhi Tongluo Capsules and tirofiban has a significant therapeutic effect on the acute phase of cerebral infarction within 48 h, which can not only significantly improve the patient's neurological function and independent living ability, but also promote the recovery of serological indicators and effectively improve oxidative stress damage.