安宫牛黄丸辅助再灌注治疗重症急性缺血性卒中的疗效研究

Efficacy of Angong Niuhuang pill assisted reperfusion therapy on severe acute ischemic stroke

目的探讨安宫牛黄丸辅助再灌注治疗重症急性缺血性卒中(AIS)的疗效。方法回顾性选取2021年5月至2023年5月绍兴市人民医院收治的60例再灌注治疗时间窗内重症AIS患者为研究对象,采用安宫牛黄丸辅助再灌注治疗30例,为观察组;采用单纯再灌注治疗30例,为对照组。观察并比较两组患者治疗后病情及神经功能指标[包括美国国立卫生研究院卒中量表(NIHSS)、格拉斯哥昏迷量表(GCS)、改良Rankin量表(mRS)评分以及梗死后加重、梗死后出血、脑疝、神经功能恢复、治疗期间2周内死亡比例]、炎症指标[包括C反应蛋白(CRP)、中性粒细胞与淋巴细胞比值(NLR)、血小板与淋巴细胞比值(PLR)、全身免疫炎症指数(SII)]等。结果观察组患者在90 d NIHSS评分,14、30 d GCS评分,90 d mRS评分以及神经功能恢复比例方面均优于对照组(均P<0.05)。两组患者治疗前后CRP、NLR、PLR、SII等炎症指标比较,差异均无统计学意义(均P>0.05)。结论安宫牛黄丸辅助再灌注治疗AIS有助于促进患者早期意识的恢复和远期神经功能缺损的改善,但对炎症指标影响不大。

Objective To investigate the effects of Angong Niuhuang pill assisted reperfusion therapy on severe acute ischemic stroke(AIS).Methods Sixty patients with severe AIS were selected from Shaoxing People's Hospital from May 2021 to May 2023.Among them,30 cases were treated with Angong Niuhuang pill assisted reperfusion as observation group,another 30 cases were only treated with reperfusion as control group.The state of illness and neurological function indicators[National Institutes of Health Stroke Scale(NIHSS),Glasgow Coma Scale(GCS),modified Rankin Scale(mRS),disease progression after cerebral infarction,hemorrhage after cerebral infarction,cerebral hernia,recovery of nerve function,and the ratio of death within two weeks after treatment],inflammation indicators[C-reactive protein(CRP),neutrophil to lymphocyte ratio(NLR),platelet to lymphocyte ratio(PLR)and systemic immune inflammation index(SII)]were observed and compared between the two groups after treatment.Results The scores of NIHSS at 90 d,GCS at 14 d and 30 d,mRS at 90 d and the proportion of neurological function recovery in observation group were better than those in control group(all P<0.05).There was no significant difference in CRP,NLR,PLR and SII between the two groups before and after treatment(all P>0.05).Conclusion Angong Niuhuang pill assisted reperfusion therapy can promote the recovery of early consciousness and the improvement of long-term neurological deficit in severe acute AIS patients,but it has little effect on inflammatory indexes.