银杏二萜内酯葡胺注射液联合调督舒筋手法对急性脑梗死患者ET-1、S100β及血液流变学的影响

Effects of ginkgo biloba diterpene lactone glucosamine injection combined with Tui Na techniques on endothelin-1,S100β,and hemorheology in patients with acute cerebral infarction

目的分析银杏二萜内酯葡胺注射液联合调督舒筋手法对急性脑梗死患者血清内皮素1(ET-1)、中枢神经特异蛋白(S100β)及血液流变学的影响。方法回顾性分析宁波市康复医院2022年3月至2023年9月收治的急性脑梗死患者100例的临床资料,按照治疗方法将患者分为观察组、对照组各50例。对照组予银杏二萜内酯葡胺注射液治疗,观察组在对照组的基础上联合调督舒筋手法治疗,两组治疗4周。比较两组临床疗效、血清ET-1、S100β蛋白水平及血液流变学变化、不良反应发生率。结果治疗4周后,观察组躯干损伤量表评分均低于对照组(t=14.96、45.82、430.07、331.30、670.82、195.02,均P<0.05);观察组血清ET-1、S100β蛋白分别为(45.45±4.28)μmoL/L、(0.56±0.12)μg/L,均低于对照组的(53.52±5.78)μmoL/L、(0.78±0.16)μg/L(t=7.93、7.78,均P<0.05);观察组全血黏度、血浆黏度、纤维蛋白原分别为(4.56±0.45)mPa·s、(1.62±0.41)mPa·s、(3.69±0.42)g/L,均低于对照组的(5.26±0.97)mPa·s、(1.98±0.46)mPa·s、(4.08±0.49)g/L(t=4.63、4.13、4.27,均P<0.05)。观察组不良反应发生率为6%(3/50),低于对照组的32%(16/50)(χ^(2)=10.98,P<0.05)。结论银杏二萜内酯葡胺注射液联合调督舒筋手法可显著提高急性脑梗死患者临床疗效,降低血清ET-1、S100β蛋白含量,改善血液流变学指标,不良反应发生率低。

Objective To investigate the effects of ginkgo biloba diterpene lactone glucosamine injection combined with Tui Na techniques on endothelin-1,S100β,and hemorheology in patients with acute cerebral infarction.Methods The clinical data of 100 patients with acute cerebral infarction admitted to Ningbo Rehabilitation Hospital from March 2022 to September 2023 were retrospectively analyzed.These patients were assigned to an observation group and a control group,with 50 patients in each group,based on the treatment methods used.The control group received treatment with ginkgo biloba diterpene lactone glucosamine injection,while the observation group received the same treatment along with treatment with Tui Na techniques for regulating and relaxing muscles.Both groups underwent treatment for 4 weeks.Clinical efficacy,serum endothelin-1 and S100βprotein levels,changes in hemorheology,and the incidence of adverse reactions were compared between the two groups.Results After 4 weeks of treatment,the Trunk Impairment Scale(TIS)scores in the observation group were lower than those in the control group(t=14.96,45.82,430.07,331.30,670.82,195.02,all P<0.05).The serum levels of endothelin-1 and S100βprotein in the observation group were(45.45±4.28)μmoL/L and(0.56±0.12)μg/L,respectively,which were significantly lower than those in the control group[(53.52±5.78)μmoL/L,(0.78±0.16)μg/L,t=7.93,7.78,both P<0.05].The whole blood viscosity,plasma viscosity,and fibrinogen levels in the observation group were(4.56±0.45)mPa·s,(1.62±0.41)mPa·s,and(3.69±0.42)g/L,respectively,which were significantly lower than those in the control group[(5.26±0.97)mPa·s,(1.98±0.46)mPa·s,(4.08±0.49)g/L,t=4.63,4.13,4.27,all P<0.05].The incidence of adverse reactions in the observation group was significantly lower than that in the control group[6%(3/50)vs.32%(16/50),χ^(2)=10.98,P<0.05].Conclusion The combination of ginkgo biloba diterpene lactone injection and Tui Na techniques significantly enhances clinical efficacy in patients with acute cerebral infarction.This combined therapy reduces serum levels of endothelin-1 and S100βprotein,improves hemorheological parameters,and leads to a lower incidence of adverse reactions compared with treatment with ginkgo biloba diterpene lactone glucosamine injection alone.