苦蝶子注射液联合氯吡格雷治疗急性脑梗死的临床研究

Clinical study on Kudiezi Injection combined with clopidogrel in treatment of acute cerebral infarction

目的探讨苦蝶子注射液联合氯吡格雷治疗急性脑梗死的临床疗效。方法选取2017年4月—2018年4月在郑州市第六人民医院治疗的急性脑梗死患者190例,根据用药的不同分为对照组(95例)和治疗组(95例)。对照组口服硫酸氢氯吡格雷片,50 mg/次,1次/d;治疗组在对照组基础上静脉滴注苦蝶子注射液,40 mL加入5%葡萄糖注射液250 mL,1次/d。两组患者均治疗2周。观察两组患者临床疗效,同时比较治疗前后两组患者NIHSS、m RS和SF-36评分及血清学指标和脑血流动力学。结果治疗后,对照组和治疗组临床有效率分别为82.11%和97.89%,两组比较差异具有统计学意义(P<0.05)。治疗后,两组NIHSS评分和m RS评分显著降低(P<0.05),SF-36评分升高(P<0.05),且治疗组NIHSS、m RS和SF-36评分明显好于对照组(P<0.05)。治疗后,两组血清可溶性肿瘤坏死因子相关凋亡诱导配体(s TRAIL)、嗜环蛋白/亲环素A(CyPA)、基质金属蛋白酶-9(MMP-9)、血小板激活因子(PAF)、血红素氧合酶1(HO1)水平均显著降低(P<0.05),且治疗组上述血清学指标明显低于对照组(P<0.05)。治疗后,两组相对平均血流量(Qmean)和平均血流速度(Vmean)水平明显升高(P<0.05),动态阻力(DR)、特性阻抗(ZCV)和脑血管周围阻力(R)明显降低(P<0.05),且治疗组上述脑血流动力学指标明显优于对照组(P<0.05)。结论苦蝶子注射液联合硫酸氢氯吡格雷片治疗急性脑梗死可有效促进神经功能恢复,及改善日常活动能力,具有一定的临床推广应用价值。

Objective To investigate the clinical effect of Kudiezi Injection combined with clopidogrel in treatment of acute cerebral infarction. Methods Patients(190 cases) with acute cerebral infarction in the Sixth People’s Hospital of Zhengzhou from April 2017 to April 2018 were divided into control(95 cases) and treatment(95 cases) groups bases on different treatments. Patients in the control group were po administered with Clopidogrel Bisulfate Tablets, 50 mg/time, once daily. Patients in the treatment group were iv administered with Kudiezi Injection on the basis of the control group, 40 mL added into 5% Glucose Injection 250 mL, once daily. Patients in two groups were treated for 2 weeks. After treatment, the clinical efficacy was evaluated, and NIHSS, mRS and SF-36 scores, serological indexes, and cerebral hemodynamics in two groups before and after treatment were compared. Results After treatment, the clinical efficacy in the control and treatment groups was 82.11% and 97.89%, respectively, and there were differences between two groups(P < 0.05). After treatment, the NIHSS and mRS scores in two groups were significantly decreased(P < 0.05), but SF-36 scores were significantly increased(P < 0.05), and the NIHSS, mRS and SF-36 scores in the treatment group were significantly better than those in the control group(P < 0.05). After treatment, the PAF, sTRAIL, MMP-9, CyPA and HO1 levels in two groups were significantly decreased(P < 0.05), and serological indexes levels in the treatment group were significantly lower than that in the control group(P < 0.05). After treatment, the Qmean and Vmean levels in two groups were significantly increased(P < 0.05), but DR, ZCV and R levels were significantly decreased(P < 0.05), and the cerebral hemodynamics indexes in the treatment group were significantly better than those in the control group(P < 0.05). Conclusion Kudiezi Injection combined with clopidogrel in treatment of acute cerebral infarction can effectively promote the recovery of nerve function and improve the daily activity, which has a certain clinical application value.