丁苯酞软胶囊联合阿托伐他汀钙片治疗脑梗塞的疗效及其对患者侧支循环建立的影响

Effect of butylphthalide soft capsules combined with atorvastatin calcium tablets in treatment of cerebral infarction and its influence on establishment of collateral circulation

目的观察丁苯酞软胶囊联合阿托伐他汀钙片治疗脑梗塞的疗效,并探讨其对患者侧支循环建立的影响。方法将我院神经内科2013年1月至2015年10月期间收治并确诊的112例脑梗塞患者按数表法随机分为对照组和观察组,每组各56例。对照组采用改善微循环、抗血小板等药物治疗,观察组则在对照组治疗基础上给予丁苯酞软胶囊联合阿托伐他汀钙片治疗,连续治疗3个月。比较两组患者的神经功能缺损(NIHSS)评分、缺血区域脑血流量、日常生活活动能力(Barthel)评分及患者对治疗的满意度。结果治疗2周、1个月、3个月后,观察组患者NIHSS评分逐渐降低,分别为(15.34±3.53)分、(12.37±4.32)分、(8.27±2.37)分,且低于同期对照组,差异均有统计学意义(P<0.05);治疗2周、1个月、3个月后,观察组患者的缺血区域脑血流量升高,分别为(26.32±8.97)m L/100 g·min、(32.35±10.84)m L/100 g·min、(41.48±12.86)m L/100 g·min,同时也高于同期对照组,差异均具有统计学意义(P<0.05);治疗2周、1个月、3个月后,观察组患者的Barthel指数增加,分别为(43.2±6.7)、(56.9±8.3)、(73.6±11.3),同时也高于同期对照组,差异均有统计学意义(P<0.05);观察组患者治疗满意率为91.1%(51/56),高于对照组的75.0%(42/56),差异有统计学意义(P<0.05)。结论丁苯酞软胶囊联合阿托伐他汀钙片治疗脑梗塞效果佳,可有效改善患者神经功能缺损,增加其缺血区脑血流量,生活活动能力也得到提高,值得临床应用。

Objective To observe the effect of butylphthalide soft capsules combined with atorvastatin calcium tablets in treatment of cerebral infarction, and its influence on establishment of collateral circulation. Methods A total of 112 patients with cerebral infarction in Department of Neurology in our hospital from January 2013 to October 2015 were randomly divided into the control group and observation group according to the number table, with 56 patients in each group. The control group received itherapy of improving microcirculation and antiplatelet, and the observation group was given butylphthalide soft capsules combined with atorvastatin calcium therapy on the basis of control group, for continuous treatment of 3 months. The neurological deficit(NIHSS) score, ischemic area of cerebral blood flow, activity of daily living(Barthel) score and satisfaction of treatment were compared between the two groups of patients. Results After 2 weeks, 1 month, 2 months of treatment, NIHSS score in observation group group were gradually decreased [(43.2 ± 6.7),(56.9 ± 8.3),(73.6 ± 11.3) respectively], which were significantly lower than those of the same period of the control group, and the differences were statistically significant(P<0.05). After 2weeks, 1 month, 2 months of treatment, ischemic regional cerebral blood flow in observation group were significantly increased [(26.32 ± 8.97) m L/100 g·min,(32.35 ± 10.84) m L/100 g·min,(41.48 ± 12.86) m L/100 g·min respectively],which were significantly higher than those of the control group, and the differences were statistically significant(P<0.05). After 2 weeks, 1 month, 2 months of treatment, barthel index in observation group were significantly increased[(43.2±6.7),(56.9 ± 8.3),(73.6 ± 11.3) respectively], which were significantly higher than those in control group, with statistically significant difference(P<0.05). The treatment satisfaction rate of observation group was 91.1%(51/56),which was significantly higher than that control group of 75.0%(42/56), and the difference was statistically significant(P<0.05). Conclusion Butylphthalide soft capsules combined with atorvastatin calcium tablets in the treatment of cerebral infarction has a better effect, which can improve neurological function defect, increase he cerebral blood flow of the ischemic areas, and improve the life ability. It is worth clinical application.