丁苯酞联合丹参川芎嗪治疗脑梗死的疗效及血液流变学机制

Effect and hemorheological mechanism of butyphthalide combined with Danshen and Ligustrazine Injection on cerebral infarction

  • 摘要:
      目的  探讨丁苯酞(NBP)联合丹参川芎嗪治疗脑梗死的疗效及血液流变学机制。
      方法  选取74例脑梗死患者,采用随机数字表法均分为2组, 2组均在控制基础疾病的同时给予脱水、抗血小板聚集和营养脑细胞等对症支持治疗,此外对照组采用丹参川芎嗪进行治疗,观察组在对照组基础上加用NBP静脉滴注。
      结果  观察组的治疗有效率为97.30%, 显著高于对照组的有效率83.78%(P < 0.05); 治疗2周时, 2组美国独立卫生研究院卒中量表(NIHSS)评分显著降低(P < 0.05), 蒙特利尔认知评估量表(MoCA)评分和日常生活活动能力(ADL)评分显著升高(P < 0.05), 且观察组的NIHSS评分显著低于对照组, MoCA评分和ADL评分显著高于对照组(P < 0.05); 治疗后, 2组血液流变学指标全血高切黏度(HSV)、全血低切黏度(LSV)、血浆黏度(PSV)、红细胞压积(HCT)以及红细胞沉降率(ESR)均显著降低(P < 0.05), 且观察组HSV、LSV、PSV、HCT及ESR水平显著低于对照组(P < 0.05); 2组不良反应发生率无显著差异(P>0.05)。
      结论  丹参川芎嗪联合NBP治疗脑梗死可改善患者血流动力学指标,减轻神经功能缺损和认知功能障碍,改善患者独立生活能力,提升治疗效果。

     

    Abstract:
      Objective  To study the efficacy and hemorheological mechanism of butylphthalide (NBP) combined with Danshen and Ligustrazine Injection in the treatment of cerebral infarction (CIS).
      Methods  A total of 74 patients with CIS in our hospital were selected and divided into two groups according to the random number table method, with 37 cases in each group. The two groups were given symptom-targeted supportive treatment such as dehydration, anti-platelet aggregation and brain cell nutrition. In addition, control group was treated with Danshen and Ligustrazine, and observation group was given intravenous infusion of NBP on the basis of control group.
      Results  The efficacy rate in observation group was significantly higher than that in control group (97.30% vs. 83.78%, P < 0.05). At 2 weeks of treatment, the National Institute of Health Stroke Scale (NIHSS) scores in the two groups were significantly decreased (P < 0.05), while the scores of Montreal Cognitive Assessment Scale (MoCA) and Activity of Daily Life (ADL) were significantly increased (P < 0.05), and the observation group had lower NIHSS score while higher scores of MoCA and ADL than those in control group (P < 0.05). The hemorheological indexes such as HSV, LSV, PSV, HCT and ESR were significantly decreased in the two groups (P < 0.05), and the highwhole blood viscosity (HSV), low whole blood viscosity (LSV), plasma viscosity (PSV), hematokrit (HCT) anderythrocyte sedimentation rate (ESR) in the observation group were lower than those in control group(P < 0.05). The incidence of adverse reactions of two groups showed no significnat difference (P>0.05).
      Conclusion  Danshen and Ligustrazine Injection combined with NBP for cerebral infarction can improve hemodynamic parameters, reduce neurological function and cognitive impairment, improve independent living ability and enhance treatment effects.

     

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