目的 觀察丹參川芎嗪注射液聯(lián)合長春西汀治療急性腦梗死的臨床療效,為臨床合理聯(lián)合用藥提供參考.方法 選取十堰市太和醫(yī)院2012年11月—2014年10月收治的急性腦梗死患者326例,隨機分為對照組和治療組,各163例.兩組患者均給予常規(guī)治療,對照組在常規(guī)治療的基礎(chǔ)上靜滴長春西汀注射液30 mg,以500 mL 0.9%生理鹽水稀釋,1次/d;治療組在對照組的基礎(chǔ)上靜滴丹參川芎嗪注射液40 mg,以500 mL 0.9%生理鹽水稀釋,1次/d,14 d為1個療程,兩組均治療1個療程.計算治療前后患者日常生活能力(ADL)及歐洲卒中量表(ESS)評分,觀察兩組的臨床療效,并記錄兩組治療前及治療1、5、9、14 d的腦電圖棘波波幅(EEG)和局部腦血流(rCBF),并測定兩組治療前后的血液流變學(xué)指標(biāo).結(jié)果 經(jīng)14 d治療后,治療組的ESS評分降低、ADL提高,總有效率達(dá)92%,與對照組比較差異有統(tǒng)計學(xué)意義(P< 0.05);兩組的EEG及rCBF均逐步恢復(fù)和增高,同組治療前后差異有統(tǒng)計學(xué)意義(P< 0.05),且治療組的EEG及rCBF改善程度均優(yōu)于對照組,兩組比較差異有統(tǒng)計學(xué)意義(P< 0.05);兩組血液流變學(xué)指標(biāo)在治療后有不同程度的降低,同組治療前后比較差異均有統(tǒng)計學(xué)意義(P< 0.05),治療組的總膽固醇、低密度脂蛋白膽固醇、纖維蛋白、全血高切黏度、全血低切黏度、血小板集聚率等血液流變學(xué)指標(biāo)降低更加明顯,與對照組比較差異有統(tǒng)計學(xué)意義(P< 0.05).結(jié)論 丹參川芎嗪注射液聯(lián)合長春西汀治療急性腦梗死能顯著增加患者rCBF、縮短EEG恢復(fù)至正常水平的時間,明顯降低ESS評分,改善患者血液流變學(xué)效應(yīng),對促進(jìn)患者神經(jīng)功能恢復(fù)及提高生活質(zhì)量有確切的臨床療效,有一定的臨床推廣價值.

Objective To observe the clinical effect of Danshen Chuanxiongqin Injection combined with vinpocetine in treatment of acute cerebral infarction, in order to provide reference for the clinical reasonable drug combination. Methods The patients with acute cerebral infarction (326 cases) of Shiyan Taihe Hospital from November 2012 to October 2014 were randomly divided into control and treatment groups, and each group had 163 cases. The patients in two groups were given conventional therapy. On the basis of conventional therapy, the patients in the control group were iv administered with Vinpocetine Injection (30 mg diluted with 500 mL physiological saline), once daily. On the basis of the contro group, the patients in the treatment group were iv administered with Danshen Chuanxiongqin Injection (40 mg diluted with 500 mL physiological saline), once daily. One course had 14 d. The patients in two groups were treated for one course. Activity of daily living (ADL) and the European stroke scale (ESS) were calculated. The clinical effect, electroencephalogram (EEG), and regional cerebral blood flow (rCBF) were observed before and 1, 5, 9, 14 d after treatment. Hemodynamic indexes were determined before and after treatment. Results After 14 d treatment, ESS scores in treatment group decreased and ADL increased. The total effective rate in treatment group was 92%, and there was statistically significant difference compared with those of control group (P <0.05). EEG and rCBF were improved more than those of control group with significant difference (P <0.05). And there was statistically significant difference between those of both groups before and after treatment (P <0.05). Hemodynamic indexes in both groups decreased to different extent after treatment, and there was statistically significant difference between those of both groups before and after treatment (P <0.05). Total cholesterol, low density lipoprotein cholesterol, protein fiber, high blood viscosity, low blood viscosity, platelet aggregation rate, and other indexes decreased more obviously, and there were statistically significant differences compared with those of control group (P <0.05). Conclusion Danshen Chuanxiongqin Injection combined with vinpocetine in treatment of acute cerebral infarction can significantly increased the time of rCBF returning to normal levels, and shorten the time of EEG returning to normal levels. And it can significantly lower ESS scores, improve hemodynamic indexes, promote neurological function recovery and has clinical effect of improving the quality of life, which is worth clinical promotion.