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[摘要]
目的 探討丁苯酞軟膠囊治療急性腦梗死的臨床療效。方法 選取2013年6月-2016年6月博羅縣人民醫(yī)院收治的急性腦梗死患者104例,所有患者采用隨機(jī)數(shù)字表法分為對照組和治療組,每組各52例。對照組給予常規(guī)治療,包括脫水降顱內(nèi)壓、服用阿司匹林抗凝、阿替普酶或尿激酶靜脈溶栓、依達(dá)拉奉改善腦循環(huán)、服用腦保護(hù)劑等,并根據(jù)患者情況進(jìn)行原發(fā)病對癥治療。治療組在對照組基礎(chǔ)上口服丁苯酞軟膠囊,0.2 g/次,2次/d。兩組患者均連續(xù)治療2周。觀察兩組的臨床療效,比較美國國立衛(wèi)生研究院卒中量表(NHISS)評分、Barthel指數(shù)、血液流變學(xué)、頸總動脈后壁內(nèi)中膜厚度(IMT)和頸總動脈血流阻力指數(shù)(RI)。結(jié)果 治療后,對照組和治療組的總有效率分別為69.23%、90.38%,兩組比較差異具有統(tǒng)計學(xué)意義(P<0.05)。治療后,兩組全血黏度、血漿黏度、纖維蛋白原水平均顯著降低,而血細(xì)胞比容顯著升高,同組治療前后比較差異有統(tǒng)計學(xué)意義(P<0.05);且治療組這些觀察指標(biāo)的改善程度明顯優(yōu)于對照組,兩組比較差異具有統(tǒng)計學(xué)意義(P<0.05)。治療后,兩組NIHSS評分顯著下降,而Barthel指數(shù)顯著上升,同組治療前后比較差異有統(tǒng)計學(xué)意義(P<0.05);且治療組這些觀察指標(biāo)的改善程度明顯優(yōu)于對照組,兩組比較差異具有統(tǒng)計學(xué)意義(P<0.05)。治療后,兩組IMT和RI均顯著降低,同組治療前后比較差異有統(tǒng)計學(xué)意義(P<0.05);且治療組這些觀察指標(biāo)明顯低于對照組,兩組比較差異具有統(tǒng)計學(xué)意義(P<0.05)。結(jié)論 丁苯酞軟膠囊治療急性腦梗死具有較好的臨床療效,可顯著改善神經(jīng)功能缺損情況,提升生活質(zhì)量,降低血液黏稠度,改善頸動脈粥樣硬化,具有一定的臨床推廣應(yīng)用價值。
[Key word]
[Abstract]
Objective To investigate the clinical effect of Butylphthalide Soft Capsules in treatment of acute cerebral infarction. Methods Patients (104 cases) with acute cerebral infarction in Boluo County People's Hospital from June 2013 to June 2016 were randomly divided into control and treatment groups, and each group had 52 cases. Patients in the control group were given routine treatment, including dehydration to reduce intracranial pressure, using aspirin anticoagulant, intravenous thrombolysis with urokinase or alteplase, improving cerebral circulation with edaravone, taking brain protective agent, and treatment of symptomatic primary disease according to patients' conditions. Patients in the treatment group were po administered with Butylphthalide Soft Capsules on the basis of the control group, 0.2 g/time, twice daily. Patients in two groups were treated for 2 weeks. After treatment, the clinical efficacies were evaluated, and NHISS score, Barthel index, blood rheology, IMT, and RI in two groups were compared. Results After treatment, the clinical efficacies in the control and treatment groups were 69.23% and 90.38%, respectively, and there was difference between two groups (P<0.05). After treatment, the levels of whole blood viscosity, plasma viscosity, and fibrinogen in two groups were significantly decreased, but the hematocrit in two groups was significantly increased, and the difference was statistically significant in the same group (P<0.05). And the observational indexes in the treatment group were significantly better than those in the control group, with significant difference between two groups (P<0.05). After treatment, the NIHSS scores in two groups were significantly decreased, but the Barthel indexes in two groups were significantly increased, and the difference was statistically significant in the same group (P<0.05). And the observational indexes in the treatment group were significantly better than those in the control group, with significant difference between two groups (P<0.05). After treatment, the IMT and RI in two groups were significantly decreased, and the difference was statistically significant in the same group (P<0.05). And the observational indexes in the treatment group were significantly lower than those in the control group, with significant difference between two groups (P<0.05). Conclusion Butylphthalide Soft Capsules has clinical curative effect in treatment of acute cerebral infarction, can significantly improve neurologic impairment, improve the life quality of, decrease blood viscosity, and improve carotid atherosclerosis, which has a certain clinical application value.
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