[關(guān)鍵詞]
[摘要]
目的 探討丁苯酞氯化鈉注射液治療急性缺血性腦梗死的臨床療效。方法 選取2015年3月-2017年3月湖北省中醫(yī)院神經(jīng)內(nèi)科收治的急性缺血性腦梗死患者100例為研究對象,所有患者隨機(jī)分為對照組和治療組,每組各50例。對照組第1天口服阿司匹林腸溶片300 mg、阿托伐他汀鈣片40 mg、硫酸氫氯吡格雷片300 mg;從第2天起劑量調(diào)整為:阿司匹林腸溶片100 mg,1次/d,阿托伐他汀鈣片40 mg,1次/晚,硫酸氫氯吡格雷片75 mg,1次/d。治療組在對照組基礎(chǔ)上靜脈滴注丁苯酞氯化鈉注射液,在發(fā)病后48 h內(nèi)開始給藥,25 mg/次,2次/d,滴注時間不少于50 min,兩次用藥間隔時間控制在6 h左右。兩組患者均連續(xù)治療14 d。觀察兩組的臨床療效,比較兩組的美國國立衛(wèi)生研究院卒中量表(NIHSS)評分和梗死灶體積。對出院患者進(jìn)行病情跟蹤隨訪3個月,比較兩組的不良反應(yīng)發(fā)生率。結(jié)果 治療后,對照組和治療組的總有效率分別為78.00%、92.00%,兩組比較差異有統(tǒng)計學(xué)意義(P<0.05)。治療8、14 d后,兩組NIHSS評分均顯著降低,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NIHSS評分明顯低于對照組,兩組比較差異有統(tǒng)計學(xué)意義(P<0.05)。治療8、14 d后,兩組梗死灶體積均顯著減小,同組治療前后比較差異有統(tǒng)計學(xué)意義(P<0.05);且治療組梗死灶體積明顯小于對照組,兩組比較差異具有統(tǒng)計學(xué)意義(P<0.05)。對照組、治療組不良反應(yīng)發(fā)生率分別為18.00%、6.00%,兩組不良反應(yīng)發(fā)生率比較差異有統(tǒng)計學(xué)意義(P<0.05)。結(jié)論 丁苯酞氯化鈉注射液治療急性缺血性腦梗死具有較好的臨床療效,可降低NIHSS評分,減小梗死灶體積,安全性較好,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 and Sodium Chloride Injection in treatment of acute ischemic cerebral infarction. Methods Patients (100 cases) with acute ischemic cerebral infarction in Department of Neurology of Hubei Provincial Hospital of Traditional Chinese Medicine from March 2015 to March 2017 were randomly divided into control and treatment groups, and each group had 50 cases. Patients in the control group were po administered with Aspirin Enteric-coated Tablets (300 mg), Atorvastatin Calcium Tablets (40 mg), and Clopidogrel Hydrogen Sulphate Tablets (300 mg) on day 1; and from the second day, the dose was adjusted to Aspirin Enteric-coated Tablets 100 mg, once daily, Atorvastatin Calcium Tablets 40 mg, once every night, and Clopidogrel Hydrogen Sulphate Tablets 75 mg, once daily. Patients in the treatment group were iv administered with Butylphthalide and Sodium Chloride Injection on the basis of the control group, 25 mg/time, twice daily, infusion time not less than 50 min, dosing interval about 2 h. Patients in two groups were treated for 14 d. After treatment, the clinical efficacies were evaluated, and NIHSS scores and infarction volume in two groups were compared. The patients were followed up for 3 months, and the incidences of adverse reactions in two groups were compared. Results After treatment, the clinical efficacies in the control and treatment groups were 78.00% and 92.00%, respectively, and there was difference between two groups (P<0.05). After treatment for 8 and 14 d, the NIHSS scores in two groups were significantly decreased, and the difference was statistically significant in the same group (P<0.05). And the NIHSS score in the treatment group was significantly lower than those in the control group, with significant difference between two groups (P<0.05). After treatment for 8 and 14 d, the infarction volumes in two groups were significantly decreased, and the difference was statistically significant in the same group (P<0.05). And the infarction volume in the treatment group was significantly smaller than those in the control group, with significant difference between two groups (P<0.05). The incidences of adverse reactions in the control and treatment groups were 18.00% and 6.00%, respectively, and there was difference between two groups (P<0.05). Conclusion Butylphthalide and Sodium Chloride Injection has clinical curative effect in treatment of acute ischemic cerebral infarction, can decrease NIHSS score, reduce infarction volume, with good safety, which has a certain clinical application value.
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