醒脑静注射液联合丁苯酞治疗大脑中动脉供血区梗死的临床观察
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篇名: 醒脑静注射液联合丁苯酞治疗大脑中动脉供血区梗死的临床观察
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摘要: 目的:探讨醒脑静注射液联合丁苯酞对大脑中动脉供血区梗死患者神经功能、认知功能、凝血功能、生活活动能力的影响及安全性。方法: 选取2014年6月-2015年12月于武汉大学人民医院就诊的大脑中动脉供血区梗死患者106例为研究对象,按照随机数字表法分为对照组和观察组,各53例。除常规对症治疗外,对照组患者给予丁苯酞软胶囊0.2 g,po,tid;观察组患者在对照组基础上给予醒脑静注射液20 mL加至0.9%氯化钠注射液250 mL,ivgtt,qd。两组患者均持续治疗14 d。观察两组患者治疗前后神经功能[按美国国立卫生研究院卒中量表(NIHSS)和临床神经功能缺损评分标准(NFDS)评分]、认知功能[按蒙特利尔认知量表(MoCA) 和简易精神状态评价量表(MMSE)评分]、凝血功能指标[凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、血浆纤维蛋白原(FIB)]、日常生活活动能力量表(BI)评分,并记录继发远隔损害和不良反应发生情况。结果:脱落病例共8例,其中对照组3例、观察组5例。治疗前,两组患者神经功能评分、认知功能评分、凝血功能指标、BI评分比较,差异均无统计学意义(P>0.05)。治疗后,两组患者NIHSS、NFDS评分和FIB水平均较治疗前明显降低,且观察组明显低于对照组,差异均有统计学意义(P<0.05);两组患者MoCA、MMSE、BI评分均较治疗前明显升高,PT、APTT均较治疗前明显延长,且观察组明显高于或长于对照组,差异均有统计学意义(P<0.05)。观察组患者的继发远隔损害发生率(11.3%)明显低于对照组(41.5%),差异有统计学意义(P<0.05)。两组患者不良反应发生率比较,差异无统计学意义(P>0.05)。结论:醒脑静注射液联合丁苯酞治疗大脑中动脉供血区梗死,可降低远隔损害发生风险,促进患者神经功能、认知功能恢复,改善凝血功能和生活活动能力,且安全性较高。
ABSTRACT: OBJECTIVE: To investigate the effects and safety of Xingnaojing injection combined with butylphthalide on neurological function, cognitive function, coagulation function and living activity. METHODS: A total of 106 patients with middle cerebral artery infarction in Wuhan University People’s Hospital during Jun. 2014-Dec. 2015 were divided into control group and observation group according to random number table, with 53 cases in each group. Besides routine symptomatic treatment, control group was given Butylphthalide soft capsules 0.2 g, po, tid. Observation group was additionally given Xingnaojing injection 20 mL added into 0.9% Sodium chloride injection 250 mL, ivgtt, qd. Both groups were treated for 14 d. The neurological function score (NIHSS, NFDS), cognitive function score (MoCA, MMSE), coagulation function indexes (PT, APTT, FIB), BI score were observed in 2 groups before and after treatment. The occurrence of secondary remote damage and ADR were recorded. RESULTS: Eight patients withdrew from the study, including 3 patients of control group and 5 of observation group. Before treatment, there was no statistical significance in neurological function scores (NIHSS, NFDS), cognitive function scores (MoCA, MMSE), coagulation function indexes or BI scores between 2 groups (P>0.05). After treatment, NIHSS, NFDS scores and FIB of 2 groups were decreased significantly compared to before treatment, and the observation group was significantly lower than the control group, with statistical significance (P<0.05). MoCA, MMSE, BI scores in 2 groups were increased significantly, and PT and APTT in 2 groups were prolonged significantly, and the observation group was significantly higher or longer than the control group, with statistical significance (P<0.05). The incidence of secondary remote damage in observation group (11.3%) was significantly lower than control group (41.5%), with statistical significance (P<0.05). There was no statistical significance in the incidence of ADR between 2 groups (P>0.05). CONCLUSIONS: For middle cerebral artery infarction, the application of Xingnaojing injection combined with butylphthalide can reduce the risk of remote damage, promote the recovery of neurological function and cognitive function, and improve coagulation function and living activity with good safety.
期刊: 2017年第28卷第17期
作者: 张子健,刘志超,何景华
AUTHORS: ZHANG Zijian,LIU Zhichao,HE Jinghua
关键字: 醒脑静注射液;丁苯酞;大脑中动脉;梗死;远隔损害;神经功能;认知功能; 凝血功能;生活活动能力
KEYWORDS: Xingnaojing injection; Butylphthalide; Middle cerebral artery; Infarction; Remote damage; Neurological function; Cognitive function; Coagulation function; Living activity
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