摘要
目的评价中风醒脑液联合依达拉奉注射液治疗急性缺血性脑卒中(acute ischemic stroke,AIS)的疗效。方法将符合入选标准的2020年5月-2021年3月本院AIS患者92例,按病历尾号分为2组,每组46例。2组均给予西医常规疗法治疗,对照组在此基础上静脉滴注依达拉奉注射液,研究组在对照组基础上联合加服中风醒脑液。2组均连续治疗2周。分别于治疗前后采用美国国立卫生研究院卒中量表(National Institute of Health Stroke Scale,NIHSS)评估患者神经功能缺损程度,改良Rankin量表(modified Ranking Scale,mRS)评估患者预后。采用全自动血液流变仪检测全血高切黏度、红细胞压积、全血低切黏度、纤维蛋白原,采用ELISA法检测超敏C反应蛋白(hs-CRP)、IL-6和内皮素-1(ET-1)水平。记录不良反应,评价疾病转归。结果治疗后,研究组mRS评分[(2.06±0.18)分比(2.73±0.23)分,t=15.56]、NIHSS评分[(5.25±2.36)分比(10.61±2.48)分,t=14.58]低于对照组(P<0.01)。治疗后,研究组血清hs-CRP[(9.04±1.98)mg/L比(14.36±2.09)mg/L,t=12.57]、IL-6[(23.14±1.46)ng/L比(39.37±2.51)ng/L,t=12.39]、ET-1[(67.18±13.22)ng/L比(98.14±22.29)ng/L,t=19.37]水平低于对照组(P<0.01);全血高切黏度[(7.53±1.37)mPa·s比(9.24±1.42)mPa·s,t=5.89]、红细胞压积[(0.27±0.06)%比(0.39±0.08)%,t=8.14]、全血低切黏度[(5.92±1.09)mPa·s比(8.35±1.24)mPa·s,t=9.98]、纤维蛋白原[(1.63±0.42)g/L比(2.47±0.58)g/L,t=7.96]低于对照组(P<0.01)。治疗期间,对照组不良反应发生率为8.70%(4/46)、研究组为15.22%(7/46),2组比较差异无统计学意义(χ^(2)=0.93,P=0.335)。治疗后,对照组转归良好率为73.9%(34/46)、研究组为93.5%(43/46),2组比较差异有统计学意义(χ^(2)=6.45,P=0.011)。结论中风醒脑液联合依达拉奉注射液可有效降低AIS患者炎性细胞因子水平,改善血液流变学指标,发挥脑保护作用。
Objective To evaluate the efficacy of Zhongfeng Xingnao liquid combined with conventional treatment for acute ischemic stroke(AIS).Methods A total of 92 patients with AIS in our hospital from May 2020 to March 2021 who met the inclusion criteria were selected and divided into 2 groups according to the end number of the medical records,with 46 cases in each group.Both groups were given conventional western medicine therapy,and the control group added intravenous drip of edaravone injection,and the study group added Zhongfeng Xingnao liquid on the basis of the control group.Both groups were treated continuously for 2 weeks.Before and after treatment,the National Institutes of Health Stroke Scale(NIHSS)and the modified Rankin Scale(mRS)were used to evaluate the degree of neurological deficit and prognosis.The whole blood high-shear viscosity,hematocrit,whole blood low-shear viscosity,fibrinogen were detected by automatic blood rheometer,and the levels of high-sensitivity C-reactive protein(hs-CRP),IL-6 and endothelin-1(ET-1)were detected by ELISA.Adverse events were recorded,and clinical effect rate was evaluated.Results After treatment,the mRS score(2.06±0.18 vs.2.73±0.23,t=15.56)and NIHSS score(5.25±2.36 vs.10.61±2.48,t=14.58)of the study group were significantly lower than those in the control group(P<0.01).The total clinical effective rate was 89.1%(41/46)in the study group and 69.6%(32/46)in the control group,with a statistically significant difference between the two groups(χ^(2)=5.37,P=0.020).After treatment,the serum levels of hs-CRP[(9.04±1.98)mg/L vs.(14.36±2.09)mg/L,t=12.57],IL-6[(23.14±1.46)ng/L vs.(39.37±2.51)ng/L,t=12.39]and ET-1[(67.18±13.22)ng/L vs.(98.14±22.29)ng/L,t=19.37]in the study group were significantly lower than those in the control group(P<0.01).The whole blood high shear viscosity[(7.53±1.37)mPa·s vs.(9.24±1.42)mPa·s,t=5.89],hematocrit[(0.27±0.06)%vs.(0.39±0.08)%,t=8.14],whole blood low shear viscosity[(5.92±1.09)mPa·s vs.(8.35±1.24)mPa·s,t=9.98]and fibrinogen[(1.63±0.42)g/L vs.(2.47±0.58)g/L,t=7.96]were significantly lower than those in the control group(P<0.01).During the treatment period,the incidence of adverse events was 8.70%(4/46)in the control group and 15.22%(7/46)in the study group,and there was no significant difference between the two groups(χ^(2)=0.93,P=0.335).After treatment,the good outcome rate was 73.9%(34/46)in the control group and 93.5%(43/46)in the study group,with a statistically significant difference between the two groups(χ^(2)=6.45,P=0.011).Conclusion The Zhongfeng Xingnao liquid combined with edaravone injection can reduce the level of inflammatory cytokines in patients with AIS,improve hemorheological indicators,and play a role in brain protection.
作者
黄勇
陈勇
张敏
黄宁
郑琰
Huang Yong;Chen Yong;Zhang Min;Huang Ning;Zheng Yan(Department of Pharmacy,Affiliated Hospital of Chengdu University of Traditional Chinese Medicine,Chengdu 610072,China;Department of Emergency,Affiliated Hospital of Chengdu University of Traditional Chinese Medicine,Chengdu 610072,China)
出处
《国际中医中药杂志》
2022年第7期739-743,共5页
International Journal of Traditional Chinese Medicine
基金
四川省中医药管理局科研项目(2017Z109)。
