摘要
目的:观察羚角钩藤汤加减联合阿替普酶静脉溶栓治疗急性缺血性脑卒中(AIS)的临床疗效。方法:回顾选取2014年3月~2017年7月我院收治的96例AIS患者,根据治疗方案分为观察组(n=48)与对照组(n=48)。对照组给予阿替普酶静脉溶栓治疗,观察组在上述基础上联合羚角钩藤汤加减治疗。对比两组临床疗效、治疗前后神经功能缺损程度(NIHSS评分)、血液流变学指标[全血黏度(高切、低切)、血浆黏度、血浆纤维蛋白原(FIB)]变化,治疗结束后随访3个月,对比两组日常生活活动能力(ADL评分)、肢体运动功能(FMA评分)。结果:(1)临床疗效:观察组临床总有效率95. 83%(46/48)高于对照组83. 33%(40/48)(P<0. 05);(2)神经功能缺损程度:治疗前两组NIHSS评分比较无显著差异(P>0. 05),治疗后两组NIHSS评分较治疗后降低(P<0. 05),且观察组NIHSS评分低于对照组(P<0. 05);(3)血液流变学:治疗前两组全血高切黏度、全血低切黏度、血浆黏度及血浆FIB水平比较无显著差异(P>0. 05),治疗后两组全血高切黏度、全血低切黏度、血浆黏度及血浆FIB水平较治疗前降低(P<0. 05),且观察组全血高切黏度、全血低切黏度、血浆黏度及血浆FIB水平低于对照组(P<0. 05);(4)预后:治疗前两组ADL评分及FMA评分比较无显著差异(P>0. 05),治疗后两组ADL评分及FMA评分较治疗前增加(P<0. 05),且观察组ADL评分及FMA评分高于对照组(P<0. 05)。结论:羚角钩藤汤加减联合阿替普酶溶栓治疗AIS疗效显著,有利于改善患者血液流变学及神经功能,对提高日常生活能力及运动功能具有积极意义。
Objective:To investigate the clinical effect of using Modified Lingjiao Gouteng Decoction combined with alteplase thrombolysis in the treatment of acute ischemic stroke (AIS).Methods:A total of 96 cases of AIS patients in our hospital from March 2014 to July 2017 were retrospectively selected and divided into observation group (n =48)and controlled group (n = 48)according to the treatment plan.The controlled group was treated with intravenous alteplase thrombolysis,and the observation group was treated with Modified Lingjiao Gouteng Decoction on the basis of the above treatment.The clinical efficacy,the degree of nerve function defect (NIHSS score)before and after treatment,changes of hemorheological indexes [whole blood viscosity (high and low shear),plasma viscosity,plasma fibrinogen (FIB)]of the two groups were compared.After 3 months of follow -up,the daily living ability (ADL score)and limb movement function (FMA score)were compared between the two groups.Resuits:(1)Clinical efficacy:the total effective rate of the observation group was 95.83%(46/48)higher than that of the controlled group 83.33%(40/48)(P <0.05).(2)Degree of nerve function defect:there was insignificant difference in NIHSS scores between the two groups before treatment (P >0.05).After treatment,the NIHSS scores of the two groups were lower than those before the treatment (P <0.05),and the NIHSS score of the observation group was -lower than that of the controlled group (P <0.05).(3)Hemorheology:there was insignificant difference in the whole blood viscosity,plasma viscosity and whole blood low shearviscosity,plasma level of FIB between the two groups before treatment (P <0.05).After treatment,the whole blood viscosity,plasma viscosity and whole blood low shear viscosity,plasma level of FIB of the two groups were lower than those before the treatment (P <0.05),and the whole blood viscosity,plasma viscosity and whole blood low shear viscosity,plasma level of FIB of the observation group were lower than those of the controlled group (P <0.05).(
作者
刘琼
林惠昌
彭观球
LIU Qiong;LIN Huichang;PENG Guanqiu(Emergency Department,the People's Hospital of Huidong County ,Huizhou Guangdong 516300,China)
出处
《四川中医》
2018年第11期128-131,共4页
Journal of Sichuan of Traditional Chinese Medicine
