摘要
目的探讨丹灯通脑胶囊联合长春西汀治疗脑梗死恢复期的临床效果。方法选取2018年1月—2019年6月北京怀柔医院收治的100例脑梗死恢复期患者,随机分为对照组和治疗组,每组各50例。对照组口服长春西汀片,5mg/次,3次/d,餐时服用。治疗组在对照组基础上口服丹灯通脑胶囊,4粒/次,3次/d。两组均连续治疗8周。比较两组临床疗效,治疗前后微循环相关指标[血小板最大聚集率(MAR)、血浆黏度(PV)、红细胞变形指数(RDI)、纤维蛋白原(FIB)、D-二聚体(D-D)]、脑血流动力学参数[大脑中动脉平均血流速度(Vm)、阻力指数(RI)]、相关量表[美国国立卫生院卒中量表(NIHSS)、脑卒中自我效能问卷(SSEQ)]评分及血清超氧化物歧化酶(SOD)、丙二醛(MDA)、髓鞘碱性蛋白(MBP)水平变化。结果治疗组总有效率90.0%显著高于对照组74.0%,两组总有效率比较差异有统计学意义(P<0.05)。两组治疗后MAR、PV、血浆FIB、D-D水平均显著低于治疗前(P<0.05),但RDI均显著升高(P<0.05);治疗后,治疗组以上微循环相关指标的改善效果均更显著(P<0.05)。两组治疗后大脑中动脉Vm、SSEQ总分均显著增多(P<0.05),但大脑中动脉RI和NIHSS评分均显著降低(P<0.05);但治疗后,治疗组大脑中动脉Vm、RI及NIHSS评分、SSEQ总分的改善效果均显著优于对照组(P<0.05)。治疗后,两组血清SOD水平较治疗前均显著增高(P<0.05),而血清MDA、MBP水平均显著下降(P<0.05);但治疗组这些指标改善更显著(P<0.05)。结论丹灯通脑胶囊联合长春西汀治疗脑梗死恢复期的整体疗效良好,能进一步改善机体微循环,纠正脑循环障碍,减轻体内氧化应激,恢复损伤神经功能,提高患者自我效能感,具有一定的临床推广应用价值.
Objective To investigate the clinical effect of Dandeng Tongnao Capsules combined with vinpocetine in treatment of convalescent period of cerebral infarction. Methods A total of 100 patients with convalescent period of cerebral infarction admitted to Beijing Huairou Hospital from January 2018 to June 2019 were randomly divided into control group(n=50) and treatment group(n=50). The control group was po administered with Vinpocetine Tablets, 5 mg/time, three times daily. The treatment group was po administered with Dandeng Tongnao Capsules on the basis of the control group, 4 grains/time, three times daily. All patients were treated for 8 weeks. The clinical efficacy was compared between the two groups. The changes of microcirculation related indicators [maximal platelet aggregation rate(MAR), plasma viscosity(PV), red blood cell deformation index(RDI), fibrinogen(FIB), D-dimer(D-D)], cerebral hemodynamic parameters [mean middle cerebral artery mean blood flow velocity(Vm), resistance index(RI)], related scale [National Institute of Health Stroke Scale(NIHSS), Stroke Self-Efficacy Questionnaire(SSEQ)] score and serum superoxide dismutase(SOD), malondialdehyde(MDA), myelin basic protein(MBP) before and after treatment in two groups were compared. Results The total effective rate of the treatment group 90.0% was significantly higher than that of the control group 74.0%, and there were differences between two groups(P < 0.05). After treatment, MAR, PV, FIB and D-D levels in both groups were significantly lower than before treatment(P < 0.05), but RDI levels were significantly higher in both groups(P < 0.05). After treatment, the improvement of microcirculation-related indicators was more significant in the treatment group and above(P < 0.05). The Vm of the middle cerebral artery and SSEQ scores in two groups increased significantly after treatment(P < 0.05), but RI of the middle cerebral artery and NIHSS scores decreased significantly(P < 0.05). However, after treatment, the improvement effect of Vm, RI, NIHSS score
作者
张文会
刘华
ZHANG Hui-wen;LIU Hua(Department of Neurology,Beijing Huairou Hospital,Beijing 101400,China;Department of Neurology,Xuanwu Hospital Capital Medical University,Beijing 100053,China)
出处
《现代药物与临床》
CAS
2020年第6期1135-1140,共6页
Drugs & Clinic
