参麦注射液联合长春西汀治疗脑梗死的临床研究  

Clinical research of Shenmai Injection combined with Vinpocetine in the treatment of cerebral infarction

作　　者：陈红英[1] 郭俐宏[2] 王文杰[1] 李英[1] 李贤玉[3] 熊顺华[3] 

机构地区：[1]湖北省十堰市太和医院(附属湖北医药学院)骨2科,湖北十堰442000 [2]湖北省十堰市太和医院(附属湖北医药学院)针灸科,湖北十堰442000 [3]湖北医药学院生理教研室,湖北十堰442000

出　　处：《中国医药导报》2015年第18期126-129,共4页China Medical Herald

摘　　要：目的：观察参麦注射液联合长春西汀治疗脑梗死的临床效果，并分析其作用机制。方法收集湖北省十堰市太和医院2013年10月~2014年5月收治的脑梗死患者212例，采用随机数字表将其分为对照组、实验组，各106例。对照组按常规治疗方法口服拜阿司匹林并静脉滴注长春西汀注射液；实验组口服拜阿司匹林，静脉滴注长春西汀注射液＋参麦注射液；采用TCD脑血流仪动态观测两组患者治疗前及治疗后14 d局部脑血流（LCBF），记录治疗前及治疗14 d后两组纤维蛋白原、血小板聚集率、全血高切黏度、全血低切黏度、血细胞比容等血液流变学指标，计算欧洲卒中评分（ESS）及治愈率。结果实验组能显著增加LCBF[（81.08±6.11）mL/（100g＆#183;min）]，降低纤维蛋白原[（2.08±0.17）g/L]、血小板聚集率[（0.61±0.04）%]、全血高切黏度[（5.01±0.27）mPa.s]、全血低切黏度[（8.92±0.75）mPa·s]、血细胞比容[（40.35±4.22）%]等血液流变学各指标，明显提高ESS评分[（76.73±5.45）分]及治愈率（91.51%），与对照组及本组治疗前比较，差异均有统计学意义（均P〈0.05）。结论参麦注射液联合长春西汀具有增加脑梗死患者LCBF、改善血液流变学各指标、促进患者神经功能恢复、提高治愈率的作用。其作用机制可能是合并用药刺激脑梗死患者血管内皮细胞释放组织纤溶酶而降低纤维蛋白原，同时抑制凝血酶源活性，促进血栓溶解以降低血液黏稠度进而阻止血栓形成，改善微循环，增加脑血流量而达到提高治愈率的目的，两药联合应用具有明显的药物协同作用。Objective To observe the clinical effect of Shenmai Injection combined with Vinpocetine in the treatment of cerebral infarction, and to analyze the mechanism. Methods 212 patients with cerebral infarction admitted to Taihe Hospital of Shiyan City from October 2013 to May 2014 were selected and they were divided into control group and ex-perimental group according to random number table, with 106 cases in each group. The control group was treated with oral administration of Aspirin and intravenous infusion of Vinpocetine Injection according to conventional therapy. The experimental group was treated with oral administration of Aspirin and intravenous infusion of Vinpocetine Injection and Shenmai Injection. The local cerebral blood flow （LCBF） of the two groups before treatment and after treatment for 14 days was monitored by TCD cerebral blood flow meter. The hemorheology indexes of fibrinogen, platelet aggregation rate, high shear viscosity, low shear viscosity of the whole blood and hematokrit before treatment and after treatment for 14 days were recorded. The European stroke scale （ESS） and cure rate were calculated. Results The experimental group could significantly increase LCBF [（81.08±6.11） mL/（100g＆#183;min）], decrease the blood rheological indexes of fibrinogen [（2.08±0.17） g/L], platelet aggregation rate [（0.61±0.04）%], high shear viscosity [（5.01±0.27） mPa·s], low shear viscosity [（8.92±0.75） mPa·], haematocrit [（40.35±4.22）%], improve ESS scores [（76.73±5.45） points] and cure rate （91.51%）, which had statistically significant differences compared with control group and before treatment （all P〈0.05）. Conclu-sion Shenmai Injection combined with Vinpocetine can increase LCBF, improve hemorheology indexes, promote the re-covery of nerve function and en hance the cure rate of patients with cerebral infarction. The mechanism of the role may be the combination of the two drugs has a synergistic effect on degradation fibrinogen and inhibition of thro

关 键 词：参麦注射液 长春西汀 脑梗死 血液流变学 局部脑血流 药物协同作用 

分 类 号：R743.3[医药卫生—神经病学与精神病学]