复元汤在超早期溶栓治疗急性期脑梗死中的应用价值  

Application value of Fuyuan Decoction in the treatment of acute cerebral infarction by super-early thrombolysis

作　　者：陈观太[1] 陈旭明[1] 宁观林[1] CHEN Guan-tai;CHEN Xu-ming;NING Guan-lin(Department of Neurology,Wuchuan People's Hospital,Zhanjiang524500,Guangdong,CHINA)

机构地区：[1]吴川市人民医院神经内科,广东湛江524500

出　　处：《海南医学》2019年第8期980-982,共3页Hainan Medical Journal

基　　金：广东省湛江市科技计划项目(编号:2018B01022)

摘　　要：目的观察复元汤联合阿替普酶超早期溶栓治疗急性脑梗死的临床疗效。方法选择吴川市人民医院神经内科2016年1月至2018年10月收治的106例急性脑梗死患者为研究对象,根据随机数表法将患者分为观察组和对照组,每组53例,对照组患者接受静脉应用阿替普酶超早期溶栓治疗,观察组患者在此基础上应用复元汤,疗程均为2周。分别于治疗前及治疗第15天对两组患者采用美国国立卫生院脑卒中量表(NIHSS)、Barthel指数评估量表(BI)进行评分,同时测定血清C反应蛋白(CRP)、白细胞介素-6 (IL-6)水平。结果治疗后,观察组患者的NIHSS评分为(6.41±1.92)分,明显低于对照组的(7.83±2.39)分,BI评分为(68.46±19.16)分,明显高于对照组的(60.25±15.74)分,差异均有统计学意义(P<0.05);观察组患者的血清CRP、IL-6水平分别为(11.02±2.31) mg/L、(19.61±6.38) ng/L,明显低于对照组的(14.49±3.14) mg/L、(24.16±6.23) ng/L,差异均有统计学意义(P<0.05);观察组患者的治疗总有效率为84.91%,明显高于对照组的71.70%,差异有统计学意义(P<0.05)。结论阿替普酶超早期溶栓是治疗急性脑梗死的有效方法,联合应用复元汤治疗可进一步降低患者血清炎症因子水平,改善神经功能缺损程度和日常生活活动能力,提高临床疗效。Objective To explore the clinical value of Fuyuan Decoction combined with ateplase in ultra-early thrombolysis for acute cerebral infarction.Methods A total of 106 patients with acute cerebral infarction treated in Department of Neurology,Wuchuan People's Hospital from January 2016 to October 2018 were selected as the research subjects.According to the random number table method,the patients were divided into an observation group and a control group,with 53 patients in each group.The control group received intravenous application of alteplase for ultra-early thrombolytic therapy,while the observation group applied Fuyuan Decoction plus alteplase,both for 2 weeks.NIH Stroke Scale (NIHSS) and Barthel Index (BI) Assessment Scale were used to evaluate the patients in the two groups before treatment and at the 15th day of treatment respectively.The serum CRP and IL-6 were measured at the same time. Results After treatment,the NIHSS score of the observation group was 6.41±1.92,significantly lower than 7.83±2.39 of the control group,and the BI score was 68.46±19.16,significantly higher than 60.25±15.74 of the control group,both with statistically significant difference (P<0.05).The serum CRP and IL-6 in the observation group were (11.02±2.31) mg/L,(19.61±6.38) ng/L,which were significantly lower than (14.49±3.14) mg/L,(24.16±6.23) ng/L in the control group (P< 0.05).The total effective rate of the observation group (84.91%) was significantly higher than that of the control group (71.70%),and the difference was statistically significant (P<0.05).Conclusion Ultra-early thrombolysis with ateplase is an effective method for the treatment of acute cerebral infarction.Combination of Fuyuan Decoction and ateplase can further reduce the level of serum inflammatory factors,improve the degree of neurological deficit and the ability of daily living activities,and improve the clinical efficacy.

关 键 词：急性脑梗死 静脉溶栓 超早期溶栓 阿替普酶 复元汤 疗效 

分 类 号：R743.33[医药卫生—神经病学与精神病学]