镇肝熄风汤联合替罗非班治疗进展性脑梗死临床研究  

Clinical Study on Zhen’gan Xifeng Tang Combined with Tirofiban for Progressive Cerebral Infarction

作　　者：王文艳 王松龄[2] 王丽萍 WANG Wenyan;WANG Songling;WANG Liping

机构地区：[1]开封市人民医院神经内科,河南开封475000 [2]河南中医药大学第二附属医院脑病科,河南郑州450002

出　　处：《新中医》2020年第24期41-44,共4页New Chinese Medicine

基　　金：开封市科技发展资助项目(2003065)。

摘　　要：目的:观察镇肝熄风汤联合替罗非班治疗进展性脑梗死的临床疗效。方法:将90例进展性脑梗死患者按随机数字表法分为观察组与对照组各45例。2组均给予抗血小板聚集、营养脑细胞、降脂稳定斑块、清除自由基等基础治疗,对照组在此基础上加用替罗非班注射液治疗,观察组在对照组基础上联合镇肝熄风汤治疗,2组均治疗14 d。比较2组临床疗效,观察2组治疗前后中医证候积分、美国国立卫生研究院卒中量表(NIHSS)评分、改良Rankin量表(mRS)评分、超敏C-反应蛋白(hs-CRP)、白细胞介素-6 (IL-6)水平、血小板聚集率(PAgT)、血小板膜糖蛋白(CD62p)的变化。结果:观察组总有效率为93.33%,对照组总有效率为55.55%,2组比较,差异有统计学意义(P<0.05)。治疗后,2组中医证候积分、NIHSS评分及mRS评分均较治疗前降低(P<0.05),观察组中医证候积分、NIHSS评分及mRS评分均比对照组降低更明显(P<0.05)。治疗后,2组hs-CRP、IL-6水平及PAgT、CD62p均较治疗前降低(P<0.05),观察组hs-CRP、IL-6水平及PAgT、CD62p均较对照组降低更明显(P<0.05)。结论:镇肝熄风汤联合替罗非班治疗进展性脑梗死,可有效改善患者的临床症状,抑制炎症因子释放,减少血小板聚集。Objective: To observe the clinical effect of Zhen’gan Xifeng tang combined with tirofiban for progressive cerebral infarction. Methods: A total of 90 cases of patients with progressive cerebral infarction were divided into the observation group and the control group according to the random number table method,45 cases in each group. Both groups were given basic treatments such as anti-platelet aggregation, nourishing brain cells, lipid-lowering and stable plaques,and scavenging free radicals;the control group was additionally treated with tirofiban injection,and the observation group was additionally treated with Zhen’gan Xifeng tang based on the treatment of the control group. Both groups were treated for14 days. The clinical effect in the two groups was compared;before and after treatment, the changes in the scores of Chinese medicine syndromes,National Institute of Health Stroke Scale(NIHSS),modified Rankin Scale(mRS),hypersensitive C-reactive protein(hs-CRP), interleukin-6(IL-6), platelet aggregation rate(PAgT), and platelet membrane glycoprotein(CD62 p) in the two groups were observed. Results:The total effective rate was 93.33% in the observation group and 55.55%in the control group,the difference being significant(P<0.05). After treatment,the scores of Chinese medicine syndromes,NHISS and mRS in the two groups were decreased when compared with those before treatment(P<0.05),and the decrease in the observation group was more significant than that in the control group(P<0.05). After treatment,the levels of hs-CRP and IL-6 as well as PAgT and CD62 p in the two groups were decreased when compared with those before treatment(P<0.05),and the decrease in the observation group was more significant than that in the control group(P<0.05). Conclusion:The therapy of Zhen’gan Xifeng tang combined with tirofiban for progressive cerebral infarction can effectively improve the clinical symptoms,inhibit the release of inflammatory factors and reduce the platelet aggregation.

关 键 词：进展性脑梗死 镇肝熄风汤 替罗非班 美国国立卫生研究院卒中量表 改良Rankin量表 炎症因子 血小板聚集率 血小板膜糖蛋白 

分 类 号：R743.3[医药卫生—神经病学与精神病学]