银杏二萜内酯葡胺、丁苯酞联合依达拉奉治疗痰瘀阻络型脑梗死的有效性及安全性分析  

The curative effects and safety of combination medication of ginkgo diterpene lactone glucamine,butylphthalide and edaravone in treatment of phlegm and blood stasis blocking collateral type cerebral infarction

作　　者：胡建萍[1] 郭佳[1] 张廷华[1] 金晶[1] 陈志剑 王俊成 HU Jianping;GUO Jia;ZHANG Tinghua(The Second Hospital of Lanzhou University,Gansu,Lanzhou 730030,China)

机构地区：[1]兰州大学第二医院,兰州市730030 [2]甘肃省舟曲县人民医院 [3]甘肃省兰州市新区中川镇卫生院

出　　处：《河北医药》2021年第2期219-222,共4页Hebei Medical Journal

基　　金：甘肃省自然科学基金项目(编号:17JR5RA240)。

摘　　要：目的银杏二萜内酯葡胺、丁苯酞、依达拉奉联合用药治疗痰瘀阻络型脑梗死的疗效及安全性。方法对兰州市兰州大学第二医院2018年3月至2019年5月92例脑梗死患者进行研究,采用随机数字表将入组患者均分为对照组(丁苯酞和依达拉奉治疗)和试验组(使用银杏二萜内酯葡胺、丁苯酞、依达拉奉进行联合治疗),每组46例。比较2组患者治疗前和治疗后(28 d)血清中GABA、Gly、Hcy、NE、MPO、TNF-α的含量,2组NIHSS、Fugl-Meyer、Barthel评分,临床疗效。结果治疗后比较,试验组[(7.96±4.52)分]患者NIHSS评分低于对照组[(12.17±3.07)分],试验组患者Fugl-Meyer评分[(74.72±6.58)分]、Barthel评分[(90.18±21.05)分]显著高于对照组[(61.08±5.43)分、(70.05±6.37)分],差异均有统计学意义(P<0.05)。治疗后比较,试验组患者GABA[(33.40±2.53)pg/ml]、Gly[(4.63±0.44)pg/ml]、Hcy[(175.17±15.43)pg/ml]含量高于对照组[(30.58±1.95)pg/ml、(3.89±0.38)pg/ml、(127.02±9.89)pg/ml],差异均有统计学意义(P<0.05)。治疗后比较,试验组患者NE[(77.91±6.19)pg/ml]含量高于对照组[(64.17±5.54)pg/ml]、试验组患者MPO[(245.35±7.27)U/g]、TNF-α[(109.41±3.28)pg/mg]含量低于对照组[(384.05±8.84)U/g、(144.57±4.63)pg/mg],差异均有统计学意义(P<0.05)。2组患者疗效构成差异有统计学意义(P<0.05)。对照组有效率95.66%、试验组93.48%,差异无统计学意义(P>0.05)。对照组并发症发生18例、试验组5例,并发症发生率差异有统计学意义(P<0.05)。结论痰瘀阻络型脑梗死患者使用银杏二萜内酯葡胺、丁苯酞、依达拉奉进行联合治疗,能显著改善患者神经功能、肢体运动能力及生活能力,其疗效确切且安全性高。Objective To investigate the curative effects and safety of combination medication of ginkgo diterpene lactone glucamine,butylphthalide and edaravone in treatment of phlegm and blood stasis blocking collateral type cerebral infarction.Methods A total of 92 patients with cerebral infarction who were treated in our hospital from March 2018 to May 2019 were enrolled in the study,who were divided into control group and experimental group,with 46 cases in each group.The patients in control group were treated by combination medication of butylphthalide and edaravone,however,the patients in experimental group were treated by combination medication of ginkgo diterpene lactone meglumine,butylphthalide and edaravone.The serum levels of GABA,Gly,Hcy,NE,MPO and TNF-αbefore treatment and after 28-day treatment were observed and compared between the two groups.Moreover the therapeutic effects,NIHSS score,Fugl-Meyer score,Barthel score were observed and compared between the two groups.Results After treatment,the NIHSS scores in experimental group were significantly lower than those in control group(P<0.05).however,the Fugl-Meyer scores and Barthel scores in experimental group were significantly higher than those in control group(P<0.05).After treatment,the levels of GABA,Gly,Hcy and NE in experimental group were significantly higher than those in control group(P<0.05).However the levels of MPO,TNF-αin experimental group were significantly lower than those in control group(P<0.05).In addition the effective rate was 95.66%in the control group and 93.48%in in experimental group,there was no significant difference between the two groups(P>0.05).Conclusion The combination medication of ginkgo diterpene glucamine,butylphthalide and edaravone in treatment of phlegm and blood stasis blocking collateral type cerebral infarction can significantly improve the nerve function,limb movement ability and living ability of patients,with definite therapeutic effects and safety.

关 键 词：银杏二萜内酯葡胺 丁苯酞 依达拉奉 联合用药 痰瘀阻络型 脑梗死 疗效分析 

分 类 号：R743[医药卫生—神经病学与精神病学]