丹灯通脑胶囊联合丁苯酞治疗急性脑梗死的临床研究  

Clinical study of Dandeng Tongnao Capsules combined with butylphthalide in treatment of acute cerebral infarction

作　　者：李尽义[1] 贾东佩[1] 徐明超[1] 吴红举[1] 白方会 LI Jinyi;JIA Dongpei;XU Mingchao;WU Hongju;BAI Fanghui(Department of Neurorehabilitation,Nanyang Central Hospital,Nanyang 473000,China)

机构地区：[1]南阳市中心医院神经康复科,河南南阳473000

出　　处：《药物评价研究》2021年第5期1047-1052,共6页Drug Evaluation Research

基　　金：南阳市卫生和计划生育委员会科研项目(ZD201778)。

摘　　要：目的探讨丹灯通脑胶囊联合丁苯酞治疗急性脑梗死的临床效果。方法选取2018年8月—2020年7月南阳市中心医院收治的86例急性脑梗死患者,按照治疗方法将患者分成对照组(n=43)和观察组(n=43)。对照组静脉滴注丁苯酞氯化钠注射液,25 mg/次,每次滴注时间≥50 min,2次/d(用药时间间隔≥6 h)。观察组在对照组基础上口服丹灯通脑胶囊,1.4 g/次,3次/d。两组均连续治疗14 d。比较两组临床疗效及安全性,观察两组治疗前后脑卒中自我效能问卷(SSEQ)评分、美国国立卫生研究院卒中量表(NIHSS)评分、大脑中动脉血流动力学参数[平均血流速度(V_(m))、阻力指数(RI)]及血浆D-二聚体(D-D)、纤维蛋白原(FIB)水平和血清血管内皮生长因子(VEGF)、血管性血友病因子(vWF)、多胺氧化酶(PAO)、金属基质蛋白酶(MMP)-9水平变化,并进行统计分析。结果治疗后,观察组总有效率为93.0%,较对照组的76.7%显著升高(P<0.05)。两组治疗后SSEQ评分均显著增高,NIHSS评分则均显著降低(P<0.05);且治疗后,观察组SSEQ评分显著高于对照组,NIHSS评分显著低于对照组(P<0.05)。治疗后,两组大脑中动脉V_(m)较同组治疗前均显著增加,大脑中动脉RI及血浆FIB、D-D水平均较本组治疗前显著降低(P<0.05);且与同期对照组比较,观察组治疗后大脑中动脉V_(m)显著更高,大脑中动脉RI及血浆FIB、D-D水平均显著更低(P<0.05)。两组治疗后血清VEGF、vWF、PAO及MMP-9水平均较本组治疗前显著下降(P<0.05);且治疗后,观察组比对照组对血清VEGF、vWF、PAO和MMP-9水平的降低作用更显著(P<0.05)。结论丹灯通脑胶囊联合丁苯酞治疗急性脑梗死的整体疗效显著,能安全有效地改善患者脑血流动力学状态,抑制血栓形成,减轻血管内皮损伤,保护神经功能,提高患者生活质量,值得临床推广。Objective To investigate the clinical effect of Dandeng Tongnao Capsules combined with butylphthalide in treatment of acute cerebral infarction.Methods A total of 86 patients with acute cerebral infarction admitted to Nanyang Central Hospital from August 2018 to July 2020 were selected,and the patients were divided into control group(n=43)and observation group(n=43)according to treatment methods.Patients in the control group were iv administered with Butylphthalide and Sodium Chloride Injection,25 mg/time,each infusion time ≥50 min,twice daily(medication time interval ≥6 h).Patients in the observation group were po administered with Dandeng Tongnao Capsule on the basis of control group,1.4 g/time,three times daily.Both groups were treated continuously for 14 d.Clinical efficacy and safety of two groups were compared.Observe of SSEQ scores,NIHSS score,arterial blood flow in the brain mechanics parameters(V_(m),RI)and plasma D-D,FIB levels,and serum VEGF,vWF,PAO,and MMP-9 before and after the treatment between two groups were analyzed statistically.Results After treatment,the total effective rate of the observation group was 93.0%,which was significantly higher than 76.7%of the control group(P<0.05).After treatment,SSEQ score in two groups was significantly increased,while NIHSS score was significantly decreased(P<0.05).After treatment,the SSEQ score in the observation group was significantly higher than that in the control group,and the NIHSS score was significantly lower than that in the control group(P<0.05).After treatment,V_(m) of middle cerebral artery in two groups was significantly increased compared with before treatment,but RI of middle cerebral artery,plasma FIB and D-D levels were significantly decreased compared with before treatment(P<0.05).Moreover,compared with the control group at the same period,V_(m) of middle cerebral artery in the observation group was significantly higher after treatment,RI of middle cerebral artery,plasma FIB and D-D levels were significantly lower(P<0.05).After treatment

关 键 词：丹灯通脑胶囊 丁苯酞 急性脑梗死 脑血流动力学 血管内皮功能 金属基质蛋白酶-9 

分 类 号：R971[医药卫生—药品]