中医药在缺血性脑卒中溶栓后再复发的干预研究  

A study on TCM intervention on recurrent ischemic stroke after thrombolysis

作　　者：高衍义 高衍生 GAO Yanyi;GAO Yansheng

机构地区：[1]新泰市中医医院,山东新泰271200 [2]宁阳县第一人民医院,山东宁阳271416

出　　处：《中医临床研究》2023年第9期53-55,共3页Clinical Journal Of Chinese Medicine

摘　　要：目的:初步研究临床运用中医药预防缺血性脑卒中静脉溶栓后再复发的有效性。方法:对入组的68例患者采用随机分组的方法,将其分为对照组35例患者:选用常规治疗+静脉溶栓治疗(所选药物为注射用重组组织型纤溶酶原激活剂rtPA,总量按0.9 mg/kg计算,首先给总量的10%,溶于0.9%氯化钠注射液10 mL中,于5 min内完成静脉推注,剩余90%溶于0.9%氯化钠注射液100 mL中,于30~60 min内静脉滴注完成,或注射用尿激酶100万~150万IU,溶于0.9%氯化钠注射液100~200 mL中,持续静脉滴注30 min);观察组33例患者:运用常规治疗+静脉溶栓+中药治疗(在中医辨证论治的基础上遣方用药,中药服用疗程为30~45天),两组均通过电话随访或实地探访形式,逐一了解患者出院后第12、24、36个月脑梗死再复发情况。同时调阅所有入组患者住院病历,查看患者是否存在脑出血、消化道出血、口腔、皮肤黏膜出血及肝、肾功损害等不良事件发生情况,均做详细记录,并将相关数据做统计学处理。结果:两组复发率及不良事件发生率分别经统计学处理χ^(2)=4.64,χ^(2)=4.22,两组均P<0.05,具有显著差异性。结论:中医药对缺血性脑卒中溶栓后可以达到一定的预防复发的作用,并且无明显不良反应,值得同道在临床推广应用。Objective:To study the clinical application of TCM intervention on recurrent ischemic stroke after thrombolysis.Methods:All 68 enrolled patients were randomly divided into the control group of 35 patients,received conventional therapy plus intravenous thrombolysis therapy(the selected drugs were recombinant tissue plasminogen activator rt-PA for injection,the total amount was calculated as 0.9 mg/kg.First,10%of the total amount was given and dissolved in 10 mL 0.9%sodium chloride injection.Within 5 minutes,intravenous infusion was completed,and the remaining 90%was dissolved in 100 mL 0.9%sodium chloride injection.Intravenous infusion was completed within 30-60 minutes,or urokinase for injection was 1 million-1.5 million IU,dissolved in 0.9%sodium chloride injection 100-200 mL,continuous intravenous infusion for 30 min),and the observation group of 33 patients were treated by conventional therapy plus intravenous thrombolysis and TCM medicine(based on the dialectical theory of TCM,the treatment course of TCM medicine was 30-45 days).The two groups were followed up by telephone or field visits to understand the recurrence of cerebral infarction 12,24 and 36 months after discharge.Meanwhile,the inpatient medical records of all enrolled patients were reviewed to check the occurrence of adverse events such as cerebral hemorrhage,digestive tract hemorrhage,oral hemorrhage,skin and mucous membrane hemorrhage and liver and kidney function damage.Detailed records were made,and relevant data was statistically processed.Results:The recurrence rate and the incidence of adverse events in the two groups were statistically treated byχ^(2)=4.64 andχ^(2)=4.22,respectively,with significant differences in both groups(P<0.05).Conclusion:Traditional Chinese medicine can achieve a certain role in preventing recurrence after thrombolytic therapy of ischemic stroke,and it has no obvious adverse reactions,which is worthy of clinical promotion and application.

关 键 词：缺血性脑卒中 静脉溶栓 中医中药 防复发 

分 类 号：R743.33[医药卫生—神经病学与精神病学]