半夏天麻白术汤联合氯吡格雷治疗急性缺血性脑卒中的临床效果及安全性  

Clinical efficacy and safety of Banxia Tianma Baizhu decoction combined with clopidogrel in the treatment of acute ischemic stroke

作　　者：成晓霞 CHENG Xiaoxia(Rehabilitation Department,Changzhou No.7 People′s Hospital,Jiangsu Province,Changzhou 213100,China)

机构地区：[1]江苏省常州市第七人民医院康复科,213100

出　　处：《临床合理用药杂志》2024年第26期12-16,共5页Chinese Journal of Clinical Rational Drug Use

摘　　要：目的 观察半夏天麻白术汤联合氯吡格雷治疗急性缺血性脑卒中的临床效果及安全性。方法 依纳入标准选取2022年3月—2023年3月常州市第七人民医院接诊的急性缺血性脑卒中研究对象,共纳入42例,遵循随机对照试验原则分为BTB联合组和CHS组,每组21例。在对症治疗基础上,CHS组予硫酸氢氯吡格雷片治疗,BTB联合组在CHS组基础上联合半夏天麻白术汤治疗,2组均用药2周。比较2组疗效差异,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Barthel指数(MBI)评分、凝血功能指标[活化部分凝血活酶时间(APTT)、纤维蛋白原(Fib)]、血脂指标[总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)]变化,及不良反应。结果 观察组患者治疗总有效率为95.24%,高于CHS组的71.43%(χ^(2)=4.285,P=0.038);治疗2周后,2组头晕头痛、口角流涎积分、NIHSS评分、Fib、TC、TG、LDL-C水平均较治疗前下降,MBI评分、APTT及BTB联合组HDL-C水平升高或延长,且BTB联合组变化的程度大于CHS组(P均<0.01)。BTB联合组与CHS组不良反应总发生率(9.53%vs.14.29%)比较差异无统计学意义(χ^(2)=0.227,P=0.633)。结论 半夏天麻白术汤联合氯吡格雷治疗急性缺血性脑卒中的临床效果肯定,可缓解中医证候表现,改善神经功能,提升日常生活能力,改善凝血指标及血脂指标,且用药安全性较高。Objective To observe the clinical efficacy and safety of Banxia Tianma Baizhu decoction combined with clopidogrel in the treatment of acute ischemic stroke.Methods Forty-two patients with acute ischemic stroke treated at Changzhou No.7 People′s Hospital from March 2022 to March 2023 were selected.They were randomly divided into an BTB joint group and a CHS group,with 21 patients in each group.On the basis of symptomatic treatment,the CHS group was treated with clopidogrel bisulfate tablets,while the BTB joint group received Banxia Tianma Baizhu decoction in addition to clopidogrel bisulfate tablets.Both groups were treated for two weeks.The differences in clinical outcomes between the two groups of patients,as well as changes in traditional Chinese medicine syndrome scores,National Institutes of Health Stroke Scale(NIHSS) scores,Modified Barthel Index(MBI) scores,coagulation function indicators(APTT,Fib),and lipid profiles(TC,TG,HDL-C,LDL-C) before and after treatment,along with comparisons of adverse reactions,were all evaluated.Results The total effective rate of treatment in the BTB joint group was 95.24%,which was higher than 71.43% in the CHS group(χ^(2)=4.285,P=0.038).After treatment,both groups showed significant decreases in dizziness,headache,drooling scores,NIHSS scores,Fib,TC,TG,and LDL-C levels compared to before treatment(P<0.01).However,MBI scores and APTT were significantly increased and prolonged in both groups after treatment(P<0.01).The BTB joint group showed an increase in HDL-C levels,and the degree of fluctuation in the BTB joint group was greater than that in the CHS group(P<0.01).There was no statistically significant difference in the overall incidence of adverse reactions between the BTB joint group and the CHS group(9.53% vs.14.29%,χ^(2)=0.227,P=0.633).Conclusion The clinical efficacy of Banxia Tianma Baizhu decoction combined with clopidogrel in treating acute ischemic stroke is affirmed.It alleviates traditional Chinese medicine syndrome manifestations,improves neurological functio

关 键 词：急性缺血性脑卒中 半夏天麻白术汤 氯吡格雷 治疗效果 

分 类 号：R743.3[医药卫生—神经病学与精神病学]