【摘要】：目的:探討醒腦靜注射液聯(lián)合丁苯酞對大腦中動脈供血區(qū)梗死患者神經(jīng)功能、認(rèn)知功能、凝血功能、生活活動能力的影響及安全性。方法:選取2014年6月-2015年12月于武漢大學(xué)人民醫(yī)院就診的大腦中動脈供血區(qū)梗死患者106例為研究對象,按照隨機(jī)數(shù)字表法分為對照組和觀察組,各53例。除常規(guī)對癥治療外,對照組患者給予丁苯酞軟膠囊0.2 g,po,tid;觀察組患者在對照組基礎(chǔ)上給予醒腦靜注射液20 m L加至0.9%氯化鈉注射液250 m L,ivgtt,qd。兩組患者均持續(xù)治療14 d。觀察兩組患者治療前后神經(jīng)功能[按美國國立衛(wèi)生研究院卒中量表(NIHSS)和臨床神經(jīng)功能缺損評分標(biāo)準(zhǔn)(NFDS)評分]、認(rèn)知功能[按蒙特利爾認(rèn)知量表(Mo CA)和簡易精神狀態(tài)評價量表(MMSE)評分]、凝血功能指標(biāo)[凝血酶原時間(PT)、活化部分凝血活酶時間(APTT)、血漿纖維蛋白原(FIB)]、日常生活活動能力量表(BI)評分,并記錄繼發(fā)遠(yuǎn)隔損害和不良反應(yīng)發(fā)生情況。結(jié)果:脫落病例共8例,其中對照組3例、觀察組5例。治療前,兩組患者神經(jīng)功能評分、認(rèn)知功能評分、凝血功能指標(biāo)、BI評分比較,差異均無統(tǒng)計學(xué)意義(P0.05)。治療后,兩組患者NIHSS、NFDS評分和FIB水平均較治療前明顯降低,且觀察組明顯低于對照組,差異均有統(tǒng)計學(xué)意義(P0.05);兩組患者M(jìn)o CA、MMSE、BI評分均較治療前明顯升高,PT、APTT均較治療前明顯延長,且觀察組明顯高于或長于對照組,差異均有統(tǒng)計學(xué)意義(P0.05)。觀察組患者的繼發(fā)遠(yuǎn)隔損害發(fā)生率(11.3%)明顯低于對照組(41.5%),差異有統(tǒng)計學(xué)意義(P0.05)。兩組患者不良反應(yīng)發(fā)生率比較,差異無統(tǒng)計學(xué)意義(P0.05)。結(jié)論:醒腦靜注射液聯(lián)合丁苯酞治療大腦中動脈供血區(qū)梗死,可降低遠(yuǎn)隔損害發(fā)生風(fēng)險,促進(jìn)患者神經(jīng)功能、認(rèn)知功能恢復(fù),改善凝血功能和生活活動能力,且安全性較高。
[Abstract]:Objective: to investigate the effect and safety of Xingnaojing injection combined with butyphthalide on the neurological function, cognitive function, coagulation function and living activity of patients with infarction in the middle cerebral artery (MCA). Methods: from June 2014 to December 2015, 106 patients with infarction in the middle cerebral artery (MCAA) were selected from Renmin Hospital, Wuhan University, and divided into control group (53 cases) and observation group (53 cases) according to random digital table method. In addition to routine symptomatic treatment, the patients in the control group were given butyphthalide soft capsule 0.2 g potid, and the patients in the observation group were given Xingnaojing injection 20 mL plus 0.9% sodium chloride injection 250 mL iv gttt QD on the basis of the control group. The patients in both groups were treated continuously for 14 days. To observe the neurological function of the two groups before and after treatment [according to the National Institutes of Health Stroke scale (NIHSS) and Clinical Neurologic deficit scoring Standard (NFDS)]. Cognitive function [according to Montreal Cognitive scale (Mo CA) and Mini-Mental State Assessment scale (MMSE)], Coagulation function Index [prothrombin time (PT),) activated partial thromboplastin time (APTT),)] Plasma fibrinogen (FIB), activity of daily living (ADL) scale (BI) score, secondary distant damage and adverse reactions were recorded. Results: there were 8 cases of shedding, including 3 cases in control group and 5 cases in observation group. Before treatment, there was no significant difference in neurological function score, cognitive function score, coagulation function index and BI score between the two groups (P0.05). After treatment, the NIHSS,NFDS score and FIB level of the two groups were significantly lower than those before treatment, and the observation group was significantly lower than the control group, the difference was statistically significant (P0.05). The Mo CA,MMSE,BI scores of the two groups were significantly higher than before treatment, PT,APTT were significantly longer than before treatment, and the observation group was significantly higher or longer than the control group, the difference was statistically significant (P0.05). The incidence of secondary distant damage in the observation group (11.3%) was significantly lower than that in the control group (41.5%), and the difference was statistically significant (P0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P0.05). Conclusion: Xingnaojing injection combined with butyphthalide can reduce the risk of distant damage, promote the recovery of nerve function, cognitive function, improve coagulation function and life ability, and is safe.
【作者單位】： 天津醫(yī)科大學(xué)基礎(chǔ)醫(yī)學(xué)院;武漢大學(xué)人民醫(yī)院神經(jīng)內(nèi)科;
【分類號】：R743.3

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