丁苯酞序贯治疗分支动脉粥样硬化病脑梗死的效果及安全性观察

目的：评价丁苯酞序贯治疗分支动脉粥样硬化病急性脑梗死的临床效果及安全性。方法采用随机对照设计，将60例急性脑梗死患者随机分为丁苯酞序贯治疗组（31例）和对照组（29例）。全部患者均根据病情给予口服阿司匹林，阿托伐他汀钙，同时给予奥扎格雷钠静脉滴注；调控血压，控制血糖、血脂，积极治疗并发症；病情稳定后行早期神经康复治疗。治疗组在常规治疗的基础上使用丁苯酞100 ml、2次/ d，静脉滴注，连续治疗14 d，以后口服丁苯酞0.2 g，3次/ d，疗程90 d。两组患者均在治疗前后进行神经功能缺损程度评分（NIHSS）及日常生活活动能力评分（BI）。并详细观察记录各种与治疗相关的不良事件。结果两组患者治疗后第14天 NIHSS 评分治疗组（4.36±3.11）分、对照组（6.12±2.67）分]均较治疗前治疗组（11.42±3.20）分、对照组（11.64±3.43）分]降低（P 均＜0.05），治疗组明显低于对照组（F组内=2.125，P ＜0.01；F组间=18.63，P ＜0.01；F交互=25.34，P ＜0.01；与对照组比较，P＜0.05）。两组患者治疗后 BI 评分治疗组（86.72±8.44）分、对照组（75.96±9.86）分]均较治疗前治疗组（26.54±13.36）分、对照组（26.38±13.02）分]增高；丁苯酞治疗后 BI 评分明显高于对照组（F组内=29.27，P ＜0.01；F组间=32.48，P ＜0.01；F交互=42.41，P ＜0.01；与对照组比较，P ＜0.05）。治疗过程中未见明显不良反应。结论丁苯酞序贯治疗能显著改善分支动脉硬化病变急性脑梗死患者的神经功能缺损及日常生活活动能力，可显著改善预后、安全性好。

Effect and safety of butyl phthalide sequential treatment in cerebral infarction of branch sclerosis of arterial congee appearance

Objective To value the effect and safety of butyl phthalide sequential treatment in cerebral infarction of branch sclerosis of arterial congee appearance. Methods Sixty patients with acute cerebral infarction were randomly divided into treated group（ n = 31）and control group（ n = 29）. According to the condition of illness,all patients were given aspirin,atorvastatin calcium,and the injection of ozagrel sodium intravenous;controlled the blood pressure,blood sugar,blood lipid,and treated complications posstively;take the early rehabilitation of nerve treatment afte the illness was in stable condition. Butyl phthalide was used in the patients of treated group（100 ml,twice per day,intravenous drip,during 14 days period therapy,and then 0. 2 g oral,third per day）,besides the routine therapy. The degree of neural function defect score（ NIHSS）and activities of daily living score（BI）between two groups were observed before and after treatment. Corresponding adverse consequences were recorded. Results Compared with pretreatment,the NIHSS of postreatment at the 14th day in treat and control groups were decreased（treated group：（4. 36 ± 3. 11）vs.（11. 42 ± 3. 20）;control group：（6. 12 ± 2. 67）vs.（11. 64 ± 3. 43）,P 〈 0. 05,and the treated group was significantly lower than control group（F inner groups = 2. 125,P 〈 0. 01;F between groups = 18. 63,P 〈 0. 01;F cross groups = 25. 34,P〈 0. 01;P 〈 0. 05）. The BI of postreatment in two group were increased（treated group：（86. 72 ± 8. 44）vs. （26. 54 ± 13. 36）;control group：（75. 96 ± 9. 86）vs.（26. 38 ± 13. 02））,and the treated group was significantly lower than control group（F inner groups = 29. 27,P 〈 0. 01;F between groups = 32. 48,P 〈 0. 01;F cross groups= 42. 41,P 〈 0. 01;P 〈 0. 05）. There was no the adverse reactions. Conclusion Butyl phthalide sequential treatment can improve the NIHSS and BI of cerebral infarction of branch sclerosis of arterial congee appearance and have a better therapy effect.