天麻素联合盐酸氟桂利嗪治疗偏头痛的疗效观察

目的探讨天麻素联合氟桂利嗪治疗偏头痛的临床疗效。方法将58例偏头痛患者随机分为对照组与研究组,对照组26例患者接受氟桂利嗪治疗,研究组32例患者在氟桂利嗪治疗基础上给予天麻素治疗,对比分析2组患者的临床治疗效果及头痛程度、头痛持续时间、头痛频率。结果研究组总有效率(84.37%)明显高于对照组(65.38%),差异有统计学意义(P0.05),研究组在头痛的发作时间、频次及程度上均小于对照组,差异有统计学意义(P0.05)。结论天麻素联合氟桂利嗪治疗偏头痛临床疗效显著,可明显降低头痛程度,缩短头痛持续时间和头痛频率,效果优于单用氟桂利嗪治疗,值得临床推广应用。     

头痛宁胶囊联合氟桂利嗪治疗偏头痛临床观察

目的观察头痛宁胶囊联合小剂量氟桂利嗪治疗偏头痛的临床疗效。方法 120例偏头痛患者随机分为治疗组60例和对照组60例,对照组按偏头痛常规口服氟桂利嗪胶囊10 mg每晚睡前服,治疗组给予头痛宁胶囊3粒/次,3次/d,氟桂利嗪胶囊2.5 mg每晚睡前服,2组均连续治疗30 d。结果治疗组总有效率为96.7%,与对照组75%,2组比较差异有统计学意义(P<0.05)。结论头痛宁胶囊联合小剂量氟桂利嗪胶囊治疗偏头痛有较好疗效。     

正天丸与氟桂利嗪联合治疗偏头痛疗效观察

目的 观察正天丸与氟桂利嗪联合治疗偏头痛的临床疗效.方法 将80例偏头痛患者,随机分为2组,治疗组40例,服用正天丸6 g,3次/d,氟桂利嗪10 mg,每晚睡前服;对照组40例,服用氟桂利嗪10 mg,每晚睡前服;2组均连续治疗4周,观察2组疗效,比较有效率.结果 治疗组总有效率92.5% ,其中治愈12例(30.0%),显效15例(37.5%),好转20例(25.0%);对照组总有效率72.5%,其中治愈7例(17.5%),显效13例(32.5%),好转9例(22.5%);治疗组总有效率明显优于对照组(P＜0.05).结论 正天丸与氟桂利嗪联合治疗偏头痛疗效好且不良反应小,值得临床推广.     

氟桂利嗪联合养血清脑颗粒治疗偏头痛的临床疗效

目的 探讨氟桂利嗪联合养血清脑颗粒治疗偏头痛的临床疗效.方法 将100例偏头痛患者随机分为治疗组和对照组各50例,治疗组给予养血清脑颗粒4g/次,3次/d,口服;氟桂利嗪5～10mg,每晚睡前服.对照组给予氟桂利嗪5～10mg每晚睡前服.2组均连续治疗30d.结果 治疗组治愈20例,显效10例,有效15例,总有效率90%;对照组治愈10例,显效10例,有效20例,总有效率80%,2组间总有效率比较差异有统计学意义(P＜0.05).结论 氟桂利嗪联合养血清脑颗粒治疗偏头痛是安全有效的.     

高压氧联合氟桂利嗪治疗偏头痛疗效分析

目的探讨高压氧联合氟桂利嗪治疗偏头痛的疗效。方法将120例偏头痛患者随机分为氟桂利嗪组、高压氧组和联合治疗组,对比分析各组间的有效率和1周治愈率。结果有效率:联合组(97.5%)高于高压氧组(82.5%)和氟桂利嗪组(80.0%),差异有统计学意义(P<0.05);1周治愈率:联合组(60.0%)、高压氧组(52.5%)高于氟桂利嗪组(22.5%),差异有统计学意义(P<0.01)。结论高压氧联合氟桂利嗪是治疗偏头痛的理想方法。     

氟桂利嗪联合血塞通治疗偏头痛的临床疗效

目的探讨氟桂利嗪与血塞通联合治疗偏头痛的临床疗效。方法 108例偏头痛患者随机分为观察组(n=54)与对照组(n=54),对照组给予氟桂利嗪治疗,观察组在对照组基础上加用血塞通治疗,对比2组治疗效果。结果 2组偏头痛发作频率及VAS评分较治疗前均显著降低(P0.01),疼痛持续时间显著缩短(P0.01),且治疗后观察组显著优于对照组(P0.01);观察组治愈率33.3%,显著高于对照组的16.7%;观察组有效率94.4%,显著高于对照组的75.9%。结论氟桂利嗪与血塞通联合治疗偏头痛,有较好的治愈率与有效率,值得临床推广。     

盐酸氟桂利嗪联合针刺治疗椎-基底动脉供血不足疗效观察

目的比较盐酸氟桂利嗪联合针刺与常规盐酸氟桂利嗪治疗椎-基底动脉供血不足(vertebral-basilar insuf-ficiency,VBI)的疗效差异。方法将75例VBI患者按就诊先后分为治疗组(38例)、观察组(37例),治疗组在观察组治疗基础上再给予针刺治疗,选取双侧风池、"供血"穴、中渚及合谷、太冲,每日针刺1次,9次为1疗程,疗程间休息1天,两组均治疗1个月评定疗效。结果治疗组总有效率为97.4%,显著优于对照组81.1%(P<0.05)。结论盐酸氟桂利嗪联合针刺治疗VBI疗效显著优于单用盐酸氟桂利嗪治疗。     

氟桂利嗪分别联合普萘洛尔与托吡酯治疗偏头痛的临床价值分析

目的对比氟桂利嗪联合普萘洛尔与氟桂利嗪联合托吡酯治疗偏头痛的临床效果。方法选取2016年7月至2018年2月收治的偏头痛患者92例为研究对象,以随机数字表法分为观察组46例,对照组46例,观察组应用氟桂利嗪联合托吡酯治疗,对照组应用氟桂利嗪联合普萘洛尔治疗,观察两组治疗前、治疗3个月后头痛改善情况、脑血管血流情况,治疗后脑电图(EEG)变化及用药期间不良反应发生情况。结果治疗前两组头痛情况差异无统计学意义(P0.05),治疗后均有改善,观察组治疗3个月后头痛发作频率、头痛程度及头痛持续时间与同期对照组对比,P0.05;治疗前两组脑血流情况差异无统计学意义(P0.05),治疗后均有好转,观察组治疗3个月后基底动脉(BA)、椎动脉(VA)、大脑中动脉(MCA)血流速度与同期对照组对比,P0.05;观察组治疗后EEGθ波增多、δ波增多、α波频率变慢比率分别为54.35%、63.04%、80.43%,与对照组30.43%、39.13%、58.70%对比,差异有统计学意义(P0.05);观察组用药期间不良反应发生率为19.57%,同对照组39.13%对比,明显减少,P0.05。结论相比于氟桂利嗪联合普萘洛尔,氟桂利嗪联合托吡酯能明显减少头痛发作次数,缩短头痛持续时间,减轻头痛程度,对患者脑血管血流及异常神经元放电改善作用显著,且安全性较高,更值得推广。     

氟桂嗪对急性脑梗死患者血小板线粒体Ca2+含量的影响

目的探讨氟桂嗪对脑缺血后血小板线粒体钙超载的影响,并研究其治疗机理.方法把急性脑梗死患者分为氟桂嗪治疗组(口服氟桂嗪5mg,每晚一次)和普通治疗组以及对照组,抽取其不同时期静脉血,用差异分离法分离血小板线粒体,FURA-3荧光法测定血小板线粒体游离Ca2+的含量.结果脑梗死后(起病24小时内、无论是否接受氟桂嗪治疗)血小板线粒体游离Ca2+浓度增加(P＜0.01);氟桂嗪治疗后第3天和7天时血小板线粒体游离Ca2+浓度降低(P＜0.05);普通治疗组血小板线粒体游离Ca2+浓度无明显变化(P＞0.05).结论氟桂嗪降低急性脑梗死患者血小板线粒体游离Ca2+含量.     

氟桂嗪治疗Tourette综合征的临床疗效观察

目的探讨氟桂嗪是否有治疗Tourette综合征(多发性抽动秽语综合征)的作用.方法163例患儿分为3组:泰必利组和泰必利加氟桂嗪治疗组以及单用氟桂嗪治疗组,用药和观察时间至少为6个月,用"不自主运动量表(AIMS)"评分法来评定治疗后抽动症状的改善程度.结果66例泰必利组中有24例抽动症状消失,痊愈率为36.36%;66例泰必利加氟桂嗪治疗组中有36例抽动症状消失,痊愈率为54.55%,两者痊愈率相比差异有显著性意义(P＜0.05).31例单用氟桂嗪治疗组中"轻度"患儿的痊愈率达100%,即病情偏轻者效果较佳,病情严重者效果较差.结论氟桂嗪对Tourette综合征确有治疗作用,其药理机制可能与氟桂嗪的抗多巴胺能活性作用有关.     

短暂性脑缺血发作与脑缺血耐受研究进展

脑缺血耐受是近年来的研究热点。短暂性脑缺血发作虽然使缺血性卒中危险增加,但同时可诱导神经细胞对再次缺血产生耐受。耐受的机制涉及血管因素、腺苷、兴奋性氨基酸、热休克蛋白、低氧诱导因子-1、促红细胞生成素、KATP通道等。临床观察显示,TIA的持续时间、发作频度、脑梗死间隔时间以及脑梗死体积等均与耐受的发生有关。     

Neuronal plasticity after ischemic preconditioning and TIA-like preconditioning ischemic periods

Transient ischemic attacks (TIAs) have recently become the center of attention since they are thought to share some characteristics with experimental ischemic preconditioning (IPC). This phenomenon describes the situation that a brief, per se harmless, cerebral ischemic period renders the brain resistant to a subsequent severe and normally damaging ischemia. Preconditioning (PC) is not restricted to the brain but also occurs in other organs. Furthermore, apart from a short ischemia, the PC event may comprise nearly any noxious stimulus which, however, must not exceed the threshold to tissue damage. In the last two decades, our knowledge concerning the underlying molecular basis of PC has substantially grown and there is hope to potentially imitate the induction of an endogenous neuroprotective state in patients with a high risk of cerebral ischemia. While, at present, there is virtually no neuropathological data on changes after TIAs or TIA-like PC ischemic periods in human brains, the following review will briefly summarize the current knowledge of plastic neuronal changes after PC in animal models, still awaiting their detection in the human brain.     

Remote ischemic conditioning approach for the treatment of ischemic stroke

Stroke is the leading cause of disability and death in North America.There has been growing interest in identifying neuroprotective strategies to reduce ischemic burden in patients with acute ischemic stroke.However,despite extensive clinical trials,no neuroprotective agent has been found for prevention of ischemic damage.Remote ischemic preconditioning(RIC)is a promising non-invasive strategy that has been proven to provide renal and cardioprotection and has recently found to have a potential broad application in the treatment of neurovascular disease,which has bee linked to its possible effects on the release and activation of endogenous neuroprotective substances against the ischemia/reperfusion injuries in experimental studies.This endogenous neuroprotection might vaccinate neural tissues against effects of acute IR following primary infarction insult.Regardless of the method of RIC administration,through manual or automated blood pressure cuff,RIC procedure is inexpensive and easy to use.Based on the experimental and clinical data,application of RIC avoids possible adverse effects and interactions associated with chemical pharmacological agents.In previous clinical studies RIC was safe and associated with only minor transient adverse effects in few cases,including petechia and minor limb pain,which were mostly resolved shortly after completing the treatment.     

皮质下缺血性抑郁

自1997年Krishnann和Alexopoulos分别提出了"血管性抑郁"的假说后,血管性抑郁受到了广泛的关注.此后,在对其中的MRI定义的血管性抑郁的研究发现,皮质下缺血性血管病变(subcortical ischemic vascular disease, SIVD)不仅与认知损害及死亡高风险有关,其在血管性抑郁的发展过程中也起着重要作用.     

Pontine ischemic rarefaction

To investigate apparently asymptomatic, bilateral symmetrical predominantly pontine hyperintensities (PHI) on magnetic resonance imaging (MRI) scans in elderly patients, we examined the pons histopathologically in two brains of elderly hypertensives with PHI, and in three without PHI, on postmortem MRI scans. We also reviewed 85 serial in vivo MRI scans of patients over 60 and compared scan findings, vascular risk factors, and clinical symptoms between patients with PHI and a control group. A subcortical arteriosclerotic encephalopathy (SAE)-like pathology was present in the pons in only the two autopsy brains with PHI and corresponded with the location of PHI on the postmortem MRI scans and with the most frequent sites of PHI on in vivo scans. SAE also involved the hemispheric white matter in one of the autopsy brains. Five of 16 (31%) patients with, and 4 of 69 (6%) without, PHI on in vivo MRI scans had marked periventricular hyperintensity (PVHI) compatible with SAE (p = 0.01). We conclude that an SAE-like pathology may be seen in the pons in elderly hypertensives and this pathology is probably the cause of PHI seen on MRI scans of patients over 60 years of age.     

Pediatric ischemic stroke

Journal of Neurology -