活血化瘀中药复方治疗重症脑梗死

目的: 探讨活血化瘀中药复方治疗重症脑梗死的临床疗效和安全性,从而指导临床进一步治疗. 方法: 64例重症加护病房(ICU)重症脑梗死患者,随机将其分为对照组和治疗组,对照组采用30 mg依达拉奉注射液,溶入250 mL生理盐水,静脉滴注,每日2次,治疗2周,治疗组在常规西药对症治疗基础上采用活血化瘀中药复方,水煎服,通过鼻饲方式进行中药灌服,早晚1次,治疗2周,每组各32例,根据神经功能缺损评分(NDL)和格拉斯哥昏迷评分(GCS),对两组临床疗效、治疗后血液流变学指标、不良反应进行观察和比较. 结果: 与对照组相比,治疗组总有效率明显升高(90.6% vs 68.8%),P<0.05;与对照组相比,治疗组治疗后NDL评分明显减少(15.7±5.4 vs 22.8±5.8)分,GCS评分明显升高(14.5±0.8 vs 12.2±0.7)分,P<0.05;与对照组相比,治疗组全血高切黏度(2.2±0.1 vs 3.5±0.2)mPa·s,全血低切黏度(4.1±0.2 vs 8.0±0.4)mPa·s,血浆黏度(1.2±0.1 vs 1.7±0.2)mPa·s均明显降低(P<0.05).治疗期间两组都没有出现明显不良反应. 结论: 活血化瘀中药复方治疗重症脑梗死的疗效显著、安全性高,明显改善患者的血流状态,值得临床推广.

Clinical Efficacy Observation of Activating Blood to Resolve Stasis Herbs on Patients with Severe Cerebral Infarction

Objective: To study the clinical efficacy of the activating blood to resolve stasis herbs on patients with severe cerebral infarction (SCI) and to provide guidance for the future clinical treatment. Method: Sixty-four intensive care unit(ICU) patients with SCI were randomized into the control group(30 mg edaravone injection dissolved in 250 mL normal saline, intravenous drip, twice daily for 2 weeks)and the observation group(the traditional Chinese medicine compound of activating blood to resolve stasis, decoction for oral dose twice daily, taken morning and evening for 2 weeks)of 32 patients per group. The national institutes of health stroke scale (NIHSS) score and Glasgow coma score (GCS), blood rheology index adverse reactions in the two groups were observed and compared after the treatment. Result: Compared with the control group, the total effective rate was significantly increased (90.6% vs 68.8%, P<0.05), the NIHSS score (15.7±5.4 vs 22.8±5.8) was significantly decreased and the GCS (14.5±0.8 vs 12.2±0.7) were obviously increased (P<0.05), the whole blood high shear viscosity (2.2±0.1 vs 3.5±0.2) mPa· s, the whole blood low shear viscosity (4.1±0.2 vs 8.0±0.4) mPa· s, plasma viscosity (1.2±0.1 vs 1.7±0.2) mPa· s were obviously decreased (P<0.05) in the observation group. There were no obvious adverse reactions in the two groups during the treatment period. Conclusion: The treatment of activating blood to resolve stasis herbs has significant efficacy and high safety for SCI. Specially, it could improve the blood flow state, which is worthy of clinical promotion.