大活络胶囊联合阿加曲班治疗急性脑梗死的临床研究

目的探讨大活络胶囊联合阿加曲班注射液治疗急性脑梗死患者的临床疗效。方法选取2020年1月—2021年1月在天津市南开医院进行治疗的82例急性脑梗死患者,根据用药差别分为对照组和治疗组,每组各41例。对照组给予阿加曲班注射液,初始剂量60 mg/d,同0.9%氯化钠注射液500 mL配伍,持续24 h静脉点滴,其后20 mg/次同0.9%氯化钠注射液150 mL配伍,2次/d,每次静脉滴注3 h;治疗组在对照组基础上口服大活络胶囊,1 g/次,3次/d。两组均经14 d治疗。观察两组的临床疗效,比较两组相关评分、血管内皮功能指标的变化情况。结果治疗后,治疗组总有效率97.56%,显著高于对照组的80.49%(P0.05)。治疗后,两组NIHSS评分、MRS评分均显著降低,但ADL评分、MoCA评分显著升高(P0.05);治疗后,治疗组相关评分改善优于对照组(P0.05)。经治疗,两组血清一氧化氮(NO)、血管生成素(Ang-1)、降钙素基因相关肽(CGRP)均显著升高,但血管性假血友病因子(v WF)、血栓调节蛋白(TM)、血管内皮细胞钙黏蛋白(VE-cadherin)、内皮素-1(ET-1)水平降低(P0.05);治疗后,治疗组患者血管内皮功能指标改善优于对照组(P0.05)。结论大活络胶囊联合阿加曲班注射液治疗急性脑梗死患者具有较好的临床疗效,可促进神经功能恢复,改善患者血管内皮功能,促进患者日常活动能力提高,有着良好的临床应用价值。

Clinical study on Dahuoluo Capsules combined with argatroban in treatment of acute cerebral infarction

Objective To investigate the clinical efficacy of Dahuoluo Capsules combined with argatroban in treatment of acute cerebral infarction. Methods A total of 82 patients with acute cerebral infarction who were treated in Tianjin Nankai Hospital from January 2020 to January 2021 were selected and divided into control group and treatment group according to drug difference, with 41 cases in each group. The control group were iv administered with Argatroban Injection, initially 60 mg/d, mixed with 0.9% sodium chloride injection 500 mL, intravenous drip for 24 h, then 20 mg/time, mixed with 0.9% sodium chloride injection 150 mL, twice daily, intravenous drip for 3 h each time. The treatment group po administered with Dahuoluo Capsules on the basis of the control group, 1 g/time, three times daily. Patients in two groups were treated for 14 d. After treatment, the clinical efficacy was evaluated, and the changes of related scores and vascular endothelial function indexes were compared between the two groups. Results After treatment, the total effective rate of treatment group was 97.56%, which was significantly higher than that of control group (80.49%) (P < 0.05). After treatment, NIHSS score and MRS score in two groups were significantly decreased, but ADL score and MoCA score were significantly increased (P < 0.05). After treatment, the improvement of relevant scores in treatment group was better than that in control group (P < 0.05). After treatment, serum nitric oxide (NO), angogenin (ANG-1), and calcitonin gene-related peptide (CGRP) in two groups were significantly increased. However, the levels of von Willebrand factor (vWF), thrombomregulatory protein (TM), vascular endothelial cell cadherin (VE-Cadherin), and endothelin-1 (ET-1) were decreased (P < 0.05). After treatment, the improvement of vascular endothelial indices in the treatment group was better than that in the control group (P < 0.05). Conclusion Dahuoluo Capsules combined with argatroban has good clinical effect in treatment of acute cerebral infarction, and can promote the recovery of neurological function, improve the vascular endothelial function of patients, promote the improvement of daily activities, which has good clinical application value.