脉络宁注射液联合脑苷肌肽治疗急性缺血性脑血管病的临床研究

目的探讨脉络宁注射液联合脑苷肌肽注射液治疗急性缺血性脑血管病的临床疗效。方法选取2015年3月—2017年3月在上海市松江区九亭医院进行治疗的缺血性脑血管病患者142例为研究对象,随机将患者分为对照组和治疗组,每组各71例。对照组静脉滴注脑苷肌肽注射液,20 m L加入到0.9%氯化钠注射液250 m L中,1次/d;治疗组在对照组基础上静脉滴注脉络宁注射液,20 m L加入到0.9%氯化钠注射液500 m L中,1次/d。两组患者均治疗3周。观察两组的临床疗效,比较两组的美国国立卫生研究院卒中量表(NIHSS)评分、改良的Rankin量表(m RS)评分、血清学指标和血液流变学指标。结果治疗后,对照组和治疗组的总有效率分别为80.28%、95.77%,两组比较差异有统计学意义(P0.05)。治疗后,两组NIHSS评分和m RS评分均显著降低,同组治疗前后比较差异有统计学意义(P0.05);且治疗组这些观察指标明显低于对照组,两组比较差异具有统计学意义(P0.05)。治疗后,两组血清超敏C反应蛋白(hs-CRP)、可溶性血管细胞间黏附分子-1(s VCAM-1)、白细胞介素-6(IL-6)、单核细胞趋化蛋白(MCP-1)水平均显著降低,胰岛素样生长因子-1(IGF-1)水平显著升高,同组治疗前后比较差异有统计学意义(P0.05);且治疗组这些观察指标的改善程度明显优于对照组,两组比较差异具有统计学意义(P0.05)。治疗后,两组血浆黏度(PV)、全血黏度高切(HS)、红细胞聚集指数(EAI)、纤维蛋白原(FIB)水平均显著降低,同组治疗前后比较差异有统计学意义(P0.05);且治疗组这些观察指标明显低于对照组,两组比较差异具有统计学意义(P0.05)。结论脉络宁注射液联合脑苷肌肽注射液治疗急性缺血性脑血管病具有较好的临床疗效,可有效地改善患者神经功能和血液流变学指标,降低机体炎症反应,提高患者生活质量,具有一定的临床推广应用价值。

Clinical study on Mailuoning Injection combined with cattle encephalon glycoside and ignotin in treatment of acute ischemic cerebrovascular disease

Objective To investigate the clinical effect of Mailuoning Injection combined with Cattle Encephalon Glycoside and Ignotin Injection in treatment of acute ischemic cerebrovascular disease. Methods Patients (142 cases) with acute ischemic cerebrovascular disease in Songjiang District Jiuting Hospital of Shanghai from March 2015 to March 2017 were randomly divided into control and treatment groups, and each group had 71 cases. Patients in the control group were iv administered with Cattle Encephalon Glycoside and Ignotin Injection, 20 mL added into normal saline 250 mL, once daily. Patients in the treatment group were iv administered with Mailuoning Injection on the basis of the control group, 20 mL added into normal saline 500 mL, once daily. Patients in two groups were treated for 3 weeks. After treatment, the clinical efficacies were evaluated, NIHSS scores, mRS scores, serological indexes, and hemorheological indexes in two groups were compared. Results After treatment, the clinical efficacies in the control and treatment groups were 80.28% and 95.77%, respectively, and there was difference between two groups (P<0.05). After treatment, NIHSS score and mRS score in two groups were significantly decreased, and the difference was statistically significant in the same group (P<0.05). And the observational indexes in the treatment group were significantly lower than those in the control group, with significant difference between two groups (P<0.05). After treatment, the levels of hs-CRP, sICAM-1, IL-6, and MCP-1 in two groups were significantly decreased, but the levels of IGF-1 in two groups were significantly increased, and the difference was statistically significant in the same group (P<0.05). And the observational indexes in the treatment group were significantly better than those in the control group, with significant difference between two groups (P<0.05). After treatment, the levels of PV, HS, FIB, and EAI in two groups were significantly decreased, and the difference was statistically significant in the same group (P<0.05). And the observational indexes in the treatment group were significantly lower than those in the control group, with significant difference between two groups (P<0.05). Conclusion Mailuoning Injection combined with Cattle Encephalon Glycoside and Ignotin Injection has clinical curative effect in treatment of acute ischemic cerebrovascular disease, can significantly improve neurological function and hemorheological indexes, decrease the body inflammatory reaction, and improve the quality of life, which has a certain clinical application value.