醒脑静注射液联合吡拉西坦治疗脑出血后认知功能障碍的临床研究

目的探讨醒脑静注射液联合吡拉西坦片治疗脑出血后认知功能障碍的临床疗效。方法选取2013年6月—2015年12月西安医学院第一附属医院神经外科收治的脑出血后认知功能障碍患者573例,随机分成对照组(286例)和治疗组(287例)。对照组口服吡拉西坦片,4片/次,3次/d。治疗组在对照组的基础上静脉滴注醒脑静注射液,20 m L加入到5%葡萄糖溶液250 m L中,1次/d。两组患者均连续治疗1个月。观察两组的临床疗效,比较两组的认知功能、日常生活能力和血浆神经元特异性烯醇化酶(NSE)水平。结果治疗后,对照组和治疗组的总有效率分别为77.97%、89.90%,两组比较差异有统计学意义(P0.05)。治疗后,两组MMSE评分和ADL评分均显著升高,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上升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NSE水平均显著下降,同组治疗前后比较差异有统计学意义(P0.05);且治疗组NSE水平的下降程度明显优于对照组,两组比较差异具有统计学意义(P0.05)。结论醒脑静注射液联合吡拉西坦片治疗脑出血后认知功能障碍具有较好的临床疗效,能改善认知功能和日常生活能力,提高NSE水平,具有一定的临床推广应用价值。

Clinical study on Xingnaojing Injection combined with piracetam in treatment of cognitive impairment after cerebral hemorrhage

Objective To explore the clinical efficacy of Xingnaojing Injection combined with Piracetam Tablets in treatment of cognitive impairment after cerebral hemorrhage. Methods Patients (573 cases) with cognitive impairment after cerebral hemorrhage in Department of Neurosurgery of the First Affiliated Hospital of Xi''an Medical College from June 2013 to December 2015 were randomly divided into the control group (286 cases) and the treatment group (287 cases). Patients in the control group were po administered with Piracetam Tablets, 4 tablets/ time, three times daily. Patients in the treatment group were iv administered with Xingnaojing Injection on the basis of the control group, 20 mL added into 5% glucose solution 250 mL, once daily. Patients in two groups were treated for one month. After treatment, the clinical efficacies were evaluated, and cognitive function, daily living ability, and NSE levels in two groups were compared. Results After treatment, the clinical efficacies in the control and treatment groups were 77.97% and 89.90%, respectively, and there was difference between two groups (P < 0.05). After treatment, MMSE scores and ADL scores 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 higher than those in the control group, with significant difference between two groups (P < 0.05). After treatment, the NSE levels in two groups were significantly decreased, and the difference was statistically significant in the same group (P < 0.05). And the NSE levels in the treatment group were significantly lower than those in the control group, with significant difference between two groups (P < 0.05). Conclusion Xingnaojing Injection combined with Piracetam Tablets has clinical curative effect in treatment of cognitive impairment after cerebral hemorrhage, can improve cognitive function and daily living ability, and increase NSE level, which has a certain clinical application value.