脑心通胶囊联合降纤酶治疗急性脑血栓的临床研究

目的研究脑心通胶囊联合注射用降纤酶治疗急性脑血栓的临床疗效。方法选取2016年12月—2018年12月恩施土家族苗族自治州中心医院收治的100例急性脑血栓患者为研究对象,将所有患者随机分为对照组和治疗组,每组各50例。对照组静脉滴注注射用降纤酶,第1～3天,10 U加入到生理盐水250 mL中,1次/d,从第4天起改为维持量5 U/次,1次/2 d;治疗组在对照组治疗的基础上口服脑心通胶囊,3粒/次,3次/d。两组患者持续治疗4周。观察两组的临床疗效,比较两组的血液流变学指标、凝血功能指标和美国国立卫生研究院卒中量表(NIHSS)评分。结果治疗后,对照组和治疗组的总有效率分别为82.00%、94.00%,两组比较差异有统计学意义(P0.05)。治疗后,两组患者红细胞压积、血浆黏度和血沉均显著降低,同组治疗前后比较差异有统计学意义(P0.05);且治疗组红细胞压积、血浆黏度和血沉水平明显低于对照组,两组比较差异有统计学意义(P0.05)。治疗后,两组患者活化部分凝血活酶时间(APTT)、纤维蛋白原(FIB)、D-二聚体(D-D)水平显著降低,凝血酶原时间(PT)显著升高,同组治疗前后比较差异有统计学意义(P0.05);并且治疗组APTT、FIB、D-D、PT水平明显优于对照组,两组比较差异有统计学意义(P0.05)。治疗后,两组NIHSS评分明显降低,同组治疗前后比较差异有统计学意义(P0.05);并且治疗组NIHSS评分明显低于对照组,两组比较差异有统计学意义(P0.05)。结论脑心通胶囊联合注射用降纤酶治疗急性脑血栓具有较好的临床疗效,能降低血液流变学指标,改善凝血功能和神经功能,具有一定的临床推广应用价值。

Clinical study on Naoxintong Capsules combined with defibrase in treatment of acute cerebral thrombosis

Objective To study the efficacy of Naoxintong Capsules combined with Defibrase for injection in treatment of acute cerebral thrombosis. Methods Patients (100 cases) with acute cerebral thrombosis in the Central Hospital of Enshi Tujia and Miao Autonomous Prefecture from December 2016 to December 2018 were randomly divided into control and treatment groups, and each group had 50 cases. Patients in the control group were iv administered with Defibrase for injection, first to third day, 10 U added into normal saline 250 mL, once daily, from the fourth day, dose maintained at 5 U/time, once every two days. Patients in the treatment group were po administered with Naoxintong Capsules on the basis of the control group, 3 grains/time, three times daily. Patients in two groups were treated for 4 weeks. After treatment, the clinical efficacies were evaluated, and hemorheology indexes, coagulation function indexes, and NIHSS scores in two groups were compared. Results After treatment, the clinical efficacies in the control and treatment groups were 82.00% and 94.00%, respectively, and there was difference between two groups (P<0.05). After treatment, hematocrit, plasma viscosity, and erythrocyte sedimentation rate 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 APTT, FIB, and D-D in two groups were significantly decreased, but the levels of PT 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, NIHSS scores in two groups were significantly decreased, and the difference was statistically significant in the same group (P<0.05). And the NIHSS score in the treatment group was significantly lower than that in the control group, with significant difference between two groups (P<0.05). Conclusion Naoxintong Capsules combined with Defibrase for injection has clinical curative effect in treatment of acute cerebral thrombosis, can reduce hemorheological indexes, improve coagulation function and nervous function, which has a certain clinical application value.