银杏内酯注射液联合吡拉西坦注射液治疗脑梗死恢复期临床研究
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R743

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Clinical Study on Ginkgolide Injection Combined with Piracetam Injection for Cerebral Infarction at Convalescence
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    摘要:

    目的:观察银杏内酯注射液联合吡拉西坦注射液治疗脑梗死恢复期气虚血瘀证的临床疗效。方 法:选取90 例脑梗死恢复期气虚血瘀证患者,依据随机数字表法分为对照组和治疗组各45 例。2 组均给予常 规治疗及康复训练,对照组在此基础上给予吡拉西坦注射液治疗,治疗组在对照组基础上给予银杏内酯注射液 治疗,2 组均治疗2 周。比较2 组临床疗效,简易智力状态检查量表(MMSE)、美国国立卫生研究院卒中量 表(NIHSS)、改良Barthel 指数(MBI) 评分,以及神经功能指标[血清神经胶质纤维酸性蛋白(GFAP)、神经 元特异性烯醇化酶(NSE)、脑源性神经营养因子(BDNF)、血管内皮生长因子(VEGF)]、炎症指标[血清同 型半胱氨酸(Hcy)、白细胞介素-6(IL-6)、白细胞介素-8(IL-8)、肿瘤坏死因子-α(TNF-α)]、血液流变 学指标[红细胞比容(HCT)、全血低切黏度(LSV)、全血高切黏度(HSV)、血浆黏度(PSV)]水平,记录不 良反应发生率。结果:治疗后,治疗组临床疗效总有效率86.67%,高于对照组68.89% (P<0.05)。2 组 MMSE、MBI 评分均较治疗前升高(P<0.05),治疗组MMSE、MBI 评分均高于对照组(P<0.05)。2 组NIHSS 评分均较治疗前降低(P<0.05),治疗组NIHSS 评分低于对照组(P<0.05)。2 组血清GFAP、NSE、Hcy、 IL-6、IL-8、TNF-α 水平均较治疗前降低(P<0.05),治疗组血清GFAP、NSE、Hcy、IL-6、IL-8、TNF-α 水平均低于对照组(P<0.05)。2 组血清BDNF、VEGF 水平均较治疗前升高(P<0.05),治疗组血清BDNF、 VEGF 水平均高于对照组(P<0.05)。2 组HCT、PSV、LSV、HSV 均较治疗前降低(P<0.05),治疗组 HCT、PSV、LSV、HSV 均低于对照组(P<0.05)。治疗期间,治疗组不良反应发生率6.67%,与对照组 11.11%比较,差异无统计学意义(P>0.05)。结论:银杏内酯注射液联合吡拉西坦注射液治疗脑梗死恢复期气 虚血瘀证,可减轻机体炎症反应,改善血液流变学、神经功能及认知功能,提高患者的生活质量,疗效显著且 安全性好。

    Abstract:

    Abstract: Objective: To observe the clinical effect of Ginkgolide Injection combined with Piracetam Injection for cerebral infarction with the qi deficiency and blood stasis syndrome at convalescence. Methods: A total of 90 cases of patients with cerebral infarction with the qi deficiency and blood stasis syndrome at convalescence were selected and divided into the control group and the treatment group according to the random number table method, with 45 cases in each group. Both groups were given conventional treatment and rehabilitation training;the control group was additionally treated with Piracetam Injection, and the treatment group was additionally treated with Ginkgolide Injection based on the treatment of the control group. Both groups were treated for 2 weeks. Clinical effects,the scores of Mini- Mental Status Exam (MMSE),National Institutes of Health Stroke Scale (NIHSS) and Modified Barthel Index (MBI), and the levels of neurofunctional indicators [serum glial fibrillary acidic protein (GFAP), neuronspecific enolase (NSE),brain-derived neurotrophic factors (BDNF),and vascular endothelial growth factors (VEGF)],inflammatory indicators [serum homocysteine (Hcy),Interleukin-6 (IL-6),Interleukin-8 (IL-8), and tumor necrosis factor- α (TNF- α)] and hemorheology indicators [hematocrit (HCT),low- shear whole blood viscosity (LSV),high-shear whole blood viscosity (HSV),and plasma viscosity (PSV)] were compared between the two groups. The incidence of adverse reactions was recorded. Results:After treatment,the total clinical effective rate was 86.67% in the treatment group,higher than that of 68.89% in the control group (P<0.05). The scores of MMSE and MBI in the two groups were increased when compared with those before treatment (P<0.05),and the scores of MMSE and MBI in the treatment group were higher than those in the control group (P<0.05). The scores of NIHSS in the two groups were decreased when compared with those before treatment (P<0.05),and the score of NIHSS in the treatment group was lower than that in the control group (P<0.05). The levels of GFAP,NSE,Hcy,IL-6,IL-8,and TNF-α in serum in the two groups were decreased when compared with those before treatment (P<0.05),and the levels of GFAP,NSE,Hcy,IL-6,IL-8,and TNF-α in serum in the treatment group were lower than those in the control group (P<0.05). The levels of BDNF and VEGF in serum in the two groups were increased when compared with those before treatment (P<0.05), and the levels of BDNF and VEGF in serum in the treatment group were higher than those in the control group (P<0.05). The levels of HCT,PSV,LSV,and HSV in the two groups were decreased when compared with those before treatment (P<0.05), and the levels of HCT,PSV,LSV,and HSV in the treatment group were lower than those in the control group (P< 0.05). During treatment,the incidence of adverse reactions was 6.67% in the treatment group and 11.11% in the control group, and the comparison between the two groups showed no significance in the difference (P>0.05). Conclusion: In the treatment of cerebral infarction with the qi deficiency and blood stasis syndrome at convalescence,Ginkgolide Injection combined with Piracetam Injection can reduce the inflammatory reactions of the body,improve hemorheology,neural function and cognitive function,and enhance the quality of life of patients. It has significant effects and good safety.

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柴建峰,陈巧红,邹礼梁.银杏内酯注射液联合吡拉西坦注射液治疗脑梗死恢复期临床研究[J].新中医,2023,55(18):26-31

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  • 在线发布日期: 2023-09-22
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