陈应南+丘锦龙+邓润杰

摘 要 目的：探讨血栓通注射液联合常规西药治疗对缺血性脑卒中患者神经功能和生活质量的影响。方法：选取2013年2月至2015年8月我院确诊的缺血性脑卒中患者136例，依据随机分配原则分为西药组和联合组各68例，西药组患者给予口服75 mg氯吡格雷治疗，1次/ d，共30 d，联合组患者在此基础上给予血栓通注射液（300 mg血栓通粉剂+150 ml生理盐水混合）治疗，2次/ d，共30 d，采用美国国立卫生院神经功能缺损评分（NIHSS）和日常生活活动能力评分（ADL）评估患者治疗前、治疗后7、14、21 d的神经功能和生活质量，并统计分析所有患者的疗效及不良反应发生情况。结果：西药组和联合组患者治疗有效率分别为69.12%、83.82%，前者明显低于后者（P<0.05）；联合组患者治疗后7、14、21 d的NIHSS评分均明显低于西药组（P<0.05）、而ADL评分均明显高于西药组（P<0.05）；2组患者治疗后均无严重不良反应发生。结论：血栓通注射液可提高缺血性脑卒中的疗效，联合常规西药治疗在促进患者神经功能恢复方面具有更为良好的效果，且具有良好的安全性，有利于改善患者的生活质量，值得临床作一步推广。

关键词 血栓通注射液 缺血性脑卒中 神经功能 生活质量

中图分类号：R286； R743.33 文献标识码：A 文章编号：1006-1533（2016）11-0028-04

Effect of Xueshuantong injection combined with clopidogrel on the neural function and the quality of life in the treatment of 68 cases of patients with ischemic stroke

CHEN Yingnan*， QIU Jinlong， DENG Runjie

（The Peoples Hospital of Po County， Meizhou City of Guangdong Province， Guangdong Meizhou 514200， China）

ABSTRACT Objective： To discuss the effect of Xueshuantong injection combined with clopidogrel on the neural function and the quality of life in the treatment of patients with ischemic stroke. Methods： One hundred and thirty-six patients with ischemic stroke diagnosed from February， 2013 to August， 2015 in our hospitals were selected and randomly divided into a western medicine group and a combination group with 68 cases each. The western medicine group was given 75 mg of clopidogrel once a day for a total of 30 days while the combination group was additionally given Xueshuantong injection （a mixture of 300 mg of Xueshuantong powder + 150 ml of saline） twice a day for a total of 30 days on the basis of the western medicine group. The neural function and the quality of life were evaluated by NIHSS and ADL scores before treatment and day 7， 14 and 21 after， and meanwhile the efficacy and the occurrence of adverse drug reactions were statistically analyzed. Results： The treatment efficiency was 69.12% in the western medicine group and 83.82% in the combination group （P<0.05）. The NIHSS scores were significantly lower while the ADL scores were significantly higher in the combination group than the western medicine group （P<0.05） on the 7th， 14th and 21th days after treatment. There were no serious adverse drug reactions occurred in both groups. Conclusion： Xueshuantong injection combined with clopidogrel can effectively improve the curative effect of ischemic cerebral apoplexy， has better efficacy in promoting the recovery of neural function and good security. This is of benefit to improving the life quality of the patients and worthy of further clinical promotion.

KEY WORDS Xueshuantong injection； ischemic stroke； neural function； quality of life

缺血性脑卒中是指由于脑的供血动脉（颈动脉和椎动脉）狭窄或闭塞、脑供血不足导致的脑组织坏死，从缺血的影响范围可分为局限性脑缺血和弥漫性脑缺血，其诱发因素较多，如血栓、动脉粥样硬化、异常物体进入颈部动脉或脑动脉等，均可能引起缺血性脑卒中的发生[1]。近年来，随着对缺血性脑卒中的病理机制及辩证治疗规律的研究的不断深入，药物治疗缺血性脑卒中取得了良好的成效。目前，缺血性脑卒中常用的治疗药物有阿司匹林、氯吡格雷等，可有效缓解脑供血动脉狭窄或闭塞，具有改善脑部血液循环的作用[2]。有研究显示，用中药治疗缺血性脑卒中患者可有效促进脑部神经功能恢复，有利于提高患者的生活水平[3]。……