叶鑫

[摘要] 目的 探討急性缺血性脑卒中治疗中脑心通胶囊联合丁苯酞治疗对患者大脑中动脉血流动力学的影响。方法 回顾性选取2017年1月至2020年1月本院急性缺血性脑卒中患者60例，依据治疗方法分为脑心通胶囊联合丁苯酞治疗组（联合治疗组，n=30）、单独丁苯酞治疗组（单独治疗组，n=30）两组，统计分析两组患者的大脑中动脉Vm、NIHSS评分、MBI评分、临床疗效、血清炎症因子水平、不良反应发生情况。 结果 联合治疗组患者治疗后较治疗前的大脑中动脉Vm升高幅度显著高于单独治疗组（P<0.05），NIHSS评分降低幅度显著高于单独治疗组（P<0.05），MBI评分升高幅度显著高于单独治疗组（P<0.05）。治疗的总有效率：联合治疗组为93.3%（28/30），单独治疗组为76.7%（23/30），前者显著高于后者（P<0.05）。联合治疗组患者治疗后较治疗前的血清CRP、IL-6、IL-10水平降低幅度均显著高于单独治疗组（P<0.05）。不良反应发生率：联合治疗组为6.6%（2/30），单独治疗组为9.9%（3/30），两组比较，差异无统计学意义（P>0.05）。 结论 急性缺血性脑卒中治疗中脑心通胶囊联合丁苯酞治疗较单独丁苯酞治疗更能有效改善患者大脑中动脉血流动力学。

[关键词] 急性缺血性脑卒中;脑心通胶囊;丁苯酞;大脑中动脉;血流动力学;神经功能;日常生活能力;临床疗效;血清炎症因子水平;不良反应

[中图分类号] R743          [文献标识码] B          [文章编号] 1673-9701（2021）13-0058-04

Impacts of Naoxintong capsule combined with butylphthalide on hemodynamics of middle cerebral artery in patients with acute ischemic stroke

YE Xin

Department I of Neurology， Mudanjiang Forest Center Hospital in Heilong Province， Mudanjiang   157000， China

[Abstract] Objective To investigate the impacts of Naoxintong capsule combined with butylphthalide on hemodynamics of middle cerebral artery in patients with acute ischemic stroke（AIS）. Methods A total of 60 patients with AIS admitted to our hospital from January 2017 to January 2020 were retrospectively selected and divided into the combined treatment group（n=30， Naoxintong capsule combined with butylphthalide） and the single treatment group （n=30， butylphthalide alone） according to the treatment methods. The Vm， NIHSS score， MBI score， clinical efficacy， serum inflammatory factor levels and adverse reactions （ADRs） in the middle cerebral artery of the two groups of patients were statistically analyzed. Results Compared with before treatment， the Vm increase range of middle cerebral artery in the combined treatment group after treatment was significantly higher than that in the single treatment group（P<0.05）. The NIHSS score decrease range in the combined treatment group was significantly higher than that in the single treatment group （P<0.05）. The MBI score increase range in the combined treatment group was significantly higher than that in the single treatment group （P<0.05）. In terms of the total efficacy rate， the combined treatment group was 93.3% （28/30）， significantly higher than 76.7%（23/30） of the single treatment group （P<0.05）. After treatment， the levels of serum CRP， IL-6 and IL-10 in the combined treatment group were significantly lower than those in the single treatment group（P<0.05）. In terms of the incidence of ADRs， the combined treatment group was 6.6%（2/30）， and the single treatment group was 9.9% （3/30）， without significant difference between the two groups （P>0.05）. Conclusion In the treatment of patients with AIS， Naoxintong capsule combined with butylphthalide can more effectively improve the hemodynamics of middle cerebral artery than butylphthalide alone.

[Key words] Acute ischemic stroke; Naoxintong capsule; Butylphthalide; Middle cerebral artery; Hemodynamics; neurological function; Activity of daily living; clinical efficacy; Serum inflammatory factor level; Adverse reactions

急性缺血性脑卒中属于一种脑血管疾病，诱发因素为颅脑、颈、椎等部位血栓形成或动脉狭窄、闭塞等，占总数的70%～80%左右[1]。神经保护、溶栓等治疗虽然能够将一定的疗效获取过来，但是治疗时间窗狭窄，副反应严重。中医认为[2]，急性缺血性脑卒中属于“中风”范畴，中药辨证施治能够将肯定的疗效获取过来。丁苯酞的抗脑缺血作用较强，能够对脑能量代谢进行改善，联合脑心通胶囊可能能够促进疗效的进一步提升[3]。为了对急性缺血性脑卒中患者进行更好的治疗，从而有效改善患者预后，本研究统计分析了2017年1月至2020年1月本院急性缺血性脑卒中患者60例的临床资料，探讨急性缺血性脑卒中治疗中脑心通胶囊联合丁苯酞治疗对患者大脑中动脉血流动力学的影响。……