银丹心脑通软胶囊联合rt-PA对缺血性脑卒中患者认知功能及血脂的影响

摘要/Abstract

摘要： 目的观察银丹心脑通软胶囊联合重组人组织型纤溶酶原激活物（rt-PA）静脉溶栓对缺血性脑卒中患者整体获益水平的影响。方法选择2022年1月—2023年12月西乡县中医医院收治的100例缺血性脑卒中患者为研究对象,采用随机数表法分为对照组和联合组,每组50例。对照组开展rt-PA静脉溶栓治疗,联合组在对照组基础上联合银丹心脑通软胶囊治疗,对比临床疗效、神经功能恢复情况[美国国立卫生院脑卒中量表（NIHSS）、改良Rankin量表（mRs）]、血液流变学、血脂[三酰甘油（TG）、总胆固醇（TC）,全血黏度（WBV）与红细胞沉降率（ESR）]、氧化应激[血清一氧化氮（NO）、丙二醛（MDA）]情况。结果联合组治疗效果优于对照组,差异有统计学意义（P<0.05）;治疗前,两组NHISS与mRs评分比较,差异无统计学意义（P>0.05）,治疗后,两组NHISS与mRs评分均下降,且联合组NHISS与mRs评分下降幅度大于对照组,差异有统计学意义（P<0.05）;治疗前,两组TC、TG、WBV、ESR表达比较,差异均无统计学意义（P>0.05）,治疗后,两组TC、TG、WBV表达下降、ESR表达升高,且联合组TC、TG、WBV下降幅度与ESR升高幅度均大于对照组,差异均有统计学意义（P<0.05）;治疗前,两组MDA、NO水平比较,差异均无统计学意义（P>0.05）,治疗后,两组NO水平下降、MDA水平升高,且联合组NO水平下降幅度与MDA水平升高幅度均大于对照组,差异均有统计学意义（P<0.05）。结论缺血性脑卒中患者在rt-PA治疗基础上联合银丹心脑通软胶囊,治疗效果更佳,患者神经功能恢复更彻底,且利于改善患者血脂、血液流变学及氧化应激反应。

关键词: 缺血性脑卒中, 重组人组织型纤溶酶原激活物, 银丹心脑通软胶囊, 神经功能

Abstract: Objective To observe the effect of Yindan Xinnaotong soft capsule combined with recombinant tissue-type plasminogen activator (rt-PA) intravenous thrombolysis on the overall benefit level of patients with ischemic stroke. Methods Study sample source: 100 ischaemic stroke patients admitted to the Department of Neurology of Xixiang County Hospital of Traditional Chinese Medicine, sample selection time: between January 2022 and December 2023 period. The enrolled patients were divided into two groups using the random number table method, 50 cases in the control group, in which rt-PA intravenous thrombolytic therapy was carried out, and 50 cases in the combined group, in which the patients in the group were combined with Yindan Xinguintong soft capsule therapy on the basis of the control group, to compare the clinical efficacy, the recovery of neurological function [Stroke Scale (NIHSS), Modified Rankin Scale (mRs)], haemato-rheology, blood lipids [triacylglycerol (TG), total body fat (TG), total body fat (TG) and blood lipid [triacylglycerol (TG), and total body fat (TL)]. glycerol (TG), total cholesterol (TC), whole blood viscosity (WBV) and erythrocyte sedimentation rate (ESR)], oxidative stress [serum nitric oxide (NO), malondialdehyde (MDA)]. Results The treatment effect of the combined group was better than that of the control group, and the difference was statistically significant (P<0.05); there was no statistical difference between the scores of NHISS and mRs before treatment in the two groups (P>0.05). After treatment, the scores of NHISS and mRs in the combined group decreased significantly,with statistical difference (P<0.05). There was no statistical difference in the expressions of TC, TG, WBV and ESR between the two groups before treatment (P>0.05). After treatment,the expressions of TC, TG and WBV in the two groups decreased,while the expressions of ESR increased. Moreover,the decreases of TC, TG and WBV in the combined group were larger than those in the control group, and the differences were statistically significant (P<0.05), comparison of MDA and NO between the two groups before treatment, the difference was not statistically significant (P>0.05), after treatment, NO decreased and MDA increased in both groups,and the magnitude of NO decrease and MDA increase in the combined group was greater than that of the control group, and the difference was statistically significant (P<0.05). Conclusion Ischemic stroke patients in rt-PA treatment based on the combination of Yindan Xinhuantong soft capsule, the therapeutic effect is better,the patient's neurological function recovery is more complete, and is conducive to the improvement of the patient's blood lipids, blood rheology and oxidative stress response.

Key words: ischemic stroke, recombinant tissue-type plasminogen activator, Yindan Xinnaotong soft capsule, neurological function

中图分类号:

R743.3

付小宁, 许文丽. 银丹心脑通软胶囊联合rt-PA对缺血性脑卒中患者认知功能及血脂的影响[J]. 中华养生保健, 2024, 42(23): 31-35.

FU Xiao-ning, XU Wen-li. The Effect of Yindan Xinnaotong Soft Capsule Combined with rt-PA on Cognitive Function and Blood Lipids in Patients with Ischemic Stroke[J]. ZHONGHUA YANGSHENG BAOJIAN, 2024, 42(23): 31-35.

参考文献

[1] 周立新,倪俊.院内缺血性卒中的诊疗现状与挑战[J].中国卒中杂志,2022,17(2):200-207.
[2] 顾珍. 银丹心脑通软胶囊联合静脉溶栓治疗急性缺血性脑卒中患者的临床疗效[J].中国药物与临床,2021,21(10):1734-1736.
[3] 马妮,崔小丽,王妮,等.银丹心脑通软胶囊联合长春西汀治疗缺血性脑卒中患者的疗效[J].现代生物医学进展,2020,20(18):3482-3485.
[4] 中华医学会神经病学分会,中华医学会神经病学分会脑血管病学组,彭斌,等.中国急性缺血性脑卒中诊治指南2018[J].中华神经科杂志,2018,9(9):666-682.
[5] 高颖. 中医临床诊疗指南释义:脑病分册[M].北京:中国中医药出版社,2015:102-105.
[6] HELDNER M R, ZUBLER C, MATTLE H P, et al.National Institutes of Health Stroke Scale Score and Vessel Occlusion in 2152 Patients With Acute Ischemic Stroke[J].Stroke,2013,44(4):1153-1157.
[7] 吴少祯. 常见疾病的诊断与疗效判定(标准)[M].北京:中国中医药出版社,1999:646.
[8] JOSEPH P, BRODERICK O, ADEOYE J, et al.Evolution of the Modified Rankin Scale and Its Use in Future Stroke Trials[J].Stroke,2017,48(7):2007-2012.
[9] 欧彩虹,董治燕,杨增烨.rt-PA静脉溶栓治疗急性缺血性脑卒中的疗效及对凝血指标的影响[J].血栓与止血学,2022,28(2):181-183.
[10] 赵舒平,王雪玲,王文辉.三七通舒胶囊联合rt-PA静脉溶栓对急性缺血性脑卒中患者IGF-1,MMP-9水平的影响[J].医学临床研究,2023,40(4):543-546.
[11] 史航,刘利群,陈继业.银丹心脑通软胶囊治疗老年不稳定型心绞痛合并2型糖尿病的临床疗效观察[J].中西医结合心脑血管病杂志,2020,18(1):183-185.
[12] 李永斌,张磊.银丹心脑通软胶囊治疗老年缺血性中风病人的临床研究[J].中西医结合心脑血管病杂志,2020,18(2):350-353.
[13] 田宇,赵刚,刘志群.银丹心脑通软胶囊治疗急性脑梗死的疗效及对血清P选择素,YKL-40水平的影响[J].医学综述,2022,28(8):1646-1650.
[14] 王鑫,薛莉,李转会,等.缺血性脑卒中患者血清促红细胞生成素与血液流变学的关系分析[J].检验医学与临床,2020,17(17):2436-2438.
[15] 田宇. 银丹心脑通软胶囊辅助静脉溶栓治疗急性缺血性脑卒中的临床疗效观察[J].中西医结合心脑血管病杂志,2020,18(19):3282-3285.
[16] 聂顺桃,宋肖潇.银丹心脑通软胶囊联合阿替普酶溶栓对老年急性脑梗死患者的疗效及安全性评价[J].中国急救复苏与灾害医学杂志,2023,18(3):294-297.
[17] 徐启丽,邹常超,莫丽莉,等.银丹心脑通软胶囊治疗心血管疾病的作用机制研究进展[J].中国药房,2021,32(9):1137-1141.
[18] 张娟利,陈亚绒.银丹心脑通软胶囊联合静脉溶栓治疗急性缺血性脑卒中患者的临床疗效观察[J].血栓与止血学,2022,28(2):207-208.
[19] 高洁,董一凤,王思梦,等.基于”异病同治”理论探讨银丹心脑通软胶囊通过HIF1α-MMP9介导的HIF1α信号通路治疗脑卒中和冠心病的共同机制[J].药学学报,2023,58(6):1401-1411.
[20] 王洪涛. 银丹心脑通软胶囊联合依达拉奉注射液治疗急性脑梗死的临床疗效观察[J].中西医结合心脑血管病杂志,2019,17(13):2051-2053.