丁苯酞与马来酸桂哌齐特联合治疗对急性脑梗死患者神经功能的影响

摘要

Objective To study the curative effect and safety of dl-3-budylphthalinde and cinepazidemaleateon acute cerebral infarction.Methods One hundred and sixty patients with acute cerebral infarction were divided intofour groups continuously and randomlyxombination therapy group(40cases), budylphthalindegroup(40cases), dl-3-budylphthalinde group(40cases) and conventional treatment group(40cases).Neural function defect and activity of daily living were tested by National Institutes of HealthStroke Scale(NIHSS) and Barthel Index(BI) before therapy and after two weeks and six monthtreatment. Adverse events were statistically analyzed.Results NIHSS total score after two weeks treatment, Compared with conventionaltreatment group, budylphthalinde group or dl-3-budylphthalinde used alone has no statisticalsignificance(P>0.05), but there was synergy between the two drugs(P<0.01). BI after two weekstreatment, budylphthalinde group or dl-3-budylphthalinde used alone has statistical significance(P=0.029, ,P=0.002), but combination therapy group has better effect(P=0.001). NIHSS total scoreand BI after six month treatment, budylphthalinde group or dl-3-budylphthalinde used aloneor combination therapy has significant curative effect(P<0.01), and combination therapy grouphas better effect. The 1 case in therapy group, 2 cases in dl-3-budylphthalinde group, 1 case inconventional treatment group appeared upset stomach. Symptoms improved after symptomatictreatment.Conclusion There was synergy between 1-3-budylphthalinde combined with cinepazidemaleate. It is an effective and safe method to treat acute cerebral infarction by the two drugs.%目的 观察丁苯酞联合马来酸桂哌齐特治疗急性脑梗死的疗效及安全性.方法 连续选择符合入选条件的160例急性脑梗死的患者,采用随机数字表法分为4组.联合治疗组(n=40)、丁苯酞组(n=40)、马来酸桂哌齐特组(n=40)和常规治疗组(n=40).在治疗前、治疗后第14天及180天分别采取美国国立卫生研究院卒中量表(National Institutes of Health Stroke Scale,NIHSS)和Barthel指数(Barthel Index,BI)评定神经功能缺损程度及日常生活活动能力,并统计不良事件发生情况.结果 治疗后第14天的NIHSS评分,与常规治疗组比较,丁苯酞组或马来酸桂哌齐特组均无统计学差异(P＞0.05),使用联合治疗组有很好的协同作用(P＜0.01).治疗后第14天的Barthel指数,丁苯酞组或马来酸桂哌齐特组均有统计学差异(P=0.029,P=0.002),且使用联合治疗组疗效更显著(P=0.001).治疗后第180天NIHSS评分和Barthel指数,丁苯酞组或马来酸桂哌齐特组以及联合治疗组均有疗效(P均＜0.01),且联合治疗组效果更显著.联合治疗组有1例、丁苯酞组有2例、常规治疗组有1例出现胃部不适,给予对症治疗后好转.结论 丁苯酞联合马来酸桂哌齐特治疗急性脑梗死具有很好的协同作用,是治疗急性脑梗死的一种安全而有效方法.