CAJ | 학술논문

目的：评价丁苯酞序贯治疗分支动脉粥样硬化病急性脑梗死的临床效果及安全性。方法采用随机对照设计，将60例急性脑梗死患者随机分为丁苯酞序贯治疗组（31例）和对照组（29例）。全部患者均根据病情给予口服阿司匹林，阿托伐他汀钙，同时给予奥扎格雷钠静脉滴注；调控血压，控制血糖、血脂，积极治疗并发症；病情稳定后行早期神经康复治疗。治疗组在常规治疗的基础上使用丁苯酞100 ml、2次/ d，静脉滴注，连续治疗14 d，以后口服丁苯酞0.2 g，3次/ d，疗程90 d。两组患者均在治疗前后进行神经功能缺损程度评分（NIHSS）及日常生活活动能力评分（BI）。并详细观察记录各种与治疗相关的不良事件。结果两组患者治疗后第14天 NIHSS 评分[治疗组（4.36±3.11）分、对照组（6.12±2.67）分]均较治疗前[治疗组（11.42±3.20）分、对照组（11.64±3.43）分]降低（P 均＜0.05），治疗组明显低于对照组（F组内=2.125，P ＜0.01；F组间=18.63，P ＜0.01；F交互=25.34，P ＜0.01；与对照组比较，P＜0.05）。两组患者治疗后 BI 评分[治疗组（86.72±8.44）分、对照组（75.96±9.86）分]均较治疗前[治疗组（26.54±13.36）分、对照组（26.38±13.02）分]增高；丁苯酞治疗后 BI 评分明显高于对照组（F组内=29.27，P ＜0.01；F组间=32.48，P ＜0.01；F交互=42.41，P ＜0.01；与对照组比较，P ＜0.05）。治疗过程中未见明显不良反应。结论丁苯酞序贯治疗能显著改善分支动脉硬化病变急性脑梗死患者的神经功能缺损及日常生活活动能力，可显著改善预后、安全性好。
목적：평개정분태서관치료분지동맥죽양경화병급성뇌경사적림상효과급안전성。방법채용수궤대조설계，장60례급성뇌경사환자수궤분위정분태서관치료조（31례）화대조조（29례）。전부환자균근거병정급여구복아사필림，아탁벌타정개，동시급여오찰격뢰납정맥적주；조공혈압，공제혈당、혈지，적겁치료병발증；병정은정후행조기신경강복치료。치료조재상규치료적기출상사용정분태100 ml、2차/ d，정맥적주，련속치료14 d，이후구복정분태0.2 g，3차/ d，료정90 d。량조환자균재치료전후진행신경공능결손정도평분（NIHSS）급일상생활활동능력평분（BI）。병상세관찰기록각충여치료상관적불량사건。결과량조환자치료후제14천 NIHSS 평분[치료조（4.36±3.11）분、대조조（6.12±2.67）분]균교치료전[치료조（11.42±3.20）분、대조조（11.64±3.43）분]강저（P 균＜0.05），치료조명현저우대조조（F조내=2.125，P ＜0.01；F조간=18.63，P ＜0.01；F교호=25.34，P ＜0.01；여대조조비교，P＜0.05）。량조환자치료후 BI 평분[치료조（86.72±8.44）분、대조조（75.96±9.86）분]균교치료전[치료조（26.54±13.36）분、대조조（26.38±13.02）분]증고；정분태치료후 BI 평분명현고우대조조（F조내=29.27，P ＜0.01；F조간=32.48，P ＜0.01；F교호=42.41，P ＜0.01；여대조조비교，P ＜0.05）。치료과정중미견명현불량반응。결론정분태서관치료능현저개선분지동맥경화병변급성뇌경사환자적신경공능결손급일상생활활동능력，가현저개선예후、안전성호。
Objective To value the effect and safety of butyl phthalide sequential treatment in cerebral infarction of branch sclerosis of arterial congee appearance. Methods Sixty patients with acute cerebral infarction were randomly divided into treated group( n = 31)and control group( n = 29). According to the condition of illness,all patients were given aspirin,atorvastatin calcium,and the injection of ozagrel sodium intravenous;controlled the blood pressure,blood sugar,blood lipid,and treated complications posstively;take the early rehabilitation of nerve treatment afte the illness was in stable condition. Butyl phthalide was used in the patients of treated group(100 ml,twice per day,intravenous drip,during 14 days period therapy,and then 0. 2 g oral,third per day),besides the routine therapy. The degree of neural function defect score( NIHSS)and activities of daily living score(BI)between two groups were observed before and after treatment. Corresponding adverse consequences were recorded. Results Compared with pretreatment,the NIHSS of postreatment at the 14th day in treat and control groups were decreased(treated group:(4. 36 ± 3. 11)vs.(11. 42 ± 3. 20);control group:(6. 12 ± 2. 67)vs.(11. 64 ± 3. 43),P < 0. 05,and the treated group was significantly lower than control group(F inner groups = 2. 125,P < 0. 01;F between groups = 18. 63,P < 0. 01;F cross groups = 25. 34,P< 0. 01;P < 0. 05). The BI of postreatment in two group were increased(treated group:(86. 72 ± 8. 44)vs. (26. 54 ± 13. 36);control group:(75. 96 ± 9. 86)vs.(26. 38 ± 13. 02)),and the treated group was significantly lower than control group(F inner groups = 29. 27,P < 0. 01;F between groups = 32. 48,P < 0. 01;F cross groups= 42. 41,P < 0. 01;P < 0. 05). There was no the adverse reactions. Conclusion Butyl phthalide sequential treatment can improve the NIHSS and BI of cerebral infarction of branch sclerosis of arterial congee appearance and have a better therapy effect.