CAJ | 학술논문

目的：观察丁苯酞氯化钠注射液与甲磺酸倍他司汀联合治疗椎－基底动脉供血不足的临床疗效。方法：选择椎－基底动脉供血不足患者128例，经给予安慰剂洗脱2周后随机分为观察组和对照组，每组64例。观察组在常规治疗基础上给予丁苯酞氯化钠注射液200 ml／d、甲磺酸倍他司汀18～36 mg／d；对照组在常规治疗基础上给予甲磺酸倍他司汀18～36 mg／d；疗程均为2周。分别在用药前、用药后14 d观察患者临床疗效，血清内皮素（ ET）、一氧化氮（ NO）、不对称二甲基精氨酸（ ADMA）水平，血液流变学指标（全血比黏度、血浆比黏度、血细胞比容、红细胞聚集指数），双侧椎－基底动脉血流平均流速（Vm）和收缩峰值（Vs）等指标的改善情况。结果：治疗后2组患者临床疗效，血清ET、NO、ADMA水平，血液流变学，双侧椎基底动脉Vm、Vs等指标的改善程度与用药前比较差异均具有统计学意义（P＜0．05），且观察组明显优于对照组，差异均具有统计学意义（P＜0．05）。结论：丁苯酞氯化钠注射液联合甲磺酸倍他司汀治疗椎－基底动脉供血不足临床疗效确切，可显著改善血管内皮功能、血液流变学和椎基底动脉血流速度，预防脑卒中的发生，值得临床推广应用。
목적：관찰정분태록화납주사액여갑광산배타사정연합치료추－기저동맥공혈불족적림상료효。방법：선택추－기저동맥공혈불족환자128례，경급여안위제세탈2주후수궤분위관찰조화대조조，매조64례。관찰조재상규치료기출상급여정분태록화납주사액200 ml／d、갑광산배타사정18～36 mg／d；대조조재상규치료기출상급여갑광산배타사정18～36 mg／d；료정균위2주。분별재용약전、용약후14 d관찰환자림상료효，혈청내피소（ ET）、일양화담（ NO）、불대칭이갑기정안산（ ADMA）수평，혈액류변학지표（전혈비점도、혈장비점도、혈세포비용、홍세포취집지수），쌍측추－기저동맥혈류평균류속（Vm）화수축봉치（Vs）등지표적개선정황。결과：치료후2조환자림상료효，혈청ET、NO、ADMA수평，혈액류변학，쌍측추기저동맥Vm、Vs등지표적개선정도여용약전비교차이균구유통계학의의（P＜0．05），차관찰조명현우우대조조，차이균구유통계학의의（P＜0．05）。결론：정분태록화납주사액연합갑광산배타사정치료추－기저동맥공혈불족림상료효학절，가현저개선혈관내피공능、혈액류변학화추기저동맥혈류속도，예방뇌졸중적발생，치득림상추엄응용。
OBJECTIVE:To evaluate the clinical efficacy of butylphthalide and sodium chloride injection plus betahistine mesylate in the treatment of vertebrobasilar insufficiency.METHODS: 128 patients with vertebrobasilar insufficiency were selected and given placebo elution for 2 weeks before being randomly divided into observation group and control group, of 64 cases each.The observation group received conventional treatment plus butylphthalide and sodium chloride injection (200 ml/d) and betahistine mesylate (18-36 mg/d) for two weeks, while the control group received conventional treatment plus betahistine mesylate (18-36 mg/d) for 2 weeks.Serum levels of ET, NO and ADMA and blood rheology indexes ( whole blood viscosity, plasma viscosity, red blood cell hematocrit and erythrocyte aggregation index) , bilateral vertebral-basilar artery blood flow mean velocity( VM) and systolic peak velocity ( VS) index before and after medication ( 0 and 14 days ) were measured.RESULTS: The differences before and after treatment of 14 days in clinical efficacy, serum ET, NO and ADMA levels, blood rheology, bilateral vertebral-basilar artery blood flow mean velocity ( VM ) and systolic peak velocity ( VS ) indexes in the two groups were statistically significant (P<0.05), with observation group showing significantly better improvement than in the control group, and the differences between the two groups were statistically significant ( P <0.05 ) .CONCLUSIONS: Treatment of vertebrobasilar insufficiency with butylphthalide and sodium chloride injection plus betahistine mesylate resulted in confirmed efficacy in that which can significantly improve endothelial function, blood rheology and vertebral basilar artery blood flow velocity and prevent cerebral stroke, the use of which thus is worthy of clinical recommendation.