CAJ | 학술논문

目的：探讨复方血栓通胶囊治疗高龄急性脑梗死（ ACI）患者的临床疗效及其对血管内皮细胞功能的影响。方法选取2013年7月—2014年7月南京脑科医院神经内科收治的ACI患者97例，根据随机数字表法分为研究组48例和对照组49例。两组患者均给予控制血脂、血压等常规治疗；在此基础上研究组患者给予复方血栓通胶囊治疗，两组患者均治疗1个月。比较两组患者临床疗效，治疗前和治疗1个月后美国国立卫生研究院卒中量表（NIHSS）评分、巴氏指数（BI）评分、血管内皮细胞功能指标〔内皮素1（ET-1）、一氧化氮（NO）〕、血清炎性因子〔肿瘤坏死因子α（TNF-α）、C反应蛋白（CRP）〕水平及经颅多普勒超声检查结果〔双侧大脑中动脉（MCA）最大峰值流速（ Vp）、舒张末流速（ Vd）、平均流速（ Vm）、搏动指数（ PI）、阻力指数（ RI）〕。结果治疗前两组患者NIHSS评分、BI评分及血清TNF-α、CRP、ET-1、NO水平比较，差异无统计学意义（ P>0.05）；治疗后研究组患者NIHSS评分及血清TNF-α、CRP、ET-1水平低于对照组，BI评分和血清NO水平高于对照组（ P<0.05）。治疗前两组患者MCA Vp、Vd、Vm、PI、RI比较，差异无统计学意义（ P>0.05）；治疗后研究组患者MCA Vp、Vd、Vm均高于对照组，PI、RI低于对照组（P<0.05）。研究组患者临床疗效优于对照组（P<0.05）。结论复方血栓通胶囊治疗高龄ACI的临床疗效确切，能有效改善患者神经功能及血管内皮细胞功能，减轻炎性反应、稳定脑血流量。
목적：탐토복방혈전통효낭치료고령급성뇌경사（ ACI）환자적림상료효급기대혈관내피세포공능적영향。방법선취2013년7월—2014년7월남경뇌과의원신경내과수치적ACI환자97례，근거수궤수자표법분위연구조48례화대조조49례。량조환자균급여공제혈지、혈압등상규치료；재차기출상연구조환자급여복방혈전통효낭치료，량조환자균치료1개월。비교량조환자림상료효，치료전화치료1개월후미국국립위생연구원졸중량표（NIHSS）평분、파씨지수（BI）평분、혈관내피세포공능지표〔내피소1（ET-1）、일양화담（NO）〕、혈청염성인자〔종류배사인자α（TNF-α）、C반응단백（CRP）〕수평급경로다보륵초성검사결과〔쌍측대뇌중동맥（MCA）최대봉치류속（ Vp）、서장말류속（ Vd）、평균류속（ Vm）、박동지수（ PI）、조력지수（ RI）〕。결과치료전량조환자NIHSS평분、BI평분급혈청TNF-α、CRP、ET-1、NO수평비교，차이무통계학의의（ P>0.05）；치료후연구조환자NIHSS평분급혈청TNF-α、CRP、ET-1수평저우대조조，BI평분화혈청NO수평고우대조조（ P<0.05）。치료전량조환자MCA Vp、Vd、Vm、PI、RI비교，차이무통계학의의（ P>0.05）；치료후연구조환자MCA Vp、Vd、Vm균고우대조조，PI、RI저우대조조（P<0.05）。연구조환자림상료효우우대조조（P<0.05）。결론복방혈전통효낭치료고령ACI적림상료효학절，능유효개선환자신경공능급혈관내피세포공능，감경염성반응、은정뇌혈류량。
Objective To investigate the clinical effect of fufang xueshuantong capsule on elderly acute cerebral infarction and its impact on vascular endothelial cell function. Methods From July 2013 to July 2014,a total of 97 elderly patients with acute cerebral infarction were selected in the Department of Neurology,Nanjing Brain Hospital,and they were divided into control group(n =48)and research group(n =49). Patients of both groups received conventional treatment, including blood lipid control, blood pressure control and so on, while patients of research group received extra fufang xueshuantong capsule,both groups treated for one month. Clinical effect,NIHSS score,BI score,vascular endothelial cell function index [ including ET -1 and NO ], serum inflammatory cytokines levels ( including TNF -α and CRP ) and TCD results( including Vp,Vd,Vm,PI and RI of bilateral MCAs) before treatment and after one month of treatment were compared between the two groups. Results No statistically significant differences of NIHSS score,BI score,serum levels of TNF-α, CRP,ET-1 or NO was found between the two groups before treatment(P>0. 05);after treatment,NIHSS score and serum levels of TNF-α,CRP,ET -1 of research group were statistically significantly lower than those of control group,while BI score and serum NO level of research group were statistically significantly higher than those of control group ( P <0. 05 ). No statistically significant differences of Vp, Vd, Vm, PI or RI of bilateral MCAs was found between the two groups before treatment(P<0. 05);after treatment,Vp,Vd,Vm of bilateral MCAs of research group were statistically significantly higher than those of control group,while PI,RI of bilateral MCAs of research group was statistically significantly lower than that of control group,respectively(P<0. 05). The clinical effect of research group was statistically significantly better than that of control group ( P <0. 05 ). Conclusion Fufang xueshuantong capsule has certain clinical effect in treating elderly acute cerebral infarction, can effectively improve the neurological function and vascular endothelial cell function, relieve the inflammatory response and keep cerebral blood flow stable.