杏芎氯化钠注射液治疗急性脑梗塞32例临床观察.docx

杏芎氯化钠注射液治疗急性脑梗塞32例临床观察
【摘要】 目的观察杏芎氯化钠注射液治疗急性脑梗塞的临床疗效。方法将62例急性脑梗塞患者随机分成治疗组和对照组。两组常规治疗方法相同。治疗组给予杏芎氯化钠注射液1次/d，静脉滴注；对照组加丹奥注射液、克林澳注射液2次/d，静脉滴注，脑细胞活化剂特安欣(肌氨肽苷)注射液1次/d，静脉滴注，2周后观察疗效。结果治疗组与对照组的总有效率分别为%和%(),显效率分别为%、%()，均无显着性差异。治疗组在改善神经功能缺损方面明显好于对照组()。结论杏芎氯化钠注射液治疗急性脑梗塞具有多种治疗作用，用药简便、疗效确切，而且在改善神经功能缺损方面作用较好，值得临床推广应用。
【关键词】 杏芎氯化钠注射液； 急性脑梗塞； 临床疗效
　　Abstract:ObjectiveTo observe the therapeutic effect of Floium Ginkgo extract and Tertram Ethypyrazine sodium chloride injection on acute cerebral two cases of patients with acute cerebral infarction were divided into two groups at random, treatment group(32 cases) and control group(30 cases).Both of the groups were treated with the same ordinary　cases of the treatment group were given Floium Ginkgo extract and Tertram Ethypyrazine sodium chloride injection qd, iv gtt .The cases of the control group were given sodium Ozagrel , Cinepazide Maleate injection bid,iv gtt . and Muscular Amino Acids and Peptides and Nucleosides Injection to observe the efficacy. The treatment course was 2　was no significant difference between two groups. The total effective rate in the treatment group and the control group was % and % respectively () and the excellent effective rate was % and % respectively (). The neurological function defect scoring in the treatment group was significantly better than that of in the control group (). ConclusionBecause Floium Ginkgo extract and Tertram Ethypyrazine sodium chloride injection is easily used and has a cocktail positive effect on many kinds of treatment action and improvement of neurological function defect in clinic, it is worth being popularized and used clinically.
　　Key words Floium Ginkgo extract and Tertram Ethypyrazine sodium chloride injection, Acute cerebral infarction, Curative effect
　　Cerebral infarction is also called ischemia brain stroke, a common and frequent cerebrovascular disease in clinic, it is the third leading cause of death in all kinds of disease in middle-aged population in clinic with high morbidity mortality and disability. In recent years acute cerebral infarction is increasing tend to young［1］，at present no single western agent can cure it effectively, but Floium Ginkgo extract and Tertram Ethypyrazine sodium chloride injection can do it. It will expand a new train of thought and open widely field of vision because it contains a variety of molecules with potent biological activities and a cocktail therapeutic method to cure acute cerebral infarction, but the drug hasn‘t been used for a long period of time, we will observe its efficacy in clinic in order to further investigate therapeutic effect.
　　1 Clinical Material

　　All the cases were divided randomly into treatment group (32 cases) and control group (30cases) from 62 consecutive acute cerebral infarction patients admitted to our hospital. Diagnosis of acute cerebral infarction for each case was made according to standard of cerebral infarction diagnosis and brain computed tomography (CT) and/or magnetic resonance images (MRI) were used to confirm the diagnosis. Patients with cerebral hemorrhage, liver disfunction, renal disfunction, cardiovascular diseases and hematological diseases were excluded.

　　There was no significant difference between two groups in ages,sexes,symptoms, scores of neurological function defect and ordinary method before the patients admitted to hospital by statistical analysis.
　　Standard of diagnosis Diagnosis of acute cerebral infarction was made according to the Chinese neurological academy about essentials of diagnosis on each kind of cerebrovascular disease［2］. Brain computed tomography (CT) and/or magnetic resonance images (MRI) were used to confirm the diagnosis.
　　Tab1 Comparison of general conditions in the two groups
　　Clinical symptoms of acute cerebral infarction often suddenly trouble standing or walking, speaking or understanding, seeing with one or both eyes and dizziness, loss of balance or coordination, numbness of the face, arm or leg weakness, especially on one side of the body, severe headaches with no known cause, brief loss of consciousness or a period of decreased consciousness (fainting, confusion, convulsions or even coma).
　　2 Therapeutic Methods

　　The ordinary method : the cases with hypertension was given anti-hypertension［3］，with hyperglycemia given anti-hyperglycemia, with high lipid given lowing blood lipid, hydrocephalus, and oxygenation, radiotherapy according to the concrete conditions of acute cerebral infarction.

　　The treatment group was given Floium Ginkgo extract and Tertram Ethypyrazine sodium chloride injection 100～250ml, qd, iv　control group was given sodium Ozagrel 160mg, Cinepazide Maleate 160mg injection add to %NaCl,bid,iv gtt and Muscular Amino Acids and Peptides and Nucleosides 10ml Injection qd, iv gtt. The treatment course was 2 weeks.

　　Statistical analyses were made using the target of neurological function defect scorning and clinical symptom, for X2 test, differences with a value of　were considered significant. All the data were treated by

　　Criterion standard of efficacy:All the cases were judged effect using Nimoldipine method after treated 2wk,based on 1993 Ministry of Heath　China, Guidence of principle of clinical research of new drug of Chinese traditional medicine on stroke by scoring to observe the comprehensive function of patients consciousness, language, limbs［4］. Each of score is 0～4, the full is 28,the function defect scoring decreased more than 85% is basically cure, 50% is apparent effect, 20% is ameliorate, less than 20% or deteriorating to death is no effect or change.
　　Tab2 The treatment result
　　The excellent rate, X2＝P＞ total effective rate,X2＝，P＞，there was no significant difference by SPSS X2 test, but 1 patient was dead in treatment group mortality %；2 patients were dead in control group mortality %.
　　Tab3 neurological function defect scoring
　　The neurological function defect scores after therapy decreased more apparently than those that before therapy both between therapy and control groups through statistical treatment t test with remarkable difference ().

　　Discussion Chinese medical philosophy thinks that acute cerebral infarction caused by wind-pglegm static blood and impediment of vital energy stagnating at main channel, qi vacuity blood stasis, both qi and blood are absent, organ function is out of control. It is characterized by its emphasis on maintaining and restoring homeostasis through interaction with a wide variety of targets. So Chinese traditional medicine and materia medica expresse its special advantage and play important roles on the treatment and prevention. Floium Ginkgo extract and Tertram Ethypyrazine sodium chloride injection contains a variety of molecules with potent biological activities and many action such as anti-thrombosis, thrombolysis, dilatation of brain vessels and increasing of its blood flow, improvement of hematology, microcirculation, immunity cerebrovascular infarction and scavenging free radical, prevention of acute brain injury, restoration of injured nerve, inhibition of platelet aggregation, anti-inflammation reaction and increase of the tolerance to anoxia and anti-fatigue, promotion of cardio-cerebral celluar metabolism, enhancing memory, and relieving the sequel for apoplexy. The levels of TNF-α,ET-1 significantly decreased and NO were remarkably higher in patients with cerebral infarction when it was used alone［5］.

　　Ozagrel, a selective remarkable effective thromboxane A2 (TXA2) synthetase inhibitor［6］, antithrombotics, prevents the formation of blood clots by preventing the accumulation of platelets that form the basis of blood clots; Cinepazide Maleate a calcium channel antagonists, dilate brain blood vessel, improve microcirculation to increase its blood flow, Muscular Amino Acids and Peptides and Nucleosides an important material to take part in life activity of human body.

　　Floium Ginkgo extract and Tertram Ethypyrazine sodium chloride injection itself has a cocktail therapeutic effect and is used conveniently so it should be payed enough attention by physician for its advantage on improvement of neurological function defect with a cocktail therapeutic effect even though the total effective rate and the remarkable effect rate has no significant difference between the treatment and the control group through statistical treatment.
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