阿替普酶溶栓联合清脑通脉汤治疗超早期急性脑梗死患者的疗效观察

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摘要目的观察阿替普酶溶栓联合清脑通脉汤治疗超早期急性脑梗死患者的临床效果，寻找更安全有效的溶栓治疗方法。方法选取九江市中医医院脑病科2015年4月～2017年4月收治的60例脑梗死患者，按照随机数字表法分为治疗组和对照组，各30例。两组患者均给予控制西医基础治疗，对照组给予阿替普酶溶栓规范化治疗，治疗组在对照组基础上给予清脑通脉汤口服或鼻饲治疗。比较两组治疗前后的MIHSS评分、Barthel指数评分、治疗后的凝血功能变化及临床疗效。通过治疗前后观察和对比，验证其是否具有提高溶栓治疗安全性和疗效的目标。结果两组患者治疗前的NIHSS评分和Barthel指数比较，差异无统计学意义（P＞0.05）。两组治疗后的NIHSS量表评分及Barthel指数均较治疗前明显改善，差异有统计学意义（P＜0.05）。治疗组患者治疗后的NIHSS量表评分低于对照组，而Barthel指数评分高于对照组，差异有统计学意义（P＜0.05）。两组患者治疗后的各项凝血功能指标比较，差异无统计学意义（P＞0.05）。治疗组治疗后的总有效率为96.67%，显著高于对照组的66.67%，差异有统计学意义（P＜0.05）。结论对于急性超早期脑梗死患者，实行阿替普酶静脉溶栓联合清脑通脉汤联合治疗，不仅能够溶栓，更能够在一定程度上避免转化出血，对患者凝血功能无影响，具有显著的疗效，安全性较高，值得在临床上推广应用。

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	宗志涛

关键词 ：阿替普酶, 超早期急性脑梗死, 清脑通脉汤, 溶栓

Abstract：Objective To observe the clinical efficacy of Alteplase thrombolysis combined with Qingnao Tongmai Decoction in the treatment of patients with acute cerebral infarction in the super early stage,and to find a safer and effective method for thrombolytic therapy.Methods 60 patients with cerebral infarction from April 2015 to April 2017 were enrolled in the Department of Neurology,Jiujiang Hospital of Traditional Chinese Medicine.The patients were divided into the treatment group and the control group according to random number table method,30 cases in each group.Two groups of patients were given control of Western medicine for basic treatment.The control group was then treated with Alteplase thrombolytic therapy.The treatment group was given Qingnao Tongmai Decoction oral or nasal feeding on the basis of the control group.The MIHSS score,the Barthel index score,the coagulation function after treatment and the clinical effect were compared before and after treatment between the two groups.The improvement of the safety and efficacy of thrombolytic therapy goals was verified by observing and comparing these indexes before and after treatment.Results There was no significant difference in the NIHSS score and Barthel index between the two groups before treatment (P＞0.05).The NIHSS scale and Barthel index after treatment of the two groups were significantly better than those before treatment,with significant difference (P＜0.05).The NIHSS score of the patients in the treatment group after treatment was lower than that of the control group,while the Barthel index score of the patients in the treatment group after treatment was higher than the control group,with significant difference (P＜0.05).There was no significant difference in the indexes of blood coagulation function between the two groups after treatment (P＞0.05).The total effective rate was 96.67% in the treatment group,which was significantly higher than that in the control group (66.67%),the difference was statistically significant (P＜0.05).Conclusion For patients with acute cerebral infarction in the super early stage,intravenous Alteplase combined with Qingnao Tongmai Decoction can not only accomplish thrombolysis,but also can avoid the transformation of bleeding to a certain extent,has no effect on the coagulation function of patients,with high efficacy and safety,it is worthy of clinical promotion and application.

Key words： Alteplase Super early acute cerebral infarction Qingnao Tongmai Decoction Thrombolysis

基金资助:江西省卫生计生委中医药科研课题（2015A229）

作者简介: 宗志涛（1976-），男，硕士，副主任医师，研究方向：神经外科疾病的微创治疗

引用本文:

宗志涛. 阿替普酶溶栓联合清脑通脉汤治疗超早期急性脑梗死患者的疗效观察[J]. 中国当代医药, 2017, 24(36): 10-12转19.
ZONG Zhi-tao. Observation on the curative effect of Alteplase thrombolysis combined with Qingnao Tongmai Decoction in the treatment of the patients with acute cerebral infarction in the super early stage. 中国当代医药, 2017, 24(36): 10-12转19.

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http://dangdaiyiyao.com/CN/ 或 http://dangdaiyiyao.com/CN/Y2017/V24/I36/10

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