天降血栓通丸联合rt-PA静脉溶栓治疗急性缺血性脑卒中的临床评估

Clinical evaluation of Tianjiang Xueshuantong Pill combined with rt-PA intravenous thrombolytic therapy for acute ischemic stroke

关键词:  天降血栓通丸  缺血性脑中风  临床疗效  神经功能

Key words:  Tianjiang Xueshuantong Pill  ischemic stroke  efficacy evaluation  neurological function

摘要:

[目的] 评估天降血栓通丸口服联合重组组织纤溶酶原激活剂（rt-PA）静脉溶栓治疗对不同年龄段急性缺血性脑卒中患者的临床疗效。[方法] 回顾性研究2017年1月—2020年2月收治的271例予以rt-PA静脉溶栓治疗的风痰阻络型急性缺血性脑卒中患者的临床资料，根据年龄分为老年组（≥65岁）和青中年组（＜65岁）；根据是否给予天降血栓通丸口服治疗，分为治疗组和对照组。患者均给予常规内科综合治疗。连续治疗30 d后，比较两组患者的美国国立卫生研究院卒中量表（NIHSS）评分、中医证候评分、改良Rankin评分量表（mRS）评分，以及Barthel指数（BI）评分的差异，评估两组患者的临床疗效。[结果] 治疗后各组患者NIHSS评分均显著降低。老年组患者治疗前NIHSS评分存在差异，排除其干扰后，治疗组与对照组相比mRS评分降低，BI评分提高，差异具有统计学意义（P＜0.05）。青中年组患者治疗组mRS评分和BI评分与对照组相比均无统计学意义（P＞0.05）。治疗后各组患者的中医证候评分均下降，老年患者中治疗组的中医证候评分低于对照组，差异具有统计学意义（P<0.05），治疗组和对照组的临床总有效率分别为91.04%和73.02%，差异具有统计学意义（P<0.05）。青中年组患者治疗后，治疗组和对照组的中医证候评分和临床总有效率比较无统计学意义（P>0.05）。[结论] 口服天降血栓通丸可有效地改善老年急性缺血性脑卒中患者的临床症状，促进患者身体康复，但对青中年患者的疗效不佳。

Abstract:

[Objective] To evaluate the clinical efficacy of Tianjiang Xueshuantong Pills (TXP) combined with rt-PA intravenous thrombolysis in patients with acute ischemic stroke of different ages.[Methods] The clinical data of 271 patients with wind-phlegm-blocking acute ischemic stroke treated with rt-PA intravenous thrombolysis admitted from January 2017 to February 2020 were retrospectively studied.They were divided into the elderly group (≥ 65 years old) and the middle-aged group (<65 years old) according to their age,and further divided into the treatment group and the control group according to whether received TXP treatment.All patients were given conventional internal medicine treatment.After 30 days of continuous treatment,the NIHSS scores,traditional Chinese medicine (TCM) syndrome scores,mRS scores,and BI scores were compared,and the clinical efficacy was evaluated.[Results] The NIHSS scores of patients in all groups were significantly reduced after treatment.The difference in the NIHSS scores of the elderly group before treatment was statistically significant,and after excluding their interference,the mRS scores decreased and the BI scores increased in the treatment group compared with the control group,which were statistically significant (P<0.05).There was no significant change in mRS scores and BI scores in the treatment group compared to the control group in the middle-aged group (P>0.05).The TCM syndrome scores of each group were decreased after treatment,and the scores of the treatment group were lower than those of the control group in the elderly patients (P <0.05).The total clinical efficiency rates of treatment group and control group was 91.04% and 73.02%,respectively,with a significant difference (P<0.05).There was no significant difference in TCM syndrome scores and efficacy between the treatment group and the control group after treatment in the middle-aged group (P>0.05).[Conclusion] Oral administration of TXP can effectively improve the clinical symptoms and promote physical recovery in elderly patients with acute ischemic stroke,but the efficacy in young and middle-aged patients is poor.