【摘要】 目的:探究麝香保心丸(SBP)治疗老年冠心病(CHD)患者并发急性脑梗死(ACI)的疗效。方法:选取某院收治的CHD合并ACI的老年患者78例,按照随机数字表法分为观察组和对照组,每组39例。对照组给予常规治疗,观察组在常规治疗的基础上加用SBP治疗。比较2组患者治疗前后神经功能缺损量表(NIHSS)评分、生活自理能力量表(ADL)评分,分析血栓弹力图(TEG)(R值、K值、M值、Ma值和CI值)、血小板聚集率(PAg T)、血管紧张素转换酶抑制剂II(Ang-II)、HS-CRP、IL-6及血脂水平(LDL-C、HDL-C、TG、TC)变化,评价临床疗效,并于治疗前和治疗后12周检测颈动脉内膜中膜平均厚度(TMT)、最大厚度(Tmax)、横切面最大面积(Smax),统计2组患者平均住院时间及12个月内因再发ACI再住院率。结果:治疗后,观察组患者NIHSS评分、ADL评分、TMT、Tmax、Smax均较对照组减少,Ang-II、HS-CRP、IL-6均较对照组降低,TEG指标、PAg T、血脂水平较对照组明显改善,平均住院天数、12个月内再住院率较对照组减少,临床疗效较对照组高,2组比较差异有统计学意义(P值均<0.05); 2组患者不良反应发生率比较差异无统计学意义(P> 0.05)。结论:SBP治疗ACI不仅具有抗血小板聚集、调整血脂、缩小动脉斑块的作用,而且具有促进神经功能恢复、提升生活自理能力、增加临床效果、减少再住院率的作用,且不增加药物不良反应。更多还原

【Abstract】 Objective: To investigate the effect of Shexiang Baoxin Pill( SBP) on senile coronary heart disease( CHD) patients complicated with acute cerebral infarction( ACI). Methods: 78 elderly patients with CHD complicated with ACI in a hospital were selected and were randomly divided into an observation group and a control group,39 in each. The control group received routine treatment. On the basis of the routine treatment,the patients of the observation group were additionally given 45 mg and 3 times a day of SBP orally. NIHSS and ADL scores were compared between the two groups before and after the treatment. Thrombosis elastigram( R value,K value,M value,MA value,and CI value),platelet aggregation rate,ANG-II,hs-CRP,IL-6,blood lipid level( LDL-C,HDL-C,TG,TC) were all examined and analyzed and were used to evaluate clinical efficacy. Before and 12 weeks after treatment,color Doppler ultrasonography was performed to detect carotid artery TMT,Tmax and Smax. The average length of hospital stay and the rate of readmission due to recurrent ACI in the two groups were calculated within 12 months. Results: In the observation group,NIHSS score,ADL score,TMT,Tmax,Smax,Ang-II,CRP,IL-6,TEG,PAg T and serum lipid levels were significantly improved compared with the control group. The average hospital stay and the rate of readmission within 12 months were shorter or lower,and the total effective rate was also higher than that of the control group. The differences between the two groups were all statistically significant( P < 0. 05). There was no significant difference in the incidence of adverse reactions between the two groups( P > 0. 05). Conclusion: In the treatment of ACI,SBP not only has the effects of anti-platelet aggregation,adjusting blood lipid and narrowing arterial plaques,but also has the effects of promoting the recovery of neurological function,improving self-care ability,enhancing clinical efficacy and reducing the rate of re-hospitalization,without increasing the side effects.更多还原