标题：奥扎格雷钠再灌注联合芪蝎活血通络汤治疗脑血栓形成临床研究

      作者：刘玉琴 1，王亚娟 2，何锋 2    渭南市第二医院药剂科 1、神经内科 2，陕西 渭南 714000

      卷次： 2020年31卷16期

      【摘要】 目的 探讨奥扎格雷钠再灌注联合芪蝎活血通络汤治疗脑血栓形成的效果，为患者诊疗提供依据。方法 选取2018年7月至2019年6月渭南市第二医院收治的脑血栓患者80例为研究对象，按随机数表法将患者分为对照组和观察组各40例，对照组采用奥扎格雷钠再灌注治疗，观察组在此基础上联合芪蝎活血通络汤治疗。治疗7 d后比较两组患者的治疗效果，以及治疗前后美国国立卫生研究院卒中量表(NIHSS)评分、日常生活活动能力(ADL)评分、血清胶质纤维酸性蛋白(GFAP)、血管紧张素Ⅱ(Ang-Ⅱ)、血管内皮生长因子(VEGF)、白细胞介素-6(IL-6)、C反应蛋白( CRP)、肿瘤坏死因子-α (TNF-α)水平和药物不良反应情况。结果 观察组患者的治疗总有效率为95.00%，明显高于对照组的77.50%，差异有统计学意义(P<0.05)；两组患者治疗后的NIHSS评分较治疗前均显著降低，且观察组治疗后的NIHSS评分为(14.78±2.17)分，明显低于对照组的(20.50±3.02)分，差异均有统计学意义(P<0.05)；两组患者治疗后的ADL评分较治疗前均明显升高，且观察组治疗后的ADL评分为(52.18±5.12)分，明显高于对照组的(38.19±4.87)分，差异均有统计学意义(P<0.05)；两组患者治疗后的血清GFAP、Ang-Ⅱ水平较治疗前均明显降低，且观察组治疗后的血清GFAP、Ang-Ⅱ水平分别为(0.88±0.12) μg/L、(14.78±2.15) μg/L，明显低于对照组的(1.20±0.22) μg/L、(19.20±2.68) μg/L，差异均有统计学意义(P<0.05)；两组患者治疗后的VEGF水平较治疗前明显升高，且观察组治疗后的VEGF水平为(89.10±5.27) ng/L，明显高于对照组(75.18±6.12) ng/L，差异均有统计学意义(P<0.05)；两组患者治疗后的炎症因子 IL-6、CRP、TNF-α水平较治疗前明显降低，且观察组治疗后的 IL-6、CRP、TNF-α水平分别为(41.18±3.17) pg/mL、(8.17±1.90) mg/L、(22.41±3.48) ng/L，明显低于对照组的(49.12±4.10) pg/mL、(13.20±2.71) mg/L、(29.12±3.19) ng/L，差异均有统计学意义(P<0.05)；两组患者治疗期间的药物不良反应发生率比较差异无统计学意义(P>0.05)。结论 奥扎格雷钠再灌注治疗基础上联合芪蝎活血通络汤治疗脑血栓形成可有效改善患者神经功能缺损程度，提高患者日常生活能力，降低血清GFAP、Ang-Ⅱ、VEGF水平，抑制炎症因子表达，且安全性高，值得临床推广使用。
      【关键词】 脑血栓；奥扎格雷钠；脑缺血；神经功能；芪蝎活血通络汤；不良反应
      【中图分类号】 R743.32 【文献标识码】 A 【文章编号】 1003—6350（2020）16—2048—04

Clinical study of ozagrel sodium reperfusion combined with Qixihuoxuetongluo Decoction in the treatment ofcerebral thrombosis.
LIU Yu-qin 1, WANG Ya-juan 2, HE Feng 2. Department of Pharmacy 1, Department of Neurology 2,Weinan Second Hospital, Weinan 714000, Shaanxi, CHINA
【Abstract】 Objective To explore the effect of ozagrel sodium reperfusion combined with QixihuoxuetongluoDecoction in the treatment of cerebral thrombosis. Methods A total of 80 patients with cerebral thrombus, who admit-ted to Weinan Second Hospital from July 2018 to June 2019, were selected and divided into the control group and obser-vation group according to random number table method, with 40 patients in each group. The control group was treatedwith ozagrel sodium reperfusion, and the observation group was treated with Qixihuoxuetongluo Decoction on this basis.After 7 days of treatment, the therapeutic effects of the two groups before and after treatment were compared, as well asthe National Institutes of Health Stroke Scale (NIHSS) score, activity of daily life (ADL) score, glial fibrillary acidic pro-tein (GFAP), angiotensin (Ang) Ⅱ, vascular endothelial growth factor (VEGF), interleukin 6 (IL-6), C-reactive protein(CRP), tumor necrosis factor α (TNF-α) and adverse drug reactions. Results The total effective rate of the observationgroup was 95.00%, which was significantly higher than 77.50% of the control group (P<0.05); after treatment, NIHSSscores of the two groups decreased significantly, while the observation group was (14.78±2.17) versus (20.50±3.02) inthe control group (P<0.05); ADL scores of the two groups increased significantly, while the observation group was(52.18±5.12) versus (38.19±4.87) of the control group (P<0.05); the serum GFAP and ANG-Ⅱ in the two groups de-creased significantly, and the levels in the observation group were (0.88±0.12) μg/L, (14.78±2.15) μg/L, respectively,which were significantly lower than corresponding (1.20±0.22) μg/L and (19.20±2.68) μg/L in the control group (P<0.05); VEGF in the two groups increased significantly, while the observation group was (89.10 ± 5.27) ng/L versus(75.18±6.12) ng/L of the control group (P<0.05); the inflammatory factors IL-6, CRP, TNF-α in the two groups decreasedsignificantly, and the levels in the observation group were (41.18±3.17) pg/mL, (8 17±1.90 mg/L, (22.41±3.48) ng/L,respectively, which were significantly lower than corresponding (49.12 ± 4.10) pg/mL, (13.20 ± 2.71) mg/L, (29.12 ±3.19) ng/L of the control group (all P<0.05); there was no significant difference in the incidence of adverse reactions be-