世界中医药

目的：探究舒血宁注射液联合氢氯吡格雷治疗急性脑梗死的临床疗效及其对神经功能缺损、炎性反应因子及氧化应激的影响。方法：选取2017年2月至2018年6月江汉大学附属武汉市第六医院收治的脑梗死患者148例作为研究对象，按照随机数字表法随机分为对照组和观察组，每组74例。对照组在常规治疗的基础上加用硫酸氢氯吡格雷，观察组在对照组治疗的基础上加用舒血宁注射液，共治疗2周。观察2组患者临床疗效、血液流变学指标、神经功能相关指标（MBP、NSE、H-FABP、GFAP）、氧化应激指标（SOD、MDA、ROS）、炎性反应因子（sVCM-1、TNF-α、IL-18）及HMGB1水平变化情况。结果：治疗后2组红细胞压积、全血黏度高切、全血黏度低切、血浆黏度、MBP、NSE、H-FABP、GFAP、NIHSS评分均明显降低，观察组上述指标变化更明显，与对照组比较，差异有统计学意义（P<0.05）。与治疗前比较，2组患者治疗后sVCAM-1、TNF-α、IL-18、HMGB1均明显降低，且观察组上述指标明显低于对照组，差异有统计学意义（P<0.05）。治疗后2组MDA、ROS水平明显降低，SOD水平明显升高，观察组上述指标变化更明显，差异有统计学意义（P<0.05）。观察组治疗后的总有效率（91.89%）明显高于对照组（78.38%），差异有统计学意义（P<0.05）。结论：舒血宁注射液联合氢氯吡格雷治疗脑梗死具有改善血液流变学、降低炎性反应、减少神经功能缺损症状、降低氧自由基水平的作用，从而提高临床治疗效果。

English Summary:

To explore the clinical effects of Shuxuening Injection combined with clopidogrel hydrogen in the treatment of acute cerebral infarction and the influence of nerve function defection,inflammatory factors and the oxidative stress. Methods:A total of 148 cases of cerebral infarction were selected as research objects in the Sixth Hospital of Wuhan,Affiliated to Jianghan University from February 2017 to June 2018 according to random number table method and were divided into a control group and an observational group,with 74 cases of each group. The control group was given clopidogrel hydrogen sulfate combined with routine therapy,while the observational group was given Shuxuening Injection based on the treatment of the control group. The treatment lasted for 2 weeks. The clinical effects,the indexes of blood rheology,the relative indexes of nerve function (MBP,NSE,H-FABP,GFAP),oxidative stress index (SOD,MDA and ROS),inflammatory factors (sVCM-1,TNF-α,IL-18) and the level of HMGB1 were observed of 2 groups. Results:After treatment,the red blood cells deposit,whole blood high shear viscosity,whole blood low shear viscosity,plasma viscosity,MBP,NSE,H-FABP,GFAP,NIHSS score decreased significantly of 2 groups. The above indicators changed more obviously of the observational group,the differences were statistically significant (P<0.05). Compared with those before treatment,the level of sVCM-1,TNF-α,IL-18 and HMGB1 decreased significantly of 2 groups. The above indexes of the observational group was obviously lower than that of the control group after treatment (P<0.05). After treatment,the level of MDA and ROS decreased significantly of 2 groups,and the level of SOD increased significantly of 2 groups. The above indicators changed more obviously of the observational group,the differences were statistically significant (P<0.05). The total effective rate of the observational group after treatment (91.89%) was significantly higher than that of the control group (78.38%),and the difference was statistically significant (P<0.05). Conclusion:Shuxuening Injection combined with clopidogrel hydrogen in the treatment of cerebral infarction can improve the blood rheology,reduce inflammatory reaction,reduce the symptoms of nerve function defection,reduce the level of oxygen free radicals,thus improve the clinical therapeutic effects.

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