目的 探討銀杏酮酯滴丸聯(lián)合阿托伐他汀鈣治療缺血性腦梗死的臨床療效。方法 選取2012年8月—2015年1月上海市奉賢區(qū)中心醫(yī)院收治的急性缺血性腦梗死患者120例,隨機(jī)分為對(duì)照組和治療組,每組各60例。對(duì)照組口服阿托伐他汀鈣片,1片/次,1次/d。治療組在對(duì)照組治療基礎(chǔ)上口服銀杏酮酯滴丸,5丸/次,3次/d。兩組患者均治療2周,出院后堅(jiān)持服藥12周。觀察兩組的臨床療效,比較兩組治療前后神經(jīng)功能缺損(NIHSS)評(píng)分、巴特爾日常生活能力指數(shù)(BI)、頸動(dòng)脈內(nèi)膜-中膜厚度值(IMT)、斑塊面積和個(gè)數(shù)、細(xì)胞間黏附分子-1(ICAM-1)和血管細(xì)胞黏附分子-1(VCAM-1)的變化。結(jié)果 治療后,對(duì)照組和治療組的總有效率分別為76.67%、91.67%,兩組總有效率比較差異有統(tǒng)計(jì)學(xué)意義(P< 0.05)。治療2周、出院12周時(shí),兩組NIHSS評(píng)分、IMT、斑塊面積、斑塊個(gè)數(shù)、sICAM-1、sVCAM-1均顯著降低,BI指數(shù)顯著升高,同組治療前后差異有統(tǒng)計(jì)學(xué)意義(P< 0.05);且治療組的改善程度優(yōu)于對(duì)照組,兩組比較差異具有統(tǒng)計(jì)學(xué)意義(P< 0.05)。結(jié)論 銀杏酮酯滴丸聯(lián)合阿托伐他汀鈣治療缺血性腦梗死具有較好的臨床療效,可改善患者的神經(jīng)功能和生活質(zhì)量,能夠顯著降低黏附分子的表達(dá),具有一定的臨床推廣應(yīng)用價(jià)值。

Objective To observe the clinical effect of Yinxing Guttate Dropping Pills combined with atorvastatin calcium in treatment of ischemic cerebral infarction. Methods Patients (120 cases) with ischemic cerebral infarction in Shanghai Fengxian District Central Hospital from August 2012 to January 2015 were randomly divided into control and treatment groups, and each group had 60 cases. The patients in the control group were po administered with Atorvastatin Calcium Tablets, 1 tablet/time, once daily. The patients in the treatment group were po administered with Yinxing Guttate Dropping Pills on the basis of the control group, 5 pills/time, three times daily. The patients in two groups were hospitalized for 2 weeks, and they took drugs for 12 weeks after discharge. After treatment, the efficacy was evaluated, and the changes of NIHSS scores, BI, IMT, plaque area and numbers, ICAM-1, and VCAM-1 in two groups before and after treatment were compared. Results After treatment, the efficacies in the control and treatment groups were 76.67% and 91.67%, respectively, and there were differences between two groups (P < 0.05). After 2 weeks in hospital and 12 weeks after discharge, the NIHSS scores, IMT, plaque area and numbers, ICAM-1, and VCAM-1 in two groups were significantly decreased, BI was significantly increased, and the difference was statistically significant in the same group (P < 0.05). These observational indexes in the treatment group were better than those in the control group, with significant difference between two groups (P < 0.05).Conclusions Yinxing Guttate Dropping Pills combined with atorvastatin calcium has clinical curative effect in treatment of ischemic cerebral infarction, and can improve nerve function and quality of life, also can significantly reduce the expression of adhesion molecules, which has a certain clinical application value.