摘要
目的研究银杏酮酯分散片联合高压氧治疗急性脑梗死(ACI)的临床疗效。方法取2019年4月—2022年10月于医院接受治疗的326例ACI患者作为研究对象,依据干预方式的不同将其分为治疗组(163例)与对照组(163例)。两组均接受吸氧、降压调脂、抗血小板聚集等对症处理,在此基础上,治疗组予以银杏酮酯分散片合高压氧治疗,而对照组仅予高压氧治疗,两组患者均连续治疗2周。分别于治疗前后进行颈动脉粥样硬化指标[颈动脉厚度(intimal-medial thickness,IMT)、颈动脉斑块面积]、核因子-κB(nuclear factorkappa-B,NF-κB)信号通路相关因子[核因子-κB(nuclear factorkappa-B p50,NF-κB p50)、核因子-κB p65(nuclear factor-kappaB p65,NF-κB p65)信使RNA(Messenger RNA,mRNA)和蛋白]及其下游炎症因子[白细胞介素-8(Interleukin-8,IL-8)、白细胞介素-1β(Interleukin-1β,IL-1β)IL-1β、肿瘤坏死因子-α(Tumor necrosis factor-α,TNF-α)]水平检测,同期评价Barthel指数(Barthel Index,BI)评分、美国国立卫生院卒中量表(National Institutes of Health Stroke Scale,NIHSS)评分、中医证候评分,另外于疗程结束后评价临床疗效,记录试验期间所出现的药物相关不良事件。结果治疗后,治疗组的总有效率为95.71%,高于对照组的84.66%,组间差异显著统计学意义(P<0.05),而两组间不良事件则差异无统计学意义(P>0.05)。同时,两组治疗后的BI评分均明显升高,且治疗组较对照组更高(P<0.05),而两组治疗后的NIHSS评分、中医证候积分、IMT、斑块面积、TNF-α、IL-8、IL-1β、NF-κB p50、p65 mRNA和蛋白均明显降低,且治疗组较对照组更低(P<0.05)。结论银杏酮酯分散片联合高压氧能够显著抑制ACI患者NF-κB炎症信号通路的激活,并改善其炎症损伤状态,进一步稳定动脉粥样硬化斑块,明显提升临床疗效,不良反应少,同时利于神经功能及预后质量的优化。
Objective To study the clinical efficacy of Ginkgolide Dispersible Tablets combined with hyperbaric oxygen in the treatment of acute cerebral infarction(ACI).Methods A total of 326 patients with ACI who were treated in the hospital from April 2019 to October 2022 were selected as the study subjects.They were divided into treatment group(163 cases)and control group(163 cases)according to different intervention methods.Both groups received symptomatic treatment such as oxygen inhalation,blood pressure reduction and lipid regulation,and anti-platelet aggregation.On this basis,the treatment group was treated with Ginkgolide Dispersible Tablets and hyperbaric oxygen,while the control group was only treated with hyperbaric oxygen,and the patients in both groups were treated continuously for 2 weeks.The levels of carotid atherosclerosis indicators[carotid intima-media thickness(IMT),carotid plaque area],NF-κB signaling pathway-related factors(NF-κB p50,p65 mRNA and protein),and downstream inflammatory factors[interleukin-8(IL-8),interleukin-1β(IL-1β),tumor necrosis factor-alpha(TNF-α)]were measured before and after treatment.Simultaneously,Barthel Index(BI)scores,National Institutes of Health Stroke Scale(NIHSS)scores,traditional Chinese medicine syndrome scores were assessed.Additionally,the clinical efficacy was evaluated after the course of treatment and the drug-related adverse events during the trial period were recorded.Results After treatment,the total effective rate of the treatment group was 95.71%,higher than that of the control group(84.66%).There was a significant difference between the two groups(P<0.05),but there was no significant difference in adverse events between the two groups(P>0.05).At the same time,the BI scores of the two groups were significantly higher after treatment,and BI score of the treatment group was higher than that of the control group(P<0.05).The NIHSS score,traditional Chinese medicine syndrome points,IMT,plaque area and the levels of TNF-α,IL-8,IL-1β,NF-κB p50,p65 mRNA and protein were significantly lower in the treatment group than those in the control group(P<0.05).Conclusion Ginkgolide Dispersible Tablets combined with hyperbaric oxygen can significantly inhibit the activation of NF-κB inflammatory signal pathway in patients with ACI and improve its inflammatory damage status,further stabilizing the atherosclerotic plaque,significantly improving the clinical efficacy,with less adverse reactions.And at the same time,it is conducive to the optimization of neurological function and quality of prognosis.
作者
周前鹏
龙已婷
ZHOU Qianpeng;LONG Yiting(Department of Neurology,Zhuzhou Central Hospital,Zhuzhou 412000,Hunan,China)
出处
《中华中医药学刊》
北大核心
2025年第6期126-129,共4页
Chinese Archives of Traditional Chinese Medicine
基金
国家自然科学基金项目(81525008)。
关键词
急性脑梗死
银杏酮酯分散片
高压氧
临床治疗效果
acute cerebral infarction
Ginkgolide Dispersible Tablets
hyperbaric oxygen
clinical treatment effect
