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目的观察氯毗格雷联合银杏达莫治疗脑梗死的临床疗效,为脑梗死的治疗提供依据。方法选取2010年8月至2013年5月我院收治的脑梗死患者125例,随机分为联合治疗组(63例)和对照组(62例)。在常规治疗的基础上,联合治疗组予以波立维(化学名氯毗格雷)联合银杏达莫治疗,对照组给予银杏达莫治疗。治疗14 d后,观察两组的治疗效果,采用神经功能缺损(NFDS)评分及日常生活活动指数(Barthel指数)进行疗效评估,并观察治疗前后两组的纤维蛋白原(FIB)、C反应蛋白(CRP)和白细胞介素6(IL-6)等实验室指标。结果联合治疗组总有效率为95.24%,对照组为82.26%,两组差异有统计学意义(χ2=3.946,P<0.05);治疗后联合治疗组NFDS评分、Barthel指数分别为(11.73±4.06)分、45.27±13.51,对照组分别为(16.28±4.37)分、39.19±11.85,两组差异有统计学意义(t值分别3.64、3.16,P<0.05),且两组的NFDS评分、Barthel指数与治疗前比较,差异亦有统计学意义(t值分别4.36、3.53、3.97和3.02,P<0.05);联合治疗组治疗后FIB、CRP及IL-6水平分别为(2.16±0.88)g/L、(2.95±1.22)mg/L和(42.78±15.53)ng/L,对照组分别为(2.65±0.93)g/L、(3.46±1.87)mg/L和(63.54±21.69)ng/L,两组比较,差异均有统计学意义(P<0.05)。结论波立维联合银杏达莫治疗脑梗死疗效显著,且能有效改善神经功能缺损,促进患者早日康复,值得临床推广。
Objective To observe the clinical efficacy of clopidogrel combined with ginkgo biloba in the treatment of cerebral infarction and provide evidence for the treatment of cerebral infarction. Methods 125 patients with cerebral infarction admitted to our hospital from August 2010 to May 2013 were randomly divided into combined treatment group (63 cases) and control group (62 cases). On the basis of routine treatment, the combined treatment group was treated with Boliwei (chemical name clopidogrel) combined with ginkgo biloba, while the control group was treated with biloba damo. After 14 days of treatment, the curative effect of the two groups was observed. The therapeutic effect was evaluated by NFDS score and Barthel index. FIB, C-reactive protein (CRP) and interleukin 6 (IL-6) and other laboratory indicators. Results The total effective rate was 95.24% in the combined treatment group and 82.26% in the control group, with significant difference between the two groups (χ2 = 3.946, P <0.05). The NFDS score and Barthel index in the combined treatment group were (11.73 ± 4.06 ), 45.27 ± 13.51 respectively, and the control group was (16.28 ± 4.37) and 39.19 ± 11.85 respectively (t = 3.64, 3.16 respectively, P <0.05) The difference was also statistically significant (t = 4.36, 3.53, 3.97 and 3.02 respectively, P <0.05). The levels of FIB, CRP and IL-6 in the combined treatment group were (2.16 ± 0.88) g (2.95 ± 0.93) g / L, (3.46 ± 1.87) mg / L, and (63.54 ± 21.69) ng / L respectively in the control group and (42.78 ± 15.53) ng / L, the difference between the two groups was statistically significant (P <0.05). Conclusion The combination of berberine and ginkgo biloba is effective in treating cerebral infarction, and can effectively improve the neurological deficit and promote the early recovery of patients, which is worthy of clinical promotion.