疏血通注射液联合沙库巴曲缬沙坦钠片治疗脑梗死合并高血压患者的临床研究OA
Clinical trial on the treatment of patients with cerebral infarction complicated with hypertension by Shuxuetong injection combined with sacubitril/valsartan tablets
目的 观察疏血通注射液联合沙库巴曲缬沙坦钠片治疗脑梗死合并高血压患者的临床疗效和安全性.方法 纳入本院治疗的脑梗死合并高血压患者,依据随机数表法分为试验组和对照组.其中对照组给予沙库巴曲缬沙坦钠片,每次100 mg,bid,口服;试验组在对照组基础上给予疏血通注射液每次6 mL,qd,静脉滴注.2组均治疗2周.比较2组患者的临床疗效、24 h平均舒张压及收缩压、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、血液流变学(全血黏度、纤维蛋白原及血细胞比容)、血脂[总胆固醇、甘油三酯、低密度脂蛋白胆固醇(LDL-C)水平]、血清血管性假血友病因子(vWF)、同型半胱氨酸(Hcy)水平,并进行安全性评价.结果 本研究最终纳入92例患者,试验者对照组各46例.治疗后,试验组和对照组患者的总有效率分别为93.48％(43例/46例)和78.26％(36例/46例),试验组显著高于对照组(P＜0.05).试验组和对照组NIHSS评分分别为(7.93±1.44)和(10.24±1.86)分;ADL 评分分别为(79.02±8.05)和(71.66±7.36)分,试验组的NIHSS评分显著低于对照组(P＜0.05),ADL评分显著高于对照组(P＜0.05).试验组和对照组患者收缩压分别为(120.51±12.77)和(136.48±14.29)mmHg;舒张压分别为(80.36±9.66)和(89.74±11.02)mmHg;全血黏度分别为(4.69±0.59)和(7.16±0.84)mPa·s;纤维蛋白原水平分别为(3.17±0.65)和(4.41±1.02)g·L-1;红细胞比容分别为 0.30±0.04 和0.41±0.05;总胆固醇水平分别为(4.22±0.54)和(5.86±1.01)mmol·L-1;甘油三酯水平分别为(1.35±0.32)和(1.79±0.44)mmol·L-1;LDL-C水平分别为(2.03±0.25)和(2.48±0.38)mmol·L-1;vWF 水平分别为(131.57±14.36)％和(144.74±14.61)％,Hcy 水平分别为(12.32±1.48)和(18.62±2.09)μmol·L-1,试验组上述指标均显著低于对照组(均P＜0.05).试验组不良反应主要有低血压、高钾血症、出血,对照组不良反应主要有低血压、高钾血症、肾功能异常.试验组和对照组总药物不良反应发生率分别为10.87％(5例/46例)和8.70％(4例/46例),在统计学上差异无统计学意义(P＞0.05).结论 对于脑梗死合并高血压患者,采用疏血通注射液联合沙库巴曲缬沙坦钠片治疗初步显示更优疗效,可改善神经功能,提高自理能力,降低血压、血脂水平,改善血液流变学.
Objective To observe the clinical efficacy and safety of Shuxuetong injection combined with sacubitril/valsartan tablets in the treatment of patients with cerebral infarction complicated with hypertension.Methods Patients with cerebral infarction complicated with hypertension admitted to our hospital were randomly divided into the treatment group and the control group according to the random number table method.The control group was given sacubitril/valsartan sodium tablets 100 mg each time,twice a day,orally.On the basis of the control group,the treatment group was given Shuxuetong injection 6 mL each time,once a day,intravenously.Both groups were treated for 2 weeks.The clinical efficacy,24-hour average diastolic and systolic blood pressure,National Institutes of Health Stroke Scale(NIHSS)score,activities of daily living(ADL)score,hemorheology(whole blood viscosity,fibrinogen and hematocrit),blood lipids[total cholesterol,triglycerides,low-density lipoprotein cholesterol(LDL-C)levels],serum von Willebrand factor(vWF)and homocysteine(Hcy)levels of the patients in the two groups were compared,and the safety was evaluated.Results This study ultimately included 92 patients,with 46 in the treatment group and 46 in the control group.After treatment,the total effective rates of the treatment group and the control group were 93.48％(43 cases/46 cases)and 78.26％(36 cases/46 cases),respectively.The treatment group was significantly higher than the control group(P＜0.05).The NIHSS scores of the treatment group and the control group were(7.93±1.44)and(10.24±1.86)respectively;the ADL scores were(79.02±8.05)and(71.66±7.36)respectively.The NIHSS score of the treatment group was significantly lower than that of the control group(P＜0.05),and the ADL score was significantly higher than that of the control group(P＜0.05).The systolic blood pressure of the treatment group and the control group was(120.51±12.77)and(136.48±14.29)mmHg,respectively;the diastolic blood pressure was(80.36±9.66)and(89.74±11.02)mmHg,respectively;the whole blood viscosity was(4.69±0.59)and(7.16±0.84)mPa·s,respectively;the fibrinogen level was(3.17±0.65)and(4.41±1.02)g·L-1,respectively;the hematocrit was 0.30±0.04 and 0.41±0.05,respectively;the total cholesterol level was(4.22±0.54)and(5.86±1.01)mmol·L-1,respectively;the triglyceride level was(1.35±0.32)and(1.79±0.44)mmol·L-1,respectively;the LDL-C level was(2.03±0.25)and(2.48±0.38)mmol·L-1,respectively;the vWF level was(131.57±14.36)％and(144.74±14.61)％,respectively;the Hcy level was(12.32±1.48)and(18.62±2.09)μmol·L-1,respectively.All the above indicators in the treatment group were significantly lower than those in the control group(all P＜0.05).The adverse reactions in the treatment group mainly included hypotension,hyperkalemia and bleeding.The adverse reactions in the control group mainly included hypotension,hyperkalemia and renal dysfunction.The total incidence of drug adverse reactions in the treatment group and the control group was 10.87％(5 cases/46 cases)and 8.70％(4 cases/46 cases)respectively.There was no statistically significant difference in the two group(P＞0.05).Conclusion For patients with cerebral infarction and hypertension,the treatment with Shuxuetong injection combined with sacubitril/valsartan sodium tablets shows better therapeutic effects initially.It can improve neurological function,enhance self-care ability,lower blood pressure and lipid levels,and improve hemorheology.
夏长青;王菲;孙贤;王淑玲;张姝媛
石家庄市中医院光华院区脑病一科,河北石家庄 050000石家庄市中医院光华院区脑病一科,河北石家庄 050000石家庄市中医院光华院区脑病一科,河北石家庄 050000石家庄市中医院 脑病科,河北石家庄 050000石家庄市中医院光华院区脑病一科,河北石家庄 050000
医药卫生
沙库巴曲缬沙坦钠片疏血通注射液脑梗死合并高血压血压血液流变学
sacubitril valsartan sodium tabletsshuxuetong injectioncerebral infarction complicated by hypertensionblood pressurehemorheology
《中国临床药理学杂志》 2026 (7)
908-913,6
河北省中医药管理局科研计划基金项目资助(2022477)
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