摘要
背景:通心络具有益气通络,活血化瘀之功效,临床用于治疗缺血性脑血管疾病取得较好疗效,而单光子发射计算机断层显像(SPECT),可以客观、灵敏地为临床疗效评价提供可靠的参考依据。目的:应用SPECT和临床神经功能缺损评分,来观察通心络胶囊对脑梗死患者的疗效。设计:病例分析。单位:重庆医科大学附属第一医院神经内科。对象:选择2002-03/2003-07重庆医科大学附属第一医院神经内科住院急性脑梗死患者22例,男12例,女10例;年龄40-78岁,病程3 h-3 d。方法:将22例急性脑梗死患者按自愿原则分为通心络组11例及对照组11例。对照组服用丹参片,4片/次,3次/d;通心络组:通心络胶囊, 4粒/次,3次/d。二组均服用15 d。于治疗前和治疗后应用SPECT ROI 技术测定其病变及健侧镜像ROI区域内的平均放射性计数,以了解其局部脑血流量变化,每个患者在治疗前后做神经功能缺损评分判定其情况。主要观察指标:①两组患者治疗前、后改良爱丁堡+斯堪的纳维亚评分。②两组患者治疗前、后ROI区域内的平均放射性计数。③两组患者治疗前、后SPECT核素显像。结果:22例脑梗死患者全部进入结果分析。①改良爱丁堡+斯堪的纳维亚评分:治疗后通心络组明显高于对照组[(49.182±5.344 5), (28.364±4.610 3)分,P<0.001]。③ROI区域内平均放射性计数:治疗前对照组,治疗组患侧皆有不同程度局部脑血流减低;治疗15 d后, 服用通心络后原脑血流减低区有改善(66.536±18.676,39.518±11.853. P<0.05)。③SPECT核素显像通心络服用后血流灌注改善明显,而对照组不明显。结论:通心络胶囊对脑梗死患者的脑血流功能改善有肯定作用,随着脑血流功能改善其临床神经功能缺损评分亦改善,说明其有促进神经功能恢复作用。
BACKGROUND: Tongxinluo acts on benefiting qi, promoting circulation in collateral, activating blood circulation and resolving stasis, which is well effective in treatment of ischemic cerebral vascular disease. Single-photon emission computed tomography (SPECT) provides reliable reference evidence objectively and sensitively for clinical evaluation of therapeutic effects. OBJECTIVE: SPECT and clinical neurofunctional defect score (NDS) were used to observe the therapeutic effect of tongxinluo capsule on cerebral infarction. DESIGN: Case analysis was designed. SETTING: lnternal Department of Neurology of First Affiliated Hospital of Chongqing Medical University. PARTICIPANTS: Totally 22 cases of acute cerebral infarction were admitted in Internal Department of Neurology of First Affiliated Hospital of Chongqing Medical University from March 2002 and July 2003, in which 12 cases were male and 10 cases were female, aged varied from 40 to 78 years, sick duration in range from 3 hours to 3 days. METHODS: Voluntarily, 22 cases of acute cerebral infarction were randomized in tongxinluo capsule group (capsule group) (11 cases) and the control (11 cases). In the control, danshen tablet was administrated, 4 tablet/time, 3 times/d. In capsule group, tongxinluo capsule group was administrated, 4 pills/time, 3 times/d. The drugs were administrated for 15 days in two groups. Before and after treatment, SPECT ROI technique was used to assay ROI average radioactive counts on the affected and healthy sides to understand local blood flowing volume of brain in two groups. Neurofunctional defect evaluation was done before and after treatment on each patient. MAIN OUTCOME MEASURES: ① SNSS scores before and after treatment in two groups. ② ROI average radioactive counts before and after treatment in two groups. ③SPECT radionuclide before and after treatment in two groups. RESULTS: Totally 22 cases of cerebral infarction all entered result analysis. ① SNSS score: It was higher remarkably in capsule group than the control after treatment [(49.182±5.344. 5), (28.364±4.610 3) score P 〈 0.001]. ② RO1 average radioactive count: Local blood flowing volume in brain on the affected side of the control and treatment group before treatment was decreased. Fifteen days after treatment, the volume in original decreasedflowing area of brain was improved after taking the capsule (66.536±18.676, 39.518±11.853, P 〈 0.05).③ Blood perfusion was improved remarkably after administration of the capsule reflected in SPECT radionuclide, but it was not improved remarkably in the control. CONCLUSION: Tongxinluo capsule improves definitely cerebral blood flow in patients with cerebral infarction. With improvement of blood flowing in brain, the neurofunctional defect score is promoted clinically, too. It is explained that the capsule promotes the recovery of nerve function.
出处
《中国临床康复》
CSCD
北大核心
2005年第41期126-128,i0004,共4页
Chinese Journal of Clinical Rehabilitation