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目的观察丁苯酞软胶囊联合氯吡格雷治疗进展性脑梗死的临床疗效及安全性。方法将78例进展性脑梗死患者随机分为对照组39例和试验组39例。对照组予以口服氯吡格雷首剂剂量300 mg,qd,以后每次剂量为75 mg,qd;试验组在对照组治疗的基础上,予以口服丁苯酞软胶囊每次200 mg,tid。2组患者均治疗28 d。比较2组患者的临床疗效和药物不良反应发生率,以及治疗前后的巴氏指数(BI)评定量表评分和欧洲卒中量表(ESS)评分、微小RNA-155、CD4~+CD25~+Treg变化情况。结果治疗后,试验组和对照组的总有效率分别为89.74%(35/39例)和66.67%(26/35例),差异有统计学意义(P<0.05)。治疗后,试验组与对照组的ESS评分分别为(82.54±4.78),(73.24±3.46)分;BI评分分别为(72.33±2.80),(61.10±2.94)分;微小RNA-155表达量分别为(0.63±0.03),(0.98±0.05);CD4~+CD25~+Treg细胞百分率分别为(1.55±0.44)%,(2.16±0.31)%,差异均有统计学意义(P<0.05)。试验组出现的药物不良反应主要有皮疹、腹部不适、恶心,对照组出现的药物不良反应主要有消化道出血、腹痛、便秘。试验组和对照组的药物不良反应发生率比较差异无统计学意义(10.26%vs 12.82%,P>0.05)。结论丁苯酞软胶囊联合氯吡格雷治疗进展性脑梗死的临床疗效确切,可保护患者的神经功能,有效地降低微RNA-155、CD4~+CD25~+Treg细胞的表达水平,且安全性较高。
Objective To observe the clinical efficacy and safety of butylphthalide soft capsule and clopidogrel in the treatment of patients with progressive cerebral infarction. Methods A total of 78 patients with progressive cerebral infarction were randomly divided into control group (39 cases) and experimental group (39 cases). The control group was given oral clopidogrel the first dose of 300 mg, qd, after each dose of 75 mg, qd; test group in the control group based on the treatment, to be given oral butylphthalide soft capsule 200 mg, tid. Two groups of patients were treated for 28 days. The clinical efficacy and incidence of adverse drug reactions were compared between the two groups. The scores of BI and ESR before and after treatment were also compared. The levels of microRNA-155, CD4 ~ + CD25 ~ + Treg Changes. Results After treatment, the total effective rates of the experimental group and the control group were 89.74% (35/39 cases) and 66.67% (26/35 cases), respectively, with statistical significance (P <0.05). After treatment, the ESS scores of the experimental group and the control group were (82.54 ± 4.78) and (73.24 ± 3.46) points respectively; the BI scores were (72.33 ± 2.80) and (61.10 ± 2.94) points respectively; (0.63 ± 0.03) and (0.98 ± 0.05) respectively. The percentage of CD4 ~ + CD25 ~ + Treg cells were (1.55 ± 0.44)% and (2.16 ± 0.31)%, respectively, with statistical significance (P <0.05). Adverse drug reactions occurred in the experimental group mainly rash, abdominal discomfort, nausea, adverse drug reactions occurred in the control group mainly gastrointestinal bleeding, abdominal pain, constipation. There was no significant difference in the incidence of adverse drug reactions between the experimental group and the control group (10.26% vs 12.82%, P> 0.05). Conclusion Butylphthalide soft capsule combined with clopidogrel treatment of progressive cerebral infarction clinical efficacy is exact, can protect the patient’s neurological function, effectively reduce the microRNA-155, CD4 ~ + CD25 ~ Treg cell expression levels, and safety Higher.