| Objective: To compare the efficacy of butyphthalide alone and butyphthalide combined with Urinarykallid in the treatment of acute cerebral infarction.Method:Collect 120 cases of the patients who sufferring the acute cerebral infarction and receive inpatient treatment on December 1,2015 to April 30,2016 in the Second Hospital of Hebei Medical University,Department of Neurology,which 80 cases were male and 40 females,age range 30 to 80 years old.The participates were divided into two groups:urinary kallidinogenase combined with butylphthalide group(n=60),butylphthalide group(n=60).Both groups were given basic treatment,including antiplatelet,statin preparations,neuroprotective,improved circulation and free radical scavenging and other drug treatment.The combined group was given injection of Uricovine0.15 PNA unit + saline 100 ml,intravenous infusion,one bottle at a time,once a day,Butylphthalide sodium chloride(specifications for 100 ml: butylphthalide25 mg,sodium chloride 0.9 g),intravenous drip,100 ml(25 mg)each time,2times a day,the time interval in more than six hours.Butylphthalide group was given butylphthalide sodium chloride(specifications for 100 ml: butyl phthalide 25 mg,sodium chloride 0.9 g),intravenous drip,100 ml(25 mg)each time,2 times a day,the time interval in more than six hours.Both groups were treated with 14 days for a course of treatment.The NIHSS scores were scored before treatment and 28 days after treatment.120 subjects were divided into five types according to TOAST classification: Large-artery atherosclerosis(L-type),Cardioembolism(C-type),Small-artery occlusion lacunar(S-type),Acute stroke of other determined etiology(O-type),Stroke of other undetermined etiology(U-type).All the data collected were analyzed by SPSS21.0 statistic software.Count date compared with in group should use R×C chi-square test;Measurement date were described as mean±standard deviation.Two samples were compared using independent samples of t-test,paired data using paired samples t-test,If date distribution meet the coincidence with the normality and variance,complete randomized analysis of variance should come to the first.If not,multiple independent samples non-paremetric test,Kruskal-Wallis H Test,would be a better choice.Set the significance level α=0.05,with P ﹤ 0.05 was considered statistically significant.Results:1 The combined group: the age(58.47 ± 11.75)and sex ratio(39 males and 21 females).Butylphthalide group treatment group: the age(58.03±10.45)and sex ratio(41males and 19 females).There was no significant difference in age and sex ratio between the two groups(P﹥0.05).The combined group:13cases of diabetes,41 cases of hypertension and 10 cases of coronary heart disease.Butylphthalide treatment group:15 cases of diabetes,37 cases of hypertension and 12 cases of coronary heart disease.There was no statistically significant difference in risk factors for cerebrovascular disease between previous diabetes mellitus,hypertension,and coronary heart disease(P ﹥0.05).The combined group:25 cases of smoking,22 cases of drinking.Butylphthalide group: 19 cases of smoking,25 cases of drinking.There was no significant difference between the two groups in smoking and alcohol consumption(P> 0.05).2 There was no significant difference between the two groups(P =0.809,P> 0.05)in the NIHSS score before treatment((11.03 ± 3.63)in the combined treatment group and(10.87 ± 3.92)in the treatment group alone),The NIHSS scores of the two groups were decreased after 28 days of treatment,and the decrease of NIHSS score before and after treatment with the combined group was statistically significant(P = 0.00,P <0.05),The decrease of NIHSS score before and after treatment with the separate treatment group was statistically significant(P=0.00,P﹤0.05),The difference between of thetwo groups was statistically significant(P = 0.000001,P <0.05)in the NIHSS score at 28 days after treatment((5.01 ± 2.02)in the combined treatment group,(7.71 ± 3.41)in butylphthalide treatment group).3 The total effective rate was 96.67% in the combined group after 28 days,the total effective rate of butylphthalide treatment group was 81.67%,the difference between of the two groups was significant(P=0.008,P﹤0.05).4 The two groups were divided into five types according to TOAST classification.In the combined treatment group: L-type(13.32±2.95),S-type(8.28±1.93),C-type(9.75±2.60),O-type(5.33±1.53),U-type(9.44±2.55).In butylphthalide treatment group: L-type(13.00±2.79),S-type(8.05±2.27),C-type(9.33±2.66),O-type(5.75±1.71),U-type(9.44±2.55).There was no significant difference between the NIHSS scores before treatment in the subgroups of the two treatment group(P>0.05).The NIHSS scores of the L-type and the S-type in the two groups after treatment were lower than those before treatment and statistically significant difference(P﹤0.05).The NIHSS scores of the L-type in the combined treatment group after treatment was lower than butylphthalide treatment group and statistically significant difference(P=0.000014,P ﹤ 0.05).The NIHSS scores of the S-type in the combined treatment group after treatment was lower than butylphthalide treatment group,but no significant difference(P=0.255,P﹥0.05).Conclusion:1 Butylphthalide and urinary kallidinogenase combined with butylphthalide in the treatment of acute cerebral infarction can be less neurological deficits.The combination of the two can be more effective in reducing the degree of neurological deficits.The total effective rate and clinical efficacy are greatly improved,therefore.Butylphthalide combined with urinary kallidinogenase treatment program worthy of promotion.So that patients get better treatment.2 In the TOAST classification of cerebral infarction,the combination of butylphthalide and urinary kallidinogenase can significantly improve the neurological deficit of the L-type and the S-type acute cerebral infarction.Thecombined group can improve the clinical curative effect,so as to guide the clinical application of different types according to different types of cerebral infarction. |
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