Objective To investigate the clinical treatment effect of troxerutin combined with butylphthalide in the treatment of patients with cerebral infarction.

Methods  98 patients with cerebral infarction admitted to Nanyang Central Hospital from February 2020 to April 2022 were selected, and were divided into observation group (n=51) and control group (n=47) according to the treatment methods. The control group was treated with butylphthalide, and the observation group was treated with troxerutin on the basis of control group. The differences in efficacy, incidence of adverse effects, neurological function, ability to perform daily living, coagulation function (D-dimer, D-D), prothrombin time (PT), fibrinogen (FIB), nitric oxide (NO), endothelin-1 (ET-1) and vascular pseudohemophilic factor (vWF) levels before and after treatment in the two groups were compared.

Results  The total effective rate of the observation group was higher than that of the control group (98.04% vs. 76.60%, P<0.05). In terms of neurological function, after treatment, the NIHSS score of the two groups decreased, the observation group was lower than the control group(7.38±2.33 vs. 12.78±2.75, P<0.001), the BI score of the two groups increased, and the study group was higher than the control group (58.01±10.72 vs. 46.45±8.35, P<0.001). In terms of coagulation function, the levels of D-D, PT, FIB, NO, ET-1 and vWF in the two groups were improved after treatment, and the levels in the observation group were better than those in the control group (P<0.05).

Conclusion  The combination of troxerutin and butylphthalide may help regulate the levels of NO, ET-1 and vWF in patients with cerebral infarction, improve neurological function, daily living ability and coagulation function, and has certain reference value for the treatment of cerebral infarction.

1.Jing J, Meng X, Zhao X, et al. Dual antiplatelet therapy in transient ischemic attack and minor stroke with different infarction patterns: subgroup analysis of the CHANCE randomized clinical trial[J]. JAMA Neurol, 2018, 75(6): 711-719. DOI: 10.1001/jamaneurol.2018.0247.

2.顾玉梅,杨旭. 丹参注射液联合丁苯酞治疗脑梗死急性期患者及对S100B、CRP及神经功能影响[J]. 辽宁中医药大学学报, 2018, 20(4): 107-110. [Gu YM, Yang X. Effect of salvia miltiorrhiza injection combined with butylphthalide on patients with acute cerebral infarction and their effects on S100B, CRP and nerve function[J]. Journal of Liaoning University of Traditional Chinese Medicine, 2018, 20(4): 107-110.] DOI: 10.13194/j.issn.1673-842x.2018.04.028.

3.郭生龙, 陈瑞利, 雷琦, 等. 丁苯酞对小鼠脑缺血再灌注损伤细胞坏死性凋亡的影响[J]. 中华行为医学与脑科学杂志, 2019, 28(2): 122-126. [Guo SL, Chen RL, Lei Q, et al. The effect of butylphthalide on cell necroptosis in cerebral ischemia reperfusion injury model mice[J]. Chinese Journal of Behavioral Medicine and Brain Science, 2019, 28(2): 122-126.] DOI: 10.3760/cma.j.issn.1674-6554.2019.02.005.

4.王方方, 刘飞飞, 郭再玉. 灯盏花素注射液联合曲克芦丁治疗急性脑梗死的临床研究[J]. 现代药物与临床, 2021, 36(4): 763-768. [Wang FF, Liu FF, Guo ZY. Clinical study on Dengzhanhuasu injection combined with troxerutin in treatment of acute cerebral infarction[J]. Drugs & Clinic, 2021, 36(4): 763-768.] DOI: 10.7501/j.issn.1674-5515.2021.04.026.

5.中华医学会, 中华医学会杂志社, 中华医学会全科医学分会,等.缺血性卒中基层诊疗指南(实践版·2021)[J].中华全科医师杂志, 2021, 20(9): 947-958. [Chinese Medical Association, Chinese Medical Association Publishing House, Chinese Society of General Practice, et al. Guideline for primary care of ischemic stroke: practice version (2021)[J]. Chinese Journal of General Practitioners, 2021, 20(9): 947-958.] DOI: 10.3760/cma.j.cn114798-20210804-00591.

6.周辉,周少珑,朱雄.丁苯酞联合依达拉奉治疗急性脑梗死疗效及对患者VEG, MMP-9, EPCs水平的影响[J]. 河北医药, 2018, 40(13): 2024-2026. [Zhou H, Zhou SL, Zhu X. Effect of butylphthalide combined with edaravone on acute cerebral infarction and its effects on the levels of VEG, MMP-9 and EPCs in patients[J]. Hebei Medical Journal, 2018, 40(13): 2024-2026.] DOI: 10.3969/j.issn.1002-7386.2018.13.027.

7.Goldstein LB, Lennihan L, Rabadi MJ, et al. Effect of dextroamphetamine on poststroke motor recovery: a randomized clinical trial[J]. JAMA Neurol, 2018, 75(12): 1494-1501. DOI: 10.1001/jamaneurol.2018.2338.

8.Koch G, Bonnì S, Casula EP, et al. Effect of cerebellar stimulation on gait and balance recovery in patients with hemiparetic stroke: a randomized clinical trial[J]. JAMA Neurol, 2019, 76(2): 170-178. DOI: 10.1001/jamaneurol.2018.3639.

9.王冰冰,曹庆营,冯社军,等.脑栓通胶囊联合注射用阿替普酶治疗急性脑梗死疗效及对患者血清NT-proBNP, TNF-α水平的影响观察[J].药物流行病学杂志, 2021, 30(9): 586-590. [Wang BB, Cao QY, Feng SJ, et al. Efficacy of Naoshuantong capsule combined with alteplase for injection in treatment of acute cerebral infarction and its influence on the levels of serum NT-proBNP, TNF-α[J]. Chinese Journal of Pharmacoepidemiology, 2021, 30(9): 586-590.] DOI: 10.19960/j.cnki.issn1005-0698.2021.09.003.

10.张轶美,刘霄,韩毅,等.丁苯酞联合血塞通对急性脑梗死患者认知功能及血清TNF-α、IL-10和NSE的影响[J].现代中西医结合杂志, 2018, 27(5): 541-544.[Zhang YM, Liu X, Han Y, et al. Effects of butylphthalein combined with Xuesaitong on cognitive function and serum TNF-α, IL-10 and NSE in patients with acute cerebral infarction[J]. Modern Journal of Integrated Traditional Chinese and Western Medicine, 2018, 27(5): 541-544.]DOI: 10.3969/j.issn.1008-8849.2018.05.026.

11.朱新岭,陈颖,杨君君,等.丁苯酞对急性脑梗死患者血管内皮功能的影响[J].中国慢性病预防与控制, 2018, 26(6): 461-464. [Zhu XL, Chen Y, Yang JJ, et al. Effects of butylphthalein on vascular endothelial function in patients with acute cerebral infarction[J].Chinese Journal of Prevention and Control of Chronic Diseases, 2018, 26(6): 461-464.] DOI: 10.16386/j.cjpccd.issn.1004-6194.2018.06.017.

12.马世俊. 通窍活血汤联合曲克芦丁脑蛋白水解物注射液对微创颅内血肿清除术后患者神经功能及血清IMA的影响[J]. 现代中西医结合杂志, 2019, 28(13): 1404-1407. [Ma SJ. Effect of Tongfu Huoxue Decoction combined with troxerutin brain protein hydrolysate injection on neurological function and serum IMA in patients after mini-invasive evacuation of intracranial hematoma[J]. Modern Journal of Integrated Traditional Chinese and Western Medicine, 2019, 28(13): 1404-1407.] DOI: 10.3969/j.issn.1008-8849.2019.13.009.

13.张克飞,王兵.曲克芦丁脑蛋白水解物联合多奈哌齐对老年帕金森病病人免疫功能及神经功能的影响[J].实用老年医学, 2019, 33(12): 1221-1225. [Zhang KF, Wang B. Effect of troxerutin and cerebrprotein hydrolysate combined with donepezil on immune function and neurological function in elderly patients with Parkinson's disease[J]. Practical Geriatrics, 2019, 33(12): 1221-1225.]DOI: 10.3969/j.issn.1003-9198.2019.12.023.

14.杜磊, 张小宁, 雷晶, 等. 丁苯酞注射液对急性脑梗死患者凝血功能和神经功能的影响[J]. 实用心脑肺血管病杂志, 2018, 26(3): 128-129. [Du L, Zhang XN, Lei J, et al. Impact of Butylphthalide Injection on blood coagulation function and neurological function in patients with acute cerebral infarction[J]. Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease, 2018, 26(3): 128-129.] DOI: CNKI:SUN:SYXL.0.2018-03-040.

15.王青, 万继锋, 刘长春, 等. 丹红注射液辅助治疗急性脑梗死对患者血清VEGF,MMP-9,hs-CRP及凝血功能的影响[J]. 现代中西医结合杂志, 2021, 30(19): 2130-2133. [Wang Q, Wan JF, Liu CC, et al. Effects of Danhong injection adjuvant therapy on serum VEGF,MMP-9,hs-CRP and coagulation function in patients with acute cerebral infarction[J]. Modern Journal of Integrated Traditional Chinese and Western Medicine, 2021, 30(19): 2130-2133.] DOI: 10.3969/j.issn.1008-8849.2021.19.020.

16.马娟, 常明则, 张格娟, 等. 依达拉奉联合阿替普酶对脑梗死患者凝血功能及神经功能的影响[J]. 血栓与止血学, 2022, 28(3): 760-761. [Ma J, Chang MZ, Zhang GJ, et al. Effects of edaravone combined with alteplase on coagulation function and nerve function in patients with cerebral infarction[J]. Chinese Journal of Thrombosis and Hemostasis, 2022, 28(3): 760-761.] DOI: 10.3969/j.issn.1009-6213.2022.03.183.

17.佘颜, 龙须, 邓常清, 等. 中风Ⅱ号方对急性脑梗死患者血管内皮损伤及炎症反应的影响[J].中国中西医结合急救杂志, 2021, 28(6): 653-657. [She Y, Long X, Deng CQ, et al. Effects of Stroke Ⅱ compound prescription on vascular endothelial injury and inflammatory reaction in patients with acute cerebral ischemic infarction[J]. Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care, 2021, 28(6): 653-657.] DOI: 10.3969/j.issn.1008-9691.2021.06.002.

18.贝筝, 陈怡, 龙登毅, 等. 丁苯酞联合依达拉奉治疗急性脑梗死患者神经功能及血管内皮功能的影响[J]. 脑与神经疾病杂志, 2019, 27(1): 5-9. [Bei Z, Chen Y, Long DY, et al. Effects of butylphthalide combined with edaravone on neurological function and vascular endothelial function in patients with acute cerebral infarction[J].Journal of Brain and Nervous Diseases, 2019, 27(1): 5-9.] DOI: CNKI:SUN:LYSJ.0.2019-01-002.

19.张红利,张智芳,白金娟,等.通窍化栓汤联合康复推拿对脑梗死患者神经功能恢复情况, ET-1和NO水平的影响[J].中医药信息, 2020, 37(1): 96-100.[Zhang HL, Zhang ZF, Bai JJ, et al. Effect of Tongqiao Huashuan Decoction Combined with Rehabilitative Tuina on Neurological Function Recovery, Levels of ET-1 and NO in Patients with Cerebral Infarction[J]. Information on Traditional Chinese Medicine, 2020, 37(1): 96-100.] DOI: 10.19656/j.cnki.1002-2406.200022.

20.唐厚梅, 董波, 张敏莉, 等. 老年高血压患者并发脑梗死与血清脂肪因子visfatin,vWF及脉压的相关性[J]. 疑难病杂志, 2019, 18(5): 450-454.[Tang HM, Dong B, Zhang ML, et al. The correlation between cerebral infarction and serum adipokines visfatin, vWF and pulse pressure in elderly pa-tients with hypertension[J]. Chinese Journal of Difficult and Complicated Cases, 2019, 18(5): 450-454.] DOI: 10.3969/j.issn.1671-6450.2019.05.005.