早期合用通天口服液治疗对伴吞咽障碍大动脉粥样硬化性脑梗死的影响

Effect of Early Combined Treatment of Tongtian Oral Liquid on Atherosclerotic Cerebral Infarction of Large Artery with Dysphagia

摘要: 目的：本研究探索早期(24小时内)经胃管给予强化药物合用通天口服液治疗对伴吞咽障碍的大动脉粥样硬化性急性脑梗死患者的影响。方法：选择2020年1月至2021年12月于神经内科确诊且住院治疗的合并吞咽障碍的大动脉粥样硬化性急性脑梗死患者72例，随机区组法1:1分为研究组和对照组。对照组于第一天起经胃管给予强化药物治疗，研究组在此基础上加用通天口服液治疗。比较两组患者发病90天的NIHSS评分以及治疗前后NIHSS差值，90天吞咽功能分级，吸入性肺炎发生率等。结果：治疗前两组NIHSS评分、吞咽功能分级无统计学差异(P > 0.05)。治疗90天后，研究组NIHSS评分显著低于对照组(P < 0.05)，研究组治疗前后NIHSS差值显著高于对照组(P < 0.05)。治疗90天后，两组吞咽功能分级有显著性差异(P < 0.05)，研究组分级明显低于对照组。90天内研究组吸入性肺炎发生率显著低于对照组(P = 0.031)。结论：通天口服液能够改善伴吞咽障碍的大动脉粥样硬化性脑梗死神经功能缺损及吞咽功能分级，降低吸入性肺炎发生率。

Abstract: Objective: This study investigated the effect of early (within 24 h) administration of intensive drugs via gastric tube combined with Tongtian oral liquid on patients with large atherosclerotic acute cerebral infarction with dysphagia. Methods: A total of 72 patients with atherosclerotic acute cere-bral infarction complicated with dysphagia, who were diagnosed and hospitalized in the Depart-ment of Neurology from January 2020 to December 2021, were divided into study group and control group by 1:1 used randomized block design. The control group was given intensive drug therapy through gastric tube from the first day, and the study group was additionally treated with Tongtian oral liquid. The NIHSS score at 90 days after onset, the difference of NIHSS before and after treat-ment, the swallowing function grading at 90 days, and the incidence of aspiration pneumonia were evaluated between the two groups. Results: There was no significant difference in NIHSS score and swallowing function grade between the two groups before treatment (P > 0.05). After 90 days of treatment, the NIHSS score in the study group was significantly lower than that in the control group (P < 0.05), and the difference of NIHSS before and after treatment in the study group was signifi-cantly higher than that in the control group (P < 0.05). After 90 days of treatment, there were sig-nificant differences in swallowing function grades between the two groups (P < 0.05), and the classi-fication of the study group was significantly lower than that of the control group. The incidence of aspiration pneumonia in the study group was significantly lower than that in the control group within 90 days (P = 0.031). Conclusions: Tongtian oral liquid can improve the neurological deficit and swallowing function grade of large atherosclerotic cerebral infarction with dysphagia, and re-duce the incidence of aspiration pneumonia.