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ObjectiveTo systematically review the existing studies on Xueshuantong for injection（lyophilized） in the treatment of acute cerebral infarction（ACI）， and to clarify the clinical value of Xueshuantong for injection（lyophilized） through comprehensive clinical evaluation， so as to promote clinical rational drug use and relevant policy transformation. MethodEvidence of Xueshuantong for injection（lyophilized） in terms of safety， effectiveness， economy， innovation， suitability， accessibility， traditional Chinese medicine（TCM） characteristics（6+1 dimensions） and information service was comprehensively collected. Evidence-based medicine， questionnaire survey， health technology assessment， pharmacoeconomic evaluation and other research methods were used， and the multi-criteria decision analysis model was used to measure each dimension， in order to comprehensively evaluate the clinical value of Xueshuantong for injection（lyophilized）. ResultSpontaneous reporting system， Meta-analysis of adverse reactions， and active safety monitoring study showed that the main adverse reactions of Xueshuantong for injection（lyophilized） were rash， pruritus， chest tightness， headache， dizziness and other general adverse reactions， the incidence of serious adverse reactions was judged to be rare， the known risk was small， the evidence was sufficient， and the safety evaluation was grade A. The results of Meta-analysis showed that Xueshuantong for injection（lyophilized） combined with conventional treatment for ACI was superior to conventional treatment in terms of improving neurological deficit score， improving daily activity score and clinical efficacy， and the effectiveness evaluation was grade B. The results of pharmacoeconomic evaluation showed that Xueshuantong for injection（lyophilized） combined with conventional treatment was relatively economic compared with conventional treatment alone， with the total clinical effective rate as the effect parameter， but the incremental effect was not significant， the economic evaluation was grade B. In addition to ACI and unstable angina of coronary heart disease， the drug also had good clinical efficacy in central retinal vein occlusion， and had a wider range of indications and awarded 16 patents， and its innovation evaluation was grade B. The suitability of medical personnel and patients was good without special technical and management requirements， and the suitability was evaluated as grade B. Xueshuantong for injection（lyophilized） had reasonable price， good affordability， certain prescription restrictions and general availability， the accessibility evaluation was grade B. Since the drug is an injection of effective parts of TCM， no grade evaluation of its TCM characteristics is conducted. The legal and non-legal information evaluation results of Xueshuantong for injection（lyophilized） showed that all the information was complete and in accordance with the requirements of national standards. Based on the grade scores of the 6 dimensions， the clinical comprehensive evaluation of Xueshuantong for injection（lyophilized） in the treatment of ACI was calculated as category B by CSC 2.0. ConclusionThe clinical value of Xueshuantong for injection（lyophilized） is good， and it is suggested that it can be directly translated into relevant policy outcomes for basic clinical medication management.
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Objective:To explore the evaluations of computed tomography(CT)perfusion imaging parameters and serum complement C1q/tumor necrosis factor related protein-3(CTRP-3),low density lipoprotein cholesterol(LDL-C),matrix metalloproteinase-9(MMP-9)on hemorrhagic transformation(HT)after acute cerebral infarction(ACI).Methods:A total of 206 ACI patients who admitted to the People's Hospital of Jianyang from August 2019 to July 2022 were retrospectively selected as the study objects.The patients were divided into HT group(45 cases)and non-HT group(161 cases)according to whether occurred HT after intravenous thrombolysis.The CT perfusion imaging parameters[blood flow(BF),blood volume(BV),mean transit time(MTT),permeability surface(PS)],CTRP-3,LDL-C,MMP-9 were compared between two groups.Receiver operating characteristic(ROC)curve model was used to analyze the area under curve(AUC)values,sensitivities and specificities of CT perfusion imaging parameters,CTRP-3,LDL-C and MMP-9 in diagnosing HT.Results:The BF and BV of HT group were lower than those of non-HT group,while the MTT and PS of HT group were higher than those of non-HT group,and the differences were statistically significant(t=-5.941,t=-5.777,t=5.863,t=6.954,P<005),respectively.The CTRP-3 and LDL-C of HT group were respectively lower than those of non-HT group,while the MMP-9 of HT group was higher than that of non-HT group,with statistical significances(t=-3.788,t=-5.835,t=6.935,P<0.05).The ROC curve analysis showed that the AUC values of BF,BV,MTT,PS,CT comprehensive parameters,CTRP-3,LDL-C and MMP-9 were respectively 0.790,0.779,0.738,0.775,0.949,0.692,0.777 and 0.785(P<0.05).The sensitivities of them were respectively 88.90%,100.00%,53.30%,66.70%,100.00%,88.90%,66.70%and 78.60%.The specificities of them were respectively 64.60%,51.60%,91.30%,77.60%,81.40%,47.80%,78.90%and 75.80%.The differences of the AUC values between CT comprehensive parameters and CTRP-3,and between that and LDL-C,and between that and MMP-9 were significant(Z=6.202,Z=4.563,Z=3.704,P<0.05),respectively.Conclusion:CT perfusion imaging parameters,serum CTRP-3,LDL-C and MMP-9 levels have close correlation with HT after ACI.The monitoring of the change degrees of them is helpful to provide important references for predicting the occurrence of HT in ACI patients after thrombolytic therapy.
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Objective To analyze the effect of edaravone combined with ginkgo diterpene lactone in treatment of acute cerebral infarction (ACI) and discuss the better clinical treatment to ACI .Methods 100 cases of ACI and who accepted treat-ments in our hospital were selected as the research objects in January 2014 to January 2015 .50 patients as observation group were given the treatment of edaravone and ginkgo diterpene lactone at the same time ,while other 50 patients as control group were merely given the treatment of ginkgo diterpene lactone .At the same time ,both groups were given treatment of conven-tional therapy .The total neurological function ,effective rate ,adverse reactions ,and the treatment satisfaction of both groups before and after the treatment were observed .Results There were no significant different of NIHSS score of two groups before treatment (P>0 .05) .After treatment ,NIHSS score of the observation group was significantly lower than the control group (P<0 .05) .The total effective rate of observation group was 90％ ,which was significantly higher than the control group (66％ ,P<0 .05) .The main adverse reactions were rash ,nausea ,dizziness of two groups ,and there were no significant differ-ent of adverse reactions rate of two groups through the treatment (P>0 .05) .The treatment of patients with satisfaction rate of observation group was 94％ ,which was significantly higher than control group (84％ , P< 0.05) .Conclusion Edaravone combined with ginkgo diterpene lactone had a good effect on improving nerve function of ACI patients ,which could improve the treatment of patients with satisfaction ,high security ,and could be recommended in clinical .
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Objective To observe the Hp infection effect on blood lipid metabolism and oxidative stress through detecting acute cerebral infarction (ACI) with Helicobacter pylori (Hp) infection serum lipid and malondialdehyde (MDA) level and superoxide dismutase (SOD) activity.Methods Chose ACI 350 cases of ACI group,80 cases of control group and detected serum Hp-IgG antibody (by colloidal gold) and 14C urea breath test (by14 C-UBT).Used the American beckman coulter AU680 fullautomatic biochemical analyzer to detect the serum lipid and SOD activity (colorimetry),and used Shanghai now 752 visible spectrophotometcr (532 nm) to detect the serum MDA level (TBA).Results The Hp infection rate of ACI group (69.5 ％) was significantly higher than that in the control group (33.8％),the differences was statistically significant (x2 =18.882,P＜0.01).The differences in serum TC,TG,LDL-C and HDL-C levels were statistically significant (t=4.167 ～5.521,all P＜0.01) compared with Hp non-infection group.The serum MDA level and SOD activity of the control group and Hp infection group were statistically significant (F=34.891～46.613,all P＜0.01).Hp infection with Hp infection group to compare serum MDA level and SOD activity differences statistically significant (t=5.197,9.713,all P＜0.01),the Hp infection group and control group in comparative differences were statistically significant (t=3.173,8.228,all P＜0.01).Conclusion Acute cerebral infarction merger of HP infection,blood lipid metabolic disturbance in body increased and enhanced oxidative stress reaction,this may be intensified HP infection is one of the reasons for acute brain infarction dis ease.
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Objective To explore pathogenes and pathogenesis of acute cerebral infarction (ACI) from the perspective of integrated traditional and western medicine.Methods To categorize the tongue and pulse manifestation of 64 ACI patients and calculate their frequency,constituent ratios.Meanwhile,patients' blood pressure and laboratory examination results are given descriptive and statistical analysis,showing their means and standard deviations,etc.Results The frequency of dark-red tongue,thin-greasy tongue fur,greasy-yellow tongue fur and taut-slippery is respectively 48,34,20,and 41,constituting 77.4％,54.8％,32.3％,64.1％ of the patients examined respectively; Mean and standard deviation of systolic blood pressure (SBP),total cholesterol (TC),white blood cell (WBC),neutrophil percentage (NEUT％),fasting plasma glucose (FPG),and hemoglobin A1c (HbA1c) is respectively (141.20± 19.20)mm Hg (1 mm Hg=0.133 kPa)、(4.47±0.97) mmol/L、(7.83±2.63) × 109/L、(71.61±9.65)％、(6.16±2.25)mmol/L、and (6.60±1.66)％.Conclusion In terms of pathogens,wind,stasis,heat (fire) and turbid pathogen (phlegm,dampness,etc.) are important factors in bringing out ACI; In respect of ACI pathogenesis characteristics,healthy qi is slightly damaged and pathogenic qi is exuberant.Yet,the role of modern medical examination results,such as blood pressure,blood glucose,blood lipids etc.in the assessment of ACI pathogens and pathogenesis awaits further exploration.
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OBJECTIVE:To evaluate the cost-effectiveness of 3 "Cocktail" therapeutic regimens in treating acute cerebral infarction(ACI).METHODS:141 patients with ACI were administered with Sodium Ozagrel + Cinepazide + Edaravone(Group A),Vinpocetine + Propylgallate + Deproteinized calf blood Extractives(Group B)or Sodium Ferulate + Buflomedil + Muscular Amino Acids and Peptides and Nucleosides(Group C)for 14d.Cost-effectiveness analysis in pharmacoeconomics was applied to analyze the therapeutic effects and costs.RESULTS:The total costs of 3 groups(A,B and C)were 5 970.67 yuan,4 865.11 yuan and 3 939.72 yuan,respectively,the efficiency rates were 82.98%,63.04% and 64.58% respectively,and the cost-effectiveness ratio were 7 195.31,7 717.50 and 6 100.53,respectively.CONCLUSION:Group A is preferable for ACI.
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The therapeutic effect and laboratory findings in 137 case of acute cerebral infarction treated with Propylene Glycol Mannurate Sulfate (PGMS) were analysed. The positive therapeutic response to PGMS in the treated group was obtained to 95. 6% and 70. 1%,and was better than that of the controls ( P