| Objectives Through clinical evaluation and the use of arteiral spin Labeling,ASL perfusion imaging technology,this study observed the clinical effect of butyphthalide in the treatment of chronic cerebral ischemia and hypoperfusion,and provided a new basis for the treatment of chronic cerebral ischemia and hypoperfusion.Methods Patients admitted to the outpatient department or ward of Neurology,Tangshan workers,Hospital affiliated to the North China University of science and Technology from June 2017 to November 2018 were selected.Patients with internal carotid artery system vascular stenosis or occlusion and low perfusion confirmed by arteiral spin Labeling.The subjects meeting the inclusion criteria were randomly divided into two groups,a total of 55 cases were collected in butyphthalide group,of which 2cases were followed up and 1 cases were selected for intravascular treatment,and 52 cases were finally included;A total of 54 cases were collected in the control group,including 2 cases of follow-up shedding,1 cases of cerebral hemorrhage,2 cases of cerebral infarction,and 49 cases were finally included.The control group was given basic treatment such as antiplatelet aggregation,antihypertensive,hypoglycemic and lipid lowering.On this basis,butyphthalide group was given Butylphthalide Injection(enbipu pharmaceutical co,LTD,China Shijiazhuang Pharmaceutical group,national drug approval word H20100041;100ml: butyphthalide 25 mg,sodium chloride 0.9g),with100 ml once a day for 2 weeks.Eubipu capsule(enbipu pharmaceutical co,LTD,China Shijiazhuang Pharmaceutical group,national drug approval word H20050299;100mg/granules)Oral,200mg/time,3 times a day for 12 weeks,a total of 14 weeks of treatment.The patients underwent ASL examination and the evaluation of the related scale(index score of BI,Independent function Rating Scale FIM,Mental state examinationMMSE,Montreal Cognitive Assessment ScaleMOCA)before and 14 weeks after treatment,The changes of cerebral blood flow(cerebral blood flow,CBF),relative cerebral blood flow value(Relative cerebral blood flow,rCBF),area of hypoperfusion and scale score of patients were observed before and after treatment.Furthermore,the effects of butyphthalide on chronic cerebral ischemia and hypoperfusion was evaluated by imaging and clinical.Results 1 The baseline data: There was no statistically significant difference in age,sex,number of years of education and past history between the two groups(P>0.05),which was comparable.2 Clinical effect of Butyphthalide in the treatment of chronic cerebral ischemia and hypoperfusion:(1)Correlation scale score Determination: Before treatment,there was no statistically significant difference between MMSE,MOCA,FIM and BI index scores in the control group(P>0.05),which was comparable.After treatment,the scores of MMSE,MOCA and FIM in butyphthalide group increased significantly,the difference was statistically significant(P<0.05).There was no significant change in the control group.There was no significant change in BI index score before and after treatment in both groups,and there was no statistical difference.(2)Comparison of clinical effects: The total effective rate of butyphthalide group was 92.3%,higher than that of control group(51%),the difference was statistically significant(P<0.05).3Clinical effect of butylphthalide in the treatment of chronic cerebral ischemia and hypoperfusion: a ASL study:(1)Compared with the CBF value and rCBF value of the two groups before treatment,the difference was not statistically significant and comparable.After treatment,the CBF value and rCBF value in the affected side of butyphthalide group was significantly increased.After treatment,the difference of CBFand rCBF in the affected side of Butyphthalide group was significantly increased.The difference was statistically significant(P<0.05),there was no significant change in the control group after treatment.(2)There was no statistically significant difference(P>0.05)in the comparison of the CBF values between the two groups before treatment,There was no significant change in the difference value of CBF and CBF in the healthy side between the two groups after treatment.(3)Before treatment,there was no statistically significant difference in the area of the maximum level of the two groups with hypoperfusion area,which was comparable.After treatment,the area of the maximal level hypoperfusion on the affected side in the butyphthalide group was significantly reduced,and the difference is statistically significant(P<0.05).and there was no significant change in the control group.Conclusions 1 Butyphthalide can obviously increase the cerebral blood flow in patients with chronic cerebral ischemia and hypoperfusion,improve cerebral perfusion.2 The technique of ASL can objectively evaluate cerebral blood perfusion and provide imaging basis for the treatment of chronic cerebral ischemia and hypoperfusion by Butyphthalide.3 Butyphthalide can significantly improve cognitive level and daily living ability in patients with chronic cerebral ischemia and hypoperfusion,and improve clinical symptoms and prognosis.Figure3;Table8;Reference 157... |
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