Zheng Mo, Xu Yun
Zhejiang Rehabilitation Medical Center, 310000 Hangzhou, Zhejiang, China.
Xiaoshan District Second People's Hospital of Hangzhou, 310000 Hangzhou, Zhejiang, China.
J Stroke Cerebrovasc Dis. 2025 Jul;34(7):108339. doi: 10.1016/j.jstrokecerebrovasdis.2025.108339. Epub 2025 May 7.
Both hyperbaric oxygen therapy and Danshen (Salvia miltiorrhiza) injection have shown potential therapeutic effects on ischemic stroke, but the impact of their combination on long-term functional outcomes and recurrence risk has not been systematically evaluated. This study aimed to assess the effects of hyperbaric oxygen combined with Danhong injection on 90-day functional independence and the 1-year recurrence rate in patients with ischaemic stroke.
This study employed a retrospective matched cohort design and collected data from patients with ischemic stroke treated at our hospital between January 2018 and December 2022. After 1:1 propensity score matching, 80 patients were included in each group. The intervention group received hyperbaric oxygen therapy (2.0-2.5 ATA, once daily for 10 sessions) combined with Danhong injection (20 ml/day for 14 consecutive days) in addition to standard treatment; the control group received standard treatment only. The primary outcome was 90-day functional independence (mRS ≤2); secondary outcomes included the 1-year stroke recurrence rate, NIHSS score improvement, and others.
The percentage of 90-day functional independence in the intervention group (72.5 %) was significantly greater than that in the control group (53.8 %) (P = 0.014), with a relative risk ratio of 1.35 (95 % CI: 1.06-1.71). Multivariate analysis revealed that combined therapy was independently associated with 90-day functional independence (adjusted OR = 2.28, 95 % CI: 1.19-4.37; P = 0.013). The 1-year stroke recurrence rate in the intervention group (7.6 %) was significantly lower than that in the control group (16.5 %) (P = 0.042), with an adjusted hazard ratio of 0.46 (95 % CI: 0.22-0.94, P = 0.033). Subgroup analysis revealed that patients aged <65 years, those with NIHSS scores ranging from 4-15, those with small-artery occlusion or large-artery atherosclerosis stroke, and those who began treatment within 24 hours benefited more significantly. The combined therapy was well tolerated, with no serious adverse events.
Hyperbaric oxygen combined with Danhong injection significantly improved 90-day functional independence and reduced the 1-year recurrence risk in patients with ischaemic stroke, particularly in specific patient subgroups. This combined treatment strategy provides a new therapeutic option for comprehensive stroke management.
高压氧治疗和丹参注射液对缺血性脑卒中均显示出潜在治疗效果，但二者联合应用对长期功能结局和复发风险的影响尚未得到系统评估。本研究旨在评估高压氧联合丹红注射液对缺血性脑卒中患者90天功能独立性及1年复发率的影响。
本研究采用回顾性匹配队列设计，收集了2018年1月至2022年12月在我院接受治疗的缺血性脑卒中患者的数据。经过1:1倾向评分匹配后，每组纳入80例患者。干预组在标准治疗基础上，接受高压氧治疗（2.0 - 2.5 ATA，每日1次，共10次）联合丹红注射液（20 ml/天，连续14天）；对照组仅接受标准治疗。主要结局为90天功能独立性（改良Rankin量表评分≤2分）；次要结局包括1年脑卒中复发率、美国国立卫生研究院卒中量表（NIHSS）评分改善情况等。
干预组90天功能独立的比例（72.5%）显著高于对照组（53.8%）（P = 0.014），相对风险比为1.35（95%置信区间：1.06 - 1.71）。多因素分析显示，联合治疗与90天功能独立性独立相关（校正比值比 = 2.28，95%置信区间：1.19 - 4.37；P = 0.013）。干预组1年脑卒中复发率（7.6%）显著低于对照组（16.5%）（P = 0.042），校正风险比为0.46（95%置信区间：0.22 - 0.94，P = 0.033）。亚组分析显示，年龄<65岁、NIHSS评分4 - 15分、小动脉闭塞或大动脉粥样硬化性脑卒中以及在24小时内开始治疗的患者获益更显著。联合治疗耐受性良好，未发生严重不良事件。
高压氧联合丹红注射液显著改善了缺血性脑卒中患者90天的功能独立性，并降低了1年复发风险，尤其是在特定患者亚组中。这种联合治疗策略为脑卒中综合管理提供了一种新的治疗选择。
