目的 探討醒腦靜注射液聯(lián)合吡拉西坦片治療腦出血后認(rèn)知功能障礙的臨床療效。方法 選取2013年6月—2015年12月西安醫(yī)學(xué)院第一附屬醫(yī)院神經(jīng)外科收治的腦出血后認(rèn)知功能障礙患者573例，隨機(jī)分成對(duì)照組（286例）和治療組（287例）。對(duì)照組口服吡拉西坦片，4片/次，3次/d。治療組在對(duì)照組的基礎(chǔ)上靜脈滴注醒腦靜注射液，20 mL加入到5%葡萄糖溶液250 mL中，1次/d。兩組患者均連續(xù)治療1個(gè)月。觀察兩組的臨床療效，比較兩組的認(rèn)知功能、日常生活能力和血漿神經(jīng)元特異性烯醇化酶（NSE）水平。結(jié)果 治療后，對(duì)照組和治療組的總有效率分別為77.97%、89.90%，兩組比較差異有統(tǒng)計(jì)學(xué)意義（P < 0.05）。治療后，兩組MMSE評(píng)分和ADL評(píng)分均顯著升高，同組治療前后比較差異有統(tǒng)計(jì)學(xué)意義（P < 0.05）；且治療組這些觀察指標(biāo)的上升程度明顯優(yōu)于對(duì)照組，兩組比較差異具有統(tǒng)計(jì)學(xué)意義（P < 0.05）。治療后，兩組NSE水平均顯著下降，同組治療前后比較差異有統(tǒng)計(jì)學(xué)意義（P < 0.05）；且治療組NSE水平的下降程度明顯優(yōu)于對(duì)照組，兩組比較差異具有統(tǒng)計(jì)學(xué)意義（P < 0.05）。結(jié)論 醒腦靜注射液聯(lián)合吡拉西坦片治療腦出血后認(rèn)知功能障礙具有較好的臨床療效，能改善認(rèn)知功能和日常生活能力，提高NSE水平，具有一定的臨床推廣應(yīng)用價(jià)值。

Objective To explore the clinical efficacy of Xingnaojing Injection combined with Piracetam Tablets in treatment of cognitive impairment after cerebral hemorrhage. Methods Patients (573 cases) with cognitive impairment after cerebral hemorrhage in Department of Neurosurgery of the First Affiliated Hospital of Xi'an Medical College from June 2013 to December 2015 were randomly divided into the control group (286 cases) and the treatment group (287 cases). Patients in the control group were po administered with Piracetam Tablets, 4 tablets/ time, three times daily. Patients in the treatment group were iv administered with Xingnaojing Injection on the basis of the control group, 20 mL added into 5% glucose solution 250 mL, once daily. Patients in two groups were treated for one month. After treatment, the clinical efficacies were evaluated, and cognitive function, daily living ability, and NSE levels in two groups were compared. Results After treatment, the clinical efficacies in the control and treatment groups were 77.97% and 89.90%, respectively, and there was difference between two groups (P < 0.05). After treatment, MMSE scores and ADL scores in two groups were significantly increased, and the difference was statistically significant in the same group (P < 0.05). And the observational indexes in the treatment group were significantly higher than those in the control group, with significant difference between two groups (P < 0.05). After treatment, the NSE levels in two groups were significantly decreased, and the difference was statistically significant in the same group (P < 0.05). And the NSE levels in the treatment group were significantly lower than those in the control group, with significant difference between two groups (P < 0.05). Conclusion Xingnaojing Injection combined with Piracetam Tablets has clinical curative effect in treatment of cognitive impairment after cerebral hemorrhage, can improve cognitive function and daily living ability, and increase NSE level, which has a certain clinical application value.

陜西省教育廳科學(xué)研究項(xiàng)目計(jì)劃項(xiàng)目（2013JK0787）