目的 觀察川蛭通絡膠囊聯(lián)合長春西汀注射液治療腦梗死恢復期的臨床療效。方法 選取2018年10月-2020年10月安陽市人民醫(yī)院收治的122例腦梗死恢復期患者，采用隨機數(shù)字表法將所有患者分為對照組和治療組，每組各61例。對照組靜脈滴注長春西汀注射液，初始劑量20 mg/次，隨后視患者個人耐受情況逐漸增加至30 mg/次，加入生理鹽水250 mL，1次/d。治療組患者在對照組治療的基礎上口服川蛭通絡膠囊，0.5 g/次，3次/d。兩組患者均連續(xù)治療2周。觀察兩組臨床療效，比較兩組日常生活能力、神經(jīng)功能缺損程度、微循環(huán)指標、血清神經(jīng)因子水平。結果 治療后，對照組的總有效率為72.13%，治療組的總有效率為91.80%，治療組的總有效率高于對照組（P<0.05）。治療后，兩組Barthel指數(shù)（BI）評分顯著升高，美國國立衛(wèi)生研究院卒中量表（NIHSS）評分顯著降低（P<0.05）；治療后，治療組BI評分較對照組高，NIHSS評分較對照組低（P<0.05）。治療后，兩組血小板最大聚集率（MAR）、纖維蛋白原（FIB）、D-二聚體（D-D）均顯著降低，差異有統(tǒng)計學意義（P<0.05）；治療后，治療組MAR、FIB、D-D低于對照組，差異有統(tǒng)計學意義（P<0.05）。治療后，兩組神經(jīng)生長因子（NGF）、腦源性神經(jīng)營養(yǎng)因子（BDNF）水平均顯著升高，差異有統(tǒng)計學意義（P<0.05）；治療后，治療組NGF、BDNF水平較對照組高（P<0.05）。結論 川蛭通絡膠囊聯(lián)合長春西汀注射液治療腦梗死恢復期具有較好臨床療效，可改善神經(jīng)功能缺損程度、日常生活能力和機體微循環(huán)，調節(jié)血清神經(jīng)因子水平。

Objective To observe the clinical efficacy of Chuanzhi Tongluo Capsules combined with Vinpocetine Injection in treatment of convalescent cerebral infarction. Methods Patients (122 cases) with convalescent cerebral infarction in Anyang People's Hospital from October 2018 to October 2020 were divided into control and treatment groups according to random number table method, and each group had 61 cases. Patients in the control group were po administered with Vinpocetine Injection, the initial dose was 20 mg/time, then gradually increased to 30 mg/time according to the patient's personal tolerance, and the drug added into normal saline 250mL, once daily. Patients in the treatment group were po administered with Chuanzhi Tongluo Capsules on the basis of the control group, 0.5 g/time, three times daily. Patients in two groups were treated for 2 weeks. After treatment, the clinical efficacies were evaluated, and the daily living ability, neurological function deficit, microcirculation related indexes, and serum nerve factors in two groups were compared. Results After treatment, the total effective rate of the control group was 72.13%, that of the treatment group was 91.80%, and the total effective rate of the treatment group was higher than that of the control group (P<0.05). After treatment, the BI score in two groups were significantly increased, but the NIHSS score in two groups were significantly decreased (P<0.05). After treatment, the BI score of the treatment group was higher than that of the control group, but the NIHSS score of the treatment group was lower than that of the control group (P<0.05). After treatment, the MAR, FIB, and D-D in two groups were significantly decreased (P<0.05). After treatment, MAR, FIB, and D-D in the treatment group were lower than those in the control group (P<0.05). After treatment, the levels of NGF and BDNF in two groups were significantly increased (P<0.05). After treatment, the levels of NGF and BDNF in the treatment group were higher than those in the control group (P<0.05). Conclusion Chuanzhi Tongluo Capsules combined with Vinpocetine Injection has good clinical efficacy in treatment of convalescent cerebral infarction, can improve the degree of neurological deficit, daily living ability, and microcirculation, and regulate serum nerve factors.

R971

河南省科技發(fā)展計劃項目（182300610427）