目的 探討芪龍膠囊聯(lián)合氯吡格雷治療急性腦梗死恢復(fù)期(氣虛血瘀型)的臨床療效。方法 納入2020年10月-2021年3月在南陽市中心醫(yī)院就診的120例急性腦梗死恢復(fù)期患者,隨機(jī)分為對(duì)照組(60例)和治療組(60例)。對(duì)照組口服硫酸氫氯吡格雷片,2片/次,1次/d;在對(duì)照組的基礎(chǔ)上,治療組口服芪龍膠囊治療,2粒/次,3次/d。兩組均治療4周。觀察兩組患者臨床療效,比較治療前后兩組患者神經(jīng)缺損和生活能力,全血黏度和血漿黏度,超敏C反應(yīng)蛋白(hs-CRP)、白細(xì)胞介素-6(IL-6)和腫瘤壞死因子-α(TNF-α)水平,及氧化應(yīng)激骨橋蛋白(OPN)、丙二醛(MDA)、超氧化物歧化酶(SOD)和谷胱甘肽過氧化物酶(GSH-Px)水平。結(jié)果 治療后,對(duì)照組和治療組臨床有效率分別為85.00%、96.67%,差異有統(tǒng)計(jì)學(xué)意義(P<0.05)。治療后,兩組NIHSS評(píng)分較治療前顯著降低,而Barthel指數(shù)顯著升高(P<0.05),且治療組NIHSS和Barthel指數(shù)顯著好于對(duì)照組(P<0.05)。治療后,兩組患者全血高切黏度、全血低切黏度和血漿黏度、hs-CRP、IL-6和TNF-α、OPN和MDA水平均顯著降低,而SOD和GSH-Px水平顯著升高(P<0.05),且治療后治療組這些指標(biāo)水平顯著好于對(duì)照組(P<0.05)。結(jié)論 芪龍膠囊輔助治療急性腦梗死恢復(fù)期(氣虛血瘀型)具有較好的療效,能顯著提高患者的神經(jīng)功能和生活自理能力,主要機(jī)制可能與改善血液流變學(xué)狀況、減輕氧化應(yīng)激反應(yīng)和降低炎癥狀況有關(guān)。

Objective To investigate the clinical efficacy of Qilong Capsules combined with clopidogrel in treatment of acute cerebral infarction in recovery period (qixue and xueyu type).Methods Patients (120 cases) with acute cerebral infarction in recovery period (qixue and xueyu type) in Nanyang Central Hospital from October 2020 to March 2021 were randomly divided into control (60 cases) and treatment (60 cases) group. Patients in the control group were po administered with Clopidogrel Bisulfate Tablets, 2 tablets/time, once daily. Patients in the treatment group were po administered with Qilong Capsules on the basis of the control group, 2 grains/time, three times daily. Patients in two groups were treated for 4 weeks. After treatment, the clinical evaluation was evaluated, nerve defect and living ability, whole blood viscosity and plasma viscosity, the levels of hs-CRP, IL-6 and TNF-α, the levels of serum OPN, MDA, SOD and GSH-Px in two groups before and after treatment were compared.Results After treatment, the clinical effective rates of the control group and the treatment group were 85.00% and 96.67% respectively (P < 0.05). After treatment, the NIHSS score in two groups was significantly lower than that before treatment, while the Barthel index was significantly higher (P < 0.05), and the NIHSS and Barthel index in the treatment group were significantly better than those of the control group (P < 0.05). After treatment, the whole blood high shear viscosity, whole blood low shear viscosity and plasma viscosity, the levels of OPN, MDA, hs-CRP, IL-6 and TNF-α in two groups were significantly decreased, while the levels of SOD and GSH-PX were significantly increased (P < 0.05), and the levels of these indexes in the treatment group were significantly better than those in the control group (P < 0.05).Conclusion Qilong Capsule has good curative effect in the adjuvant treatment of acute cerebral infarction in recovery period (qixue and xueyu type), can significantly improve the neurological function and self-care ability of patients, and the main mechanism may be related to improving hemorheology, reducing oxidative stress and reducing inflammation.

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