目的 探討川蛭通絡(luò)膠囊聯(lián)合復(fù)方腦肽節(jié)苷脂注射液治療急性腦梗死恢復(fù)期的臨床療效。方法 選擇鄭州大學(xué)第五附屬醫(yī)院2022年1—12月收治的100例急性腦梗死恢復(fù)期患者，按隨機(jī)數(shù)字表法分為對(duì)照組（50例）和治療組（50例）。對(duì)照組靜脈滴注復(fù)方腦肽節(jié)苷脂注射液，20 mL與300 mL生理鹽水混合，1次/d。在對(duì)照組基礎(chǔ)上，治療組口服川蛭通絡(luò)膠囊，0.5 g/次，3次/d。兩組均持續(xù)治療2周。比較兩組的臨床療效、量表評(píng)分、血液流變學(xué)指標(biāo)、神經(jīng)細(xì)胞因子和血管內(nèi)皮功能。結(jié)果 治療組的總有效率（92.00%）高于對(duì)照組的總有效率（76.00%，P＜0.05）。治療后，兩組美國(guó)國(guó)立衛(wèi)生研究院卒中量表（NIHSS）評(píng)分顯著下降，日常生活能力量表評(píng)分（ADL）評(píng)分顯著升高（P＜0.05），且治療組NIHSS評(píng)分、ADL評(píng)分明顯優(yōu)于對(duì)照組（P＜0.05）。治療后，兩組患者紅細(xì)胞沉降率、紅細(xì)胞壓積、全血黏度、血小板黏附率均顯著下降（P＜0.05），且治療組紅細(xì)胞沉降率、紅細(xì)胞壓積、全血黏度、血小板黏附率低于對(duì)照組（P＜0.05）。治療后，兩組血清神經(jīng)元特異性烯醇化酶（NSE）水平顯著下降，血清腦源性神經(jīng)營(yíng)養(yǎng)因子（BDNF）、神經(jīng)細(xì)胞因子神經(jīng)營(yíng)養(yǎng)因子（NTF）水平顯著升高（P＜0.05），且治療組血清神經(jīng)細(xì)胞因子水平變化優(yōu)于對(duì)照組（P＜0.05）。治療后，兩組血清內(nèi)皮素-1（ET-1）、血管性血友病因子（vWF）水平下降，血清一氧化氮（NO）水平升高（P＜0.05），且治療組血清血管內(nèi)皮功能優(yōu)于對(duì)照組（P＜0.05）。結(jié)論 川蛭通絡(luò)膠囊聯(lián)合復(fù)方腦肽節(jié)苷脂注射液對(duì)急性腦梗死恢復(fù)期患者有良好效果，能增強(qiáng)生活能力，改善血液流變學(xué)，改善神經(jīng)功能，保護(hù)血管內(nèi)皮。

Objective To explore the therapeutic effect of Chuanzhi Tongluo Capsules combined with Compound Porcine Cerebroside and Ganglioside Injection in treatment of acute cerebral infarction in recovery period. Methods Patients (100 cases) with acute cerebral infarction in recovery period in the Fifth Affiliated Hospital of Zhengzhou University from January to December 2022 were divided into control and treatment groups according to the random number table method, and each group had 50 cases. Patients in the control group were iv administered with Compound Porcine Cerebroside and Ganglioside Injection, 20 mL added into normal saline 300 mL, 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. The clinical efficacies, scale scores, hemorheological indicators, nerve cytokines, and vascular endothelial function in two groups were compared. Results The total effective rate of treatment group (92.00%) was higher than 76.00%t of control group (P < 0.05). After treatment, NIHSS scores in two groups was significantly decreased, and ADL scores in two groups was significantly increased (P < 0.05). And NIHSS score and ADL score in the treatment group were significantly better than those in the control group (P < 0.05). After treatment, the erythrocyte sedimentation rate, hematocrit, whole blood viscosity, and platelet adhesion rate of two groups were significantly decreased (P < 0.05), and the erythrocyte sedimentation rate, hematocrit, whole blood viscosity, and platelet adhesion rate in the treatment group were lower than those in the control group (P < 0.05). After treatment, the serum level of NSE in two groups was significantly decreased, but the serum levels of BDNF and NTF in two groups were significantly increased (P < 0.05). And the serum neurocytokine level in the treatment group was better than that in the control group (P < 0.05). After treatment, the serum levels of ET-1 and vWF in two groups were decreased, but the serum level of NO in two groups was increased (P < 0.05), and the serum vascular endothelial function in the treatment group was better than that in the control group (P < 0.05). Conclusion Chuanzhi Tongluo Capsules combined with Compound Porcine Cerebroside and Ganglioside Injection has clinical curative effect in treatment of acute cerebral infarction in recovery period, can enhance living ability, improve blood rheology, improve neurological function, and protect vascular endothelium.

R971

河南省醫(yī)學(xué)科技攻關(guān)計(jì)劃（聯(lián)合共建）項(xiàng)目（LHG20190412）