目的 評(píng)估川蛭通絡(luò)膠囊與阿托伐他汀鈣聯(lián)合用藥治療對(duì)急性腦梗死的臨床效果。方法 研究納入張家口市第一醫(yī)院神經(jīng)內(nèi)科自2023年7月至2024年10月收治的急性腦梗死患者120例。依據(jù)治療方案的不同將患者分為對(duì)照組（n=60）和治療組（n=60）。對(duì)照組給予阿托伐他汀鈣片（10 mg/次，每日1次）口服治療；治療組在阿托伐他汀鈣治療基礎(chǔ)上，加服川蛭通絡(luò)膠囊（2粒/次，每日3次）。所有患者均持續(xù)用藥2周。觀察兩組療效情況；比較兩組治療前后三酰甘油（TG）、高密度脂蛋白膽固醇（HDL-C）、總膽固醇（TC）、低密度脂蛋白膽固醇（LDL-C）、日常生活能力量表評(píng)分指數(shù)（Barthel）、美國(guó)國(guó)立衛(wèi)生研究院卒中量表（NIHSS）評(píng)分、血清血管生成素樣蛋白3（ANGPTL3）、神經(jīng)膠質(zhì)纖維酸性蛋白（GFAP）、血清可溶性細(xì)胞間黏附分子-1（sICAM-1）、成纖維細(xì)胞生長(zhǎng)因子-23（FGF-23）水平。結(jié)果 在總有效率方面，治療組（96.67%）顯著高于對(duì)照組（83.33%），差異有統(tǒng)計(jì)學(xué)意義（P＜0.05）；在癥狀改善時(shí)間方面，治療組患者手足麻木、口角歪斜、肢體無(wú)力及語(yǔ)言不利的改善時(shí)間均顯著短于對(duì)照組（P＜0.05）；在血脂指標(biāo)改善方面，治療后，兩組HDL-C水平顯著升高，而LDL-C、TC、TG水平降低（P＜0.05）；治療后，與對(duì)照組對(duì)比，治療組LDL-C、TC、TG水平更低，且治療組的HDL-C水平更高（P＜0.05）。在神經(jīng)功能與生活能力評(píng)分方面，治療后，兩組NIHSS評(píng)分顯著降低，而Barthel評(píng)分升高（P＜0.05）；治療后，與對(duì)照組對(duì)比，治療組NIHSS評(píng)分降低，且Barthel評(píng)分升高（P＜0.05）。在血清學(xué)指標(biāo)方面，治療后，兩組患者血清ANGPTL3、GFAP、sICAM-1、FGF-23水平均較同組治療前顯著降低（P＜0.05）；治療后，與對(duì)照組對(duì)比，治療組ANGPTL3、GFAP、sICAM-1、FGF-23水平均較低（P＜0.05）。結(jié)論 川蛭通絡(luò)膠囊與阿托伐他汀鈣聯(lián)用可顯著提升急性腦梗死患者的臨床治療效果，加速神經(jīng)功能缺損癥狀的緩解，并有效調(diào)控血清炎癥標(biāo)志物的水平。

Objective To investigate the clinical efficacy of Chuanzhi Tongluo Capsules combined with atorvastatin calcium in treatment of acute cerebral infarction. Methods A total of 120 patients with acute cerebral infarction admitted to the Department of Neurology of Zhangjiakou First Hospital from July 2023 to October 2024 were selected and divided into control group and treatment group according to differences in medication regimens, with 60 cases in each group. Patients in control group were given Atorvastatin Calcium Tablets, 10 mg each time, once daily. Patients in treatment group orally took Chuanzhi Tongluo Capsules on basis of control group, 2 capsules each time, 3 times daily. The treatment conditions of both groups were observed after two weeks of medication. The treatment conditions of both groups were observed after two weeks of medication. The therapeutic effects of two groups were observed, and the levels of TG, HDL-C, TC, LDL-C, Barthel score, NIHSS score, and serum ANGPTL3, GFAP, sICAM-1, and FGF-23 in two groups were compared between two groups. Results After drug intervention, the total effective rate of the treatment group was 96.67%, significantly higher than that of the control group (83.33%, P < 0.05). After drug intervention, the improvement time for numbness in hands and feet, crooked mouth corners, limb weakness and poor speech in the treatment group was significantly shorter than that in the control group (P < 0.05). After treatment, the levels of HDL-C in both groups increased significantly,and the levels of LDL-C, TC, and TG decreased (P < 0.05). After treatment, compared with the control group, the levels of LDL-C, TC and TG in the treatment group were lower, and the level of HDL-C in the treatment group was higher (P < 0.05). After treatment, the NIHSS scores of both groups decreased significantly, while the Barthel scores increased (P < 0.05). After treatment, compared with the control group, the NIHSS score of the treatment group decreased, and the Barthel score increased (P < 0.05). After treatment, the levels of ANGPTL3, GFAP, sICAM-1, and FGF-23 in both groups decreased significantly (P < 0.05). After treatment, compared with the control group, the levels of ANGPTL3, GFAP, sICAM-1, and FGF-23 in the treatment group were all lower (P < 0.05). Conclusion The combination of Chuanzhi Tongluo Capsules and atorvastatin calcium can significantly improve the clinical treatment effect of patients with acute cerebral infarction, accelerate the relief of neurological deficit symptoms, and effectively regulate the concentration of serum inflammatory markers.

R971

張家口市重點(diǎn)研發(fā)計(jì)劃項(xiàng)目（2322105D）