目的 探討強(qiáng)力天麻杜仲膠囊聯(lián)合硫酸氫氯吡格雷片治療急性腦梗死恢復(fù)期（氣虛血瘀型）的臨床療效。方法 納入焦作煤業(yè)（集團(tuán)）有限責(zé)任公司中央醫(yī)院神經(jīng)內(nèi)二科在2022年6月—2024年10月確診的160例急性腦梗死恢復(fù)期（氣虛血瘀型）患者作為研究對(duì)象，所有患者根據(jù)隨機(jī)數(shù)字表法隨機(jī)分為對(duì)照組和治療組，每組各80例。對(duì)照組口服硫酸氫氯吡格雷片，1片/次，1次/d；治療組在對(duì)照組的基礎(chǔ)上口服強(qiáng)力天麻杜仲膠囊，2粒/次，2次/d。兩組均治療6周。比較兩組臨床療效、NIHSS評(píng)分、MMSE-R評(píng)分、ADL-R評(píng)分、炎癥因子、氧化應(yīng)激因子和血管內(nèi)皮細(xì)胞功能因子。結(jié)果 治療后，治療組的總有效率93.75%顯著高于對(duì)照組的總有效率82.50%，差異有統(tǒng)計(jì)學(xué)意義（P＜0.05）。治療后兩組MMSE-R評(píng)分顯著升高，NIHSS評(píng)分、ADL-R評(píng)分顯著降低（P＜0.05）；治療后治療組MMSE-R評(píng)分顯著高于對(duì)照組，NIHSS評(píng)分和ADL-R評(píng)分顯著低于對(duì)照組（P＜0.05）。治療后兩組血清腫瘤壞死因子-α（TNF-α）、白細(xì)胞介素-6（IL-6）和超敏C反應(yīng)蛋白（hs-CRP）水平均顯著降低（P＜0.05）；治療后，治療組TNF-α、IL-6和hs-CRP水平均顯著低于對(duì)照組（P＜0.05）。治療后兩組超氧化物歧化酶（SOD）水平顯著升高，丙二醛（MDA）水平顯著降低（P＜0.05）；治療后治療組SOD水平顯著高于對(duì)照組，MDA水平顯著低于對(duì)照組（P＜0.05）。治療后兩組內(nèi)皮素-1（ET-1）、基質(zhì)金屬蛋白酶-9（MMP-9）和可溶性細(xì)胞間黏附分子-1（sICAM-1）水平均顯著降低（P＜0.05）；治療后治療組ET-1、MMP-9和sICAM-1水平均顯著低于對(duì)照組（P＜0.05）。結(jié)論 強(qiáng)力天麻杜仲膠囊聯(lián)合硫酸氫氯吡格雷片治療急性腦梗死恢復(fù)期（氣虛血瘀型）的臨床療效顯著，與降低機(jī)體炎癥水平以及改善氧化應(yīng)激、血管內(nèi)皮細(xì)胞功能水平有關(guān)。

Objective To investigate the clinical efficacy of Qiangli Tianma Duzhong Capsules combined with Clopidogrel Bisulfate Tablets in treatment of acute cerebral infarction during convalescence period (qi deficiency and blood stasis type). Methods A total of 160 patients with acute cerebral infarction during convalescence period (qi deficiency and blood stasis type) in the Department of Neurology, Jiaozuo Coal Industry (Group) Co., Ltd. Central Hospital from June 2022 to October 2024 were included as the research subjects. All patients were randomly divided into control group and treatment group using a random number table method, with 80 patients in each group. The control group were po administered with Clopidogrel Bisulfate Tablets, 1 tablets/time, once daily. The treatment group po administered with Qiangli Tianma Duzhong Capsules on the basis of the control group, 2 capsules/time, twice daily. Both groups were treated for 6 weeks. The clinical efficacy, NIHSS score, MMSE-R score, ADL-R score, inflammatory factors, oxidative stress factors, and endothelial cell function factors were compared between two groups. Results After treatment, the total effective rate of the treatment group was 93.75%, and was significantly higher than the total effective rate (82.50%) of the control group, and the difference was statistically significant (P < 0.05). After treatment, the MMSE-R scores of two groups significantly increased, while the NIHSS and ADL-R scores significantly decreased (P < 0.05). After treatment, the MMSE-R score in the treatment group was significantly higher than that in the control group, while the NIHSS score and ADL-R score were significantly lower than those in the control group (P < 0.05). After treatment, the serum levels of TNF-α, IL-6, and hs-CRP in two groups were significantly reduced (P < 0.05), and the levels of TNF-α, IL-6, and hs-CRP in the treatment group were significantly lower than those in the control group after treatment (P < 0.05). After treatment, the levels of SOD significantly increased in two groups, while the levels of MDA significantly decreased (P < 0.05). After treatment, the SOD level in the treatment group was significantly higher than that in the control group, but the MDA level was significantly lower than that in the control group (P < 0.05). After treatment, the levels of ET-1, MMP-9, and sICAM-1 were significantly reduced in two groups (P < 0.05). After treatment, the levels of ET-1, MMP-9, and sICAM-1 in the treatment group were significantly lower than those in the control group (P < 0.05). Conclusion Qiangli Tianma Duzhong Capsules combined with Clopidogrel Bisulfate Tablets has significant clinical efficacy in treatment of acute cerebral infarction during convalescence period (qi deficiency and blood stasis type), which is related to reducing the level of inflammation in the body and improving oxidative stress and endothelial cell function.

R971

河南省醫(yī)學(xué)科技攻關(guān)計(jì)劃項(xiàng)目（LHGJ20200488）