目的 探討天麻素注射液聯(lián)合前列地爾注射液對(duì)腔隙性腦梗死患者的療效及血脂、血液流變學(xué)的影響。方法 選取2015年10月-2017年12月連云港市贛榆區(qū)人民醫(yī)院收治的腔隙性腦梗死患者90例作為研究對(duì)象，根據(jù)入院順序隨機(jī)分為觀察組和對(duì)照組，每組各45例。對(duì)照組在常規(guī)治療基礎(chǔ)上，給予前列地爾注射液10 μg加入100 mL生理鹽水中靜脈滴注，1次/d。觀察組在對(duì)照組的基礎(chǔ)上給予天麻素注射液400 mg加入250 mL生理鹽水中靜脈滴注，1次/d。兩組均連續(xù)治療2周。觀察兩組的臨床療效，同時(shí)比較兩組治療前后的血脂和血液流變學(xué)指標(biāo)水平。結(jié)果 治療后，觀察組治療總有效率為91.11%，顯著高于對(duì)照組的73.33%，兩組比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，兩組三酰甘油（TG）、總膽固醇（TC）、低密度脂蛋白膽固醇（LDL-C）均明顯降低，同組治療前后比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）；且觀察組明顯低于對(duì)照組，兩組比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）；治療后，觀察組HDL-C水平明顯升高，同組治療前后比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05），但兩組間比較無(wú)顯著差異。治療前，兩組血液流變學(xué)指標(biāo)無(wú)顯著差異；治療后，兩組全血黏度高切變率、全血黏度低切變率、血漿黏度、紅細(xì)胞比容和紅細(xì)胞聚集指數(shù)均顯著降低，同組治療前后比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）；且觀察組明顯低于對(duì)照組，差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。結(jié)論 天麻素注射液聯(lián)合前列地爾注射液治療腔隙性腦梗死可有效改善患者的血脂水平和血液流變學(xué)指標(biāo)，療效顯著，優(yōu)于單用前列地爾治療。

Objective To investigate the clinical effects of Gastrodin Injection combined with Alprostadil Injection on patients with lacunar infarction and the effects of blood lipids and hemorheology. Methods 90 patients with lacunar infarction in Ganyu District People's Hospital of Lianyungang City from October 2015 to December 2017 were randomly divided into observation group and control group according to the order of admission, each group had 45 cases. On the basis of routine treatment, the control group was given Alprostadil Injection 10 μg added into 100 mL saline intravenous drip, once a day. Observation group were iv administered with Gastrodin Injection on the basis of control group, 400 mg added into 250 mL saline, once daily. Patients in two groups were treated for 2 weeks. After treatment, the clinical efficacy was evaluated, and the blood lipid and hemorheology indexes levels in two groups before and after treatment were compared. Results After treatment, the total effective rate of the observation group was 91.11%, which was significantly higher than 73.33% of the control group (P<0.05). After treatment, the levels of TG, TC and LDLC in the two groups were significantly decreased, and the difference was statistically significant in the same group (P<0.05). And the observation group was significantly lower than control group, with significant difference between two groups (P<0.05). After treatment, the HDL-C level of the observation group was significantly increased, and the difference was statistically significant in the same group (P<0.05), but there was no significant difference between the two groups. There was no statistically significant difference in hemorheology indexes between two groups before treatment. After treatment, high whole blood viscosity shear rate, low whole blood viscosity shear rate, plasma viscosity, erythrocyte volume, and erythrocyte aggregation index in two groups were significantly decreased, and the difference was statistically significant in the same group (P<0.05). And the hemorheology indexes in the observation group were significantly lower than those in the control group, with significant difference between two groups (P<0.05). Conclusion The combination of Gastrodin Injection combined with Alprostadil Injection in treatment of lacunar infarction can effectively improve the blood lipid level and hemorheology indexes of patients, and the curative effect is remarkable, which is better than the treatment with alprostadil alone.