目的 探討腦苷肌肽聯(lián)合奧拉西坦治療急性腦出血的臨床療效，及其對(duì)血清鐵蛋白（SF）、血清淀粉樣蛋白A （SAA）水平的影響。方法 選取2018年1月-2019年12月在上海中醫(yī)藥大學(xué)附屬龍華醫(yī)院接受治療的148例急性腦出血患者作為研究對(duì)象，按照治療方案將患者分為對(duì)照組和觀察組，每組各74例。對(duì)照組靜脈滴注奧拉西坦注射液，5 g奧拉西坦注射液加入到250 mL生理鹽水中靜滴，1次/d。觀察組在對(duì)照組治療基礎(chǔ)上靜脈滴注腦苷肌肽注射液，20 mL加入250 mL生理鹽水中靜滴，1次/d。兩組均連續(xù)給藥2周。觀察兩組患者的臨床療效，同時(shí)比較兩組患者的腦血腫量、腦水腫量、美國(guó)國(guó)立衛(wèi)生研究院卒中量表評(píng)分（NIHSS）、Barthel指數(shù)（BI）、改良Rankin量表評(píng)分（mRS）、血清白細(xì)胞介素（IL）-6、IL-10、SF及SAA水平。結(jié)果 治療后，觀察組為總有效率為89.19%，顯著高于對(duì)照組的75.68%（P<0.05）。治療后，兩組患者腦血腫量和腦水腫量均顯著降低（P<0.05），且觀察組腦血腫量和腦水腫量均顯著低于對(duì)照組（P<0.05）。治療后，兩組NIHSS、mRS評(píng)分顯著降低，BI評(píng)分顯著增加（P<0.05）；且觀察組NIHSS、mRS評(píng)分顯著低于對(duì)照組，BI評(píng)分顯著高于對(duì)照組（P<0.05）。治療后，兩組血清IL-6、SF及SAA水平均顯著降低，IL-10水平顯著增加（P<0.05）；且觀察組血清IL-6、SF及SAA水平顯著低于對(duì)照組，IL-10水平顯著高于對(duì)照組（P<0.05）。結(jié)論 奧拉西坦聯(lián)合腦苷肌肽對(duì)急性腦出血患者治療效果較好，能夠顯著降低血清SF及SAA水平，減輕炎癥反應(yīng)，保護(hù)和修復(fù)神經(jīng)損傷。

Objective To investigate the clinical efficacy of cattle encephalon glycoside and ignotin combined with oxiracetam in treatment of acute cerebral hemorrhage, and its effect on SF and SAA levels. Methods A total of 148 patients with acute cerebral hemorrhage who received treatment in Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine from January 2018 to December 2019 were selected as the research subjects. According to the treatment plan, the patients were divided into control group and observation group, with 74 patients in each group. Patients in the control group were intravenously injected with Oxiracetam Injection, 5 g of Oxiracetam Injection was added into 250 mL normal saline, once daily. Patients in the the observation group was intravenously injected with Cattle Encephalon Glycoside and Ignotin Injection on the basis of the control group, 20 mL added into 250 mL normal saline, once daily. Both groups were given continuous medication for 2 weeks. After treatment, the clinical efficacy of two groups was observed, and hematoma volume, brain edema volume, NIHSS score, BI, MRS, the levels of serum IL-6, IL-10, SF and SAA were compared between two groups. Results After treatment, the total effective rate of observation group was 89.19%, which was significantly higher than 75.68% of control group (P<0.05). After treatment, the amount of cerebral hematoma and brain edema in two groups were significantly decreased (P<0.05), and the amount of cerebral hematoma and brain edema in the observation group were significantly lower than those in the control group (P<0.05). After treatment, NIHSS and MRS scores were significantly decreased, while BI scores were significantly increased (P<0.05). The NIHSS and MRS scores of the observation group were significantly lower than those of the control group, but the BI scores of the observation group were significantly higher than those of the control group (P<0.05). After treatment, the levels of serum IL-6, SF and SAA in two groups were significantly decreased, while the level of IL-10 was significantly increased (P<0.05). The levels of serum IL-6, SF and SAA in observation group were significantly lower than those in control group, and the level of IL-10 was significantly higher than that in control group (P<0.05). Conclusion Cattle encephalon glycoside and ignotin combined with oxiracetam has good therapeutic effect on patients with acute intracerebral hemorrhage, which can significantly reduce serum SF and SAA levels, reduce inflammatory response, and protect and repair nerve damage.

R971