目的 探討?zhàn)B血清腦顆粒聯(lián)合復(fù)方天麻蜜環(huán)糖肽片治療腦動(dòng)脈硬化癥的臨床療效。方法 選取2015年5月-2016年5月在天津市南開醫(yī)院接受治療的腦動(dòng)脈硬化癥患者90例，隨機(jī)分為對(duì)照組和治療組，每組各45例。對(duì)照組口服復(fù)方天麻蜜環(huán)糖肽片，2片/次，3次/d。治療組在對(duì)照組基礎(chǔ)上口服養(yǎng)血清腦顆粒，1袋/d，3次/d。兩組患者均治療6周。觀察兩組的臨床療效，比較兩組的血脂水平、血液流變學(xué)指標(biāo)、血液動(dòng)力學(xué)指標(biāo)和血清學(xué)指標(biāo)。結(jié)果 治療后，對(duì)照組和治療組的總有效率分別為80.00%、95.56%，兩組比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，兩組總膽固醇（TC）、三酰甘油（TG）、低密度脂蛋白膽固醇（LDL-C）水平均明顯下降，而高密度脂蛋白膽固醇（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）；且治療組這些觀察指標(biāo)的改善程度明顯優(yōu)于對(duì)照組，兩組比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，兩組血漿黏度（CP）、血細(xì)胞比容（HCT）、血小板聚集率（PAR）、纖維蛋白原（FIB）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）；且治療組這些觀察指標(biāo)下降程度明顯優(yōu)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，兩組大腦中動(dòng)脈（MCA）和椎動(dòng)脈（VA）的收縮期流速（Vs）均顯著升高，而阻力指數(shù)（RI）和血管搏動(dòng)指數(shù)（PI）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）；且治療組這些觀察指標(biāo)的改善程度明顯優(yōu)于對(duì)照組，兩組比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，兩組內(nèi)皮素-1（ET-1）、基質(zhì)金屬蛋白酶（MMP-9）和血管緊張素Ⅱ（Ang-Ⅱ）水平均明顯降低，同組治療前后比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）；且治療組這些觀察指標(biāo)的下降程度明顯優(yōu)于對(duì)照組，兩組比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。結(jié)論 養(yǎng)血清腦顆粒聯(lián)合復(fù)方天麻蜜環(huán)糖肽片治療腦動(dòng)脈硬化癥具有較好的臨床療效，可明顯改善血脂水平、血液流變學(xué)指標(biāo)、血液動(dòng)力學(xué)指標(biāo)和血清學(xué)指標(biāo)，具有一定的臨床推廣應(yīng)用價(jià)值。

Objective To investigate the clinical effect of Yangxue Qingnao Granules combined with Compound Armillaria Mellea Polysaccharide and Polypeptide Tablets in treatment of cerebral atherosclerosis. Methods Patients (90 cases) with cerebral atherosclerosis in Tianjin Nankai Hospital from May 2015 to May 2016 were randomly divided into control and treatment groups, and each group had 45 cases. Patients in the control group were po administered with Compound Armillaria Mellea Polysaccharide and Polypeptide Tablets, 2 tablets/time, three times daily. Patients in the treatment group were po administered with Yangxue Qingnao Granules on the basis of the control group, 1 bag/time, three times daily. Patients in two groups were treated for 6 weeks. After treatment, the clinical efficacies were evaluated, and blood lipid level, blood rheology index, hemodynamic index, and serological index in two groups were compared. Results After treatment, the clinical efficacies in the control and treatment groups were 80.00% and 95.56%, respectively, and there was difference between two groups (P<0.05). After treatment, the levels of TC, TG, and LDL-C in two groups were significantly decreased, but the levels of HDL-C in two groups were significantly increased, and the difference was statistically significant in the same group (P<0.05). And the observational indexes in the treatment group were significantly better than those in the control group, with significant difference between two groups (P<0.05). After treatment, CP, HCT, PAR, and FIB in two groups were significantly decreased, and the difference was statistically significant in the same group (P<0.05). And the observational indexes in the treatment group were significantly lower than those in the control group, with significant difference between two groups (P<0.05). After treatment, the Vs of MCA and VA in two groups were significantly increased, but RI and PI in two groups were significantly decreased, and the difference was statistically significant in the same group (P<0.05). And the observational indexes in the treatment group were significantly better than those in the control group, with significant difference between two groups (P<0.05). After treatment, ET-1, MMP-9, and Ang-Ⅱ in two groups were significantly decreased, and the difference was statistically significant in the same group (P<0.05). And the observational indexes in the treatment group were significantly lower than those in the control group, with significant difference between two groups (P<0.05). Conclusion Yangxue Qingnao Granules combined with Compound Armillaria Mellea Polysaccharide and Polypeptide Tablets has clinical curative effect in treatment of cerebral atherosclerosis, can significantly improve blood lipid level, blood rheology index, hemodynamic index, and serological index, which has a certain clinical application value.