目的 探討芪蛭通絡(luò)膠囊聯(lián)合腦苷肌肽注射液治療腦梗死恢復(fù)期的臨床療效。方法 選取2018年3月—2019年10月新鄉(xiāng)醫(yī)學(xué)院第一附屬醫(yī)院收治的72例腦梗死恢復(fù)期患者，按照奇偶順序法將患者分為對(duì)照組和治療組，每組各36例。對(duì)照組靜脈滴注腦苷肌肽注射液，將20 mL腦苷肌肽注射液溶入5%葡萄糖注射液稀釋，1次/d，共治療14 d。治療組在對(duì)照組的基礎(chǔ)上溫水沖服芪蛭通絡(luò)膠囊，2粒/次，2次/d，連續(xù)用藥2個(gè)月。2個(gè)月后觀察兩組的臨床療效，比較兩組的炎性因子指標(biāo)、血液流變學(xué)指標(biāo)、神經(jīng)功能指標(biāo)。結(jié)果 治療后，治療組的總有效率（94.44%）較對(duì)照組（69.44%）高（P<0.05）。治療后，兩組美國(guó)國(guó)立衛(wèi)生院神經(jīng)功能缺損評(píng)分（NIHSS）評(píng)分降低（P<0.05），且治療組NIHSS評(píng)分低于對(duì)照組（P<0.05）。治療后，兩組血清腦源性神經(jīng)營(yíng)養(yǎng)因子（BDNF）水平升高，基質(zhì)金屬蛋白酶-9（MMP-9）水平均降低（P<0.05），且治療組血清BDNF水平高于對(duì)照組，MMP-9水平低于對(duì)照組（P<0.05）。治療后，兩組纖維蛋白原、紅細(xì)胞比容、低切黏度、高切黏度均降低（P<0.05），且治療組血液流變學(xué)指標(biāo)低于對(duì)照組（P<0.05）。治療后，兩組血清超敏C反應(yīng)蛋白（hs-CRP）、白細(xì)胞介素-18（IL-18）水平均降低，胰島素樣生長(zhǎng)因子-1（IGF-1）水平升高（P<0.05），且治療組IGF-1水平高于對(duì)照組，hs-CRP、IL-18水平低于對(duì)照組（P<0.05）。結(jié)論 腦梗死恢復(fù)期患者在腦苷肌肽注射液治療的基礎(chǔ)上口服芪蛭通絡(luò)膠囊可有效改善機(jī)體炎性反應(yīng)、血液流變學(xué)指標(biāo)水平，減輕神經(jīng)功能損害，安全有效。

Objective To investigate the clinical effect of Qizhi Tongluo Capsules combined with Cattle Encephalon Glycoside and Ignotin Injection in treatment of cerebral infarction in convalescent stage. Methods Patients (72 cases) with cerebral infarction in convalescent stage in the First Affiliated Hospital of Xinxiang Medical University from March 2018 to October 2019 were randomly divided into control and treatment groups, and each group had 36 cases. Patients in the control group were iv administered with Cattle Encephalon Glycoside and Ignotin Injection, 20 mL added into 5% glucose solution, once daily, treated for 14 d. Patients in the treatment group were po administered with Qizhi Tongluo Capsules on the basis of the control group, 2 grains/time, twice daily, treated for 2 months. After treatment for 2 months, the clinical efficacies were evaluated, and inflammatory factor indexes, hemorheology indexes, and nerve function indexes in two groups were compared. Results After treatment, the total effective rate of the treatment group (94.44%) was higher than that of the control group (69.44%) (P<0.05). After treatment, the NIHSS score of two groups were decreased (P<0.05), and the NIHSS score of the treatment group was lower than that of the control group (P<0.05). After treatment, the serum level of BDNF in two groups were increased, but the serum level of MMP-9 in two groups were decreased (P<0.05). And the serum level of BDNF in the treatment group was higher than that in the control group, but the serum level of MMP-9 in the treatment group was lower than that in the control group (P<0.05). After treatment, the fibrinogen, hematocrit, low shear viscosity, and high shear viscosity of two groups were decreased (P<0.05), and the hemorheological indexes of the treatment group were lower than those of the control group (P<0.05). After treatment, the serum levels of hs-CRP and IL-18 in two groups were decreased, but the serum levels of IGF-1 in two groups were increased (P<0.05). And the level of IGF-1 in the treatment group was higher than that in the control group, but the levels of hs-CRP and IL-18 in the treatment group were lower than those in the control group (P<0.05). Conclusion It is safe and effective to take Qizhi Tongluo Capsules orally on the basis of Cattle Encephalon Glycoside and Ignotin Injection in treatment of cerebral infarction in convalescent stage, which can effectively improve the body's inflammatory reaction and hemorheology index level, reduce the damage of nerve function.

R971

河南省醫(yī)學(xué)科技攻關(guān)計(jì)劃聯(lián)合共建項(xiàng)目（LHGJ20190439）