目的 探討復(fù)方地龍膠囊聯(lián)合注射用纖溶酶治療血栓性腦梗死的臨床療效。方法 選擇2019年9月—2020年9月在天津市北辰區(qū)中醫(yī)醫(yī)院治療的94例急性腦梗死患者，根據(jù)用藥的差別分為對照組（47例）和治療組（47例）。對照組靜脈滴注注射用纖溶酶，首次100單位加入生理鹽水250 mL，1次/d，然后每次200單位加入生理鹽水500 mL，1次/d；治療組在對照組的基礎(chǔ)上口服復(fù)方地龍膠囊，0.56 g/次，2次/d。兩組患者均治療10 d。觀察兩組患者臨床療效，比較治療前后兩組患者NIHSS、FIM、MoCA和MMSE評分及血清學(xué)指標(biāo)同型半胱氨酸（Hcy）、可溶性血管細(xì)胞黏附因子1（sVCAM-1）、半乳糖凝集素3（GAL3）、血清趨化因子12（CXCL12）、神經(jīng)特異性烯醇化酶（NSE）和神經(jīng)膠質(zhì)纖維酸性蛋白（GFAP）水平。結(jié)果 治療后，對照組總有效率為80.85%，顯著低于治療組的97.87%（P<0.05）。治療后，兩組患者NIHSS評分顯著下降，而FIM評分、MoCA評分和MMSE評分均顯著升高（P<0.05），且治療組改善最明顯（P<0.05）。治療后，兩組血清Hcy、sVCAM-1、GAL3、CXCL12、NSE、GFAP水平均明顯下降（P<0.05），且治療組患者下降最顯著（P<0.05）。結(jié)論 復(fù)方地龍膠囊聯(lián)合注射用纖溶酶治療血栓性腦梗死效果良好，可有效促進(jìn)患者神經(jīng)功能恢復(fù)，提高患者認(rèn)知能力。

Objective To investigate the clinical efficacy of Compound Dilong Capsules combined with Fibrinogenase for injection in treatment of acute cerebral infarction. Methods Patients (94 cases) with thrombotic cerebral infarction in Tianjin Beichen Traditional Chinese Medicine Hospital from September 2019 to September 2020 were divided into control (47 cases) and treatment (47 cases) groups based on different treatments. Patients in the control group were iv administered with Fibrinogenase for injection, added 100 units to 250 mL normal saline for the first time, then added 200 units to 500 mL normal saline for the second time, once daily. Patients in the treatment group were po administered with Compound Dilong Capsules on the basis of the control group, 0.56 g/time, twice daily. Patients in two groups were treated for 10 d. After treatment, the clinical efficacy was evaluated, and the scores of NIHSS, FIM, MoCA, and MMSE, and the levels of serum Hcy, sVCAM-1, GAL3, CXCL12, NSE, and GFAP in two groups before and after treatment were compared. Results After treatment, the effective rate of the control group was 80.85%, which was significantly lower than 97.87% of the treatment group (P<0.05). After treatment, the NIHSS score were significantly decreased, while the FIM score, MoCA score and MMSE score were significantly increased in the two groups (P<0.05), and the improvement was the most obvious in the treatment group (P<0.05). After treatment, the serum levels of Hcy, sVCAM-1, GAL3, CXCL12, NSE, and GFAP were significantly decreased in two groups (P<0.05), especially in the treatment group (P<0.05). Conclusion Compound Dilong Capsules combined with Fibrinogenase for injection has a good effect in treatment of acute cerebral infarction, can effectively promote the recovery of neurological function, improve the cognitive ability of patients.

R971