目的 探討復(fù)方地龍膠囊聯(lián)合胞二磷膽堿鈉片治療急性腦梗死恢復(fù)期的臨床療效。方法 選擇2021年4月—2022年4月在天津市北辰醫(yī)院診治的82例急性腦梗死恢復(fù)期患者，根據(jù)用藥的差別分為對(duì)照組（41例）和治療組（41例）。對(duì)照組口服胞二磷膽堿鈉片，0.2 g/次，3次/d；在此基礎(chǔ)上，治療組口服復(fù)方地龍膠囊，0.56 g/次，3次/d。兩組患者均治療4周。觀察兩組患者臨床療效，比較治療前后兩組患者NIHSS評(píng)分、FMMS評(píng)分、HPLPⅡ評(píng)分、AROM評(píng)分、SS-QOL評(píng)分和BBS評(píng)分，血清基質(zhì)細(xì)胞衍生因子-1（SDF-1）、神經(jīng)營養(yǎng)因子-3（NT-3）、同型半胱氨酸（Hcy）、氧化應(yīng)激骨橋蛋白（OPN）和腦源性神經(jīng)營養(yǎng)因子（BDNF）水平，腦血流灌注指標(biāo)收縮期最大流速（PSV）、平均流速（TMV）和阻力指數(shù)（RI），血清纖維蛋白原、D-二聚體和血漿比黏度水平。結(jié)果 治療后，治療組臨床有效率為97.56%，顯著高于對(duì)照組（80.49%，P＜0.05）。治療后，兩組NIHSS評(píng)分明顯降低，而FMMS評(píng)分、HPLPⅡ評(píng)分、AROM評(píng)分、SS-QOL評(píng)分和BBS評(píng)分明顯升高（P＜0.05），且治療組評(píng)分改善最為明顯（P＜0.05）。治療后，兩組血清SDF-1、Hcy和OPN水平明顯降低，而BDNF、NT-3水平明顯升高（P＜0.05），并以治療組改善最為明顯（P＜0.05）。治療后，兩組腦血流灌注指標(biāo)PSV和TMV明顯升高，而RI明顯降低（P＜0.05），并以治療組改善最為明顯（P＜0.05）。治療后，兩組血清纖維蛋白原、D-二聚體及血漿比黏度水平均明顯降低（P＜0.05），并以治療組下降的最為明顯（P＜0.05）。結(jié)論 復(fù)方地龍膠囊聯(lián)合胞二磷膽堿鈉片治療急性腦梗死恢復(fù)期可有效促進(jìn)神經(jīng)功能恢復(fù)，提高患者運(yùn)動(dòng)、平衡功能及健康行為改善。

Objective To investigate the clinical effect of Compound Dilong Capsules combined with citicoline sodium in treatment of the recovery period of acute cerebral infarction. Methods Patients (85 cases) in recovery period of acute cerebral infarction in Tianjin Beichen Hospital from April 2021 to April 2022 were divided into control (41 cases) and treatment (41 cases) group based on different treatment. Patients in the control group was po administered with Citicoline Sodium Tablets, 0.2 g/time, three times daily. Patients in the treatment group were po administered with Compound Dilong Capsules on the basis of the control group, 0.56 g/time, three times daily. Patients in two groups were treated for 4 weeks. After treatment, the clinical evaluation was evaluated, and the scores of NIHSS, FMMS, HPLPⅡ, AROM, SS-QOL and BBS, the levels of serum SDF-1, NT-3, Hcy, OPN and BDNF, cerebral blood flow perfusion indexes of PSV, TMV and RI, the levels of serum fibrinogen, D-dimer and plasma specific viscosity in two groups before and after treatment were compared. Results After treatment, the clinical effective rate of the treatment group was 97.56%, which was significantly higher than that of the control group (80.49%, P < 0.05). After treatment, the NIHSS score in two groups was significantly decreased, while the FMMS score, HPLP II score, AROM score, SS-QOL score and BBS score were significantly increased (P < 0.05), and the scores of the treatment group were significantly better than those in the control group (P < 0.05). After treatment, the serum levels of SDF-1, Hcy and OPN were significantly decreased, while the level of BDNF and NT-3 were significantly increased in two groups (P < 0.05), especially in the treatment group (P < 0.05). After treatment, the cerebral blood flow perfusion indexes PSV and TMV were significantly increased, while RI was significantly decreased in two groups (P < 0.05), the improvement in the treatment group was more obvious (P < 0.05). After treatment, the levels of serum fibrinogen, D-dimer and plasma specific viscosity were significantly decreased in two groups (P < 0.05), the decrease in the treatment group was more obvious (P < 0.05). Conclusion Compound Dilong Capsules combined with citicoline sodium in treatment of the recovery period of acute cerebral infarction can promote the recovery of neurological function, improve the motor and balance function of patients and improve their healthy behavior.

R971

天津市科技計(jì)劃項(xiàng)目（SHGY-2020005）