目的 探討治療急性腦梗死采用血府逐瘀膠囊與重組人TNK組織型纖溶酶原激活劑聯(lián)合治療的臨床療效。方法 選取2022年7月—2024年12月天津市中醫(yī)藥研究院附屬醫(yī)院收治的急性腦梗死90例患者，隨機數(shù)字法分為對照組45例和治療組45例。對照組給予重組人TNK組織型纖溶酶原激活劑靜脈推注，0.25 mg/kg，在5～10 s內(nèi)完成。在對照組基礎(chǔ)上，治療組口服血府逐瘀膠囊，6粒/次，每日2次。兩組均治療2周。觀察兩組患者療效，對比兩組的纖維蛋白原（FIB）、D-二聚體（D-D）、活化部分凝血活酶時間（APTT）、C反應(yīng)蛋白（CRP）水平，日?；顒又笖?shù)量表（Barthel）評分、白細胞介素-8（IL-8）水平、Fugl-Meyer運動量表（FMA）評分、白細胞介素-6（IL-6）水平、美國國立衛(wèi)生研宄院卒中量表（NIHSS）評分、腫瘤壞死因子-α（TNF-α）水平。結(jié)果 治療后，治療組總有效率95.56%，明顯高于對照組（80.00%，P＜0.05）。治療后，兩組FIB、D-D、TNF-α、IL-6、IL-8、CRP水平比治療前降低，而APTT水平升高（P＜0.05），且與對照組相比，治療后治療組凝血功能和炎性因子水平好于對照組（P＜0.05）。治療后，兩組Barthel和FMA評分比治療前升高，而NIHSS評分降低（P＜0.05），且與對照組對比，治療后治療組患者評分優(yōu)于對照組（P＜0.05）。結(jié)論 重組人TNK組織型纖溶酶原激活劑與血府逐瘀膠囊協(xié)同治療效果佳，對腦卒中癥狀具有明顯改善作用，腦神經(jīng)及肢體運動恢復(fù)顯著，患者生活質(zhì)量明顯提升。

Objective The effect of Xuefu Zhuyu Capsules combined with recombinant human TNK tissue-type plasminogen activator in treatment of acute cerebral infarction. Methods Patients (90 cases) with acute cerebral infarction in Tianjin Academy of Traditional Chinese Medicine Affiliated Hospital from July 2022 to December 2024 were randomly divided into control (45 cases) and treatment (45 cases). Patient in were iv administered with Recombinant Human TNK Tissue-type Plasminogen Activator for injection for 5～10s, 0.25 mg/kg, the max dose was 25 mg. Patient in the treatment were po administered with Xuefu Zhuyu Capsules on the basis of the control, 6 grains/time, twice daily. Patient in two were treated for 2 weeks. After treatment, and the coagulation function FIB, D-D and APTT levels, the scores of Barthel, FMA and NIHSS, the levels of TNF-α, IL-6, IL-8 and CRP in two before. Results After treatment, the total effective rate of the treatment group was 95.56%, significantly higher than that of the control group (80.00%, P < 0.05). After treatment, the levels of FIB, D-D, TNF-α, IL-6, IL-8 and CRP in both groups decreased compared with those before treatment, while the level of APTT increased (P < 0.05). Moreover, compared with the control group, the coagulation function and inflammatory factor levels in the treatment group were better than those in the control group after treatment (P < 0.05). After treatment, the Barthel and FMA scores of both groups increased compared with those before treatment, while the NIHSS score decreased (P < 0.05). Moreover, compared with the control group, the score of the treatment group was better than that of the control group after treatment (P < 0.05). Conclusion The synergistic treatment effect of recombinant human TNK tissue-type plasminogen activator and Xuefu Zhuyu Capsules is excellent, which can significantly improve stroke symptoms, significantly recover cerebral nerves and limb movements, and significantly improve the patient′s quality of life.

R971

天津市自然科學(xué)基金（19JCYBJC26100）