目的 探讨丹灯通脑胶囊联合长春西汀治疗脑梗死恢复期的临床效果。方法 选取2018年1月—2019年6月北京怀柔医院收治的100例脑梗死恢复期患者，随机分为对照组和治疗组，每组各50例。对照组口服长春西汀片，5 mg/次，3次/d，餐时服用。治疗组在对照组基础上口服丹灯通脑胶囊，4粒/次，3次/d。两组均连续治疗8周。比较两组临床疗效，治疗前后微循环相关指标[血小板最大聚集率（MAR）、血浆黏度（PV）、红细胞变形指数（RDI）、纤维蛋白原（FIB）、D-二聚体（D-D）]、脑血流动力学参数[大脑中动脉平均血流速度（V_m）、阻力指数（RI）]、相关量表[美国国立卫生院卒中量表（NIHSS）、脑卒中自我效能问卷（SSEQ）]评分及血清超氧化物歧化酶（SOD）、丙二醛（MDA）、髓鞘碱性蛋白（MBP）水平变化。结果 治疗组总有效率90.0%显著高于对照组74.0%，两组总有效率比较差异有统计学意义（P<0.05）。两组治疗后MAR、PV、血浆FIB、D-D水平均显著低于治疗前（P<0.05），但RDI均显著升高（P<0.05）；治疗后，治疗组以上微循环相关指标的改善效果均更显著（P<0.05）。两组治疗后大脑中动脉V_m、SSEQ总分均显著增多（P<0.05），但大脑中动脉RI和NIHSS评分均显著降低（P<0.05）；但治疗后，治疗组大脑中动脉V_m、RI及NIHSS评分、SSEQ总分的改善效果均显著优于对照组（P<0.05）。治疗后，两组血清SOD水平较治疗前均显著增高（P<0.05），而血清MDA、MBP水平均显著下降（P<0.05）；但治疗组这些指标改善更显著（P<0.05）。结论 丹灯通脑胶囊联合长春西汀治疗脑梗死恢复期的整体疗效良好，能进一步改善机体微循环，纠正脑循环障碍，减轻体内氧化应激，恢复损伤神经功能，提高患者自我效能感，具有一定的临床推广应用价值.

Objective To investigate the clinical effect of Dandeng Tongnao Capsules combined with vinpocetine in treatment of convalescent period of cerebral infarction. Methods A total of 100 patients with convalescent period of cerebral infarction admitted to Beijing Huairou Hospital from January 2018 to June 2019 were randomly divided into control group (n=50) and treatment group (n=50). The control group was po administered with Vinpocetine Tablets, 5 mg/time, three times daily. The treatment group was po administered with Dandeng Tongnao Capsules on the basis of the control group, 4 grains/time, three times daily. All patients were treated for 8 weeks. The clinical efficacy was compared between the two groups. The changes of microcirculation related indicators [maximal platelet aggregation rate (MAR), plasma viscosity (PV), red blood cell deformation index (RDI), fibrinogen (FIB), D-dimer (D-D)], cerebral hemodynamic parameters [mean middle cerebral artery mean blood flow velocity (V_m), resistance index (RI)], related scale [National Institute of Health Stroke Scale (NIHSS), Stroke Self-Efficacy Questionnaire (SSEQ)] score and serum superoxide dismutase (SOD), malondialdehyde (MDA), myelin basic protein (MBP) before and after treatment in two groups were compared. Results The total effective rate of the treatment group 90.0% was significantly higher than that of the control group 74.0%, and there were differences between two groups (P<0.05). After treatment, MAR, PV, FIB and D-D levels in both groups were significantly lower than before treatment (P<0.05), but RDI levels were significantly higher in both groups (P<0.05). After treatment, the improvement of microcirculation-related indicators was more significant in the treatment group and above (P<0.05). The V_m of the middle cerebral artery and SSEQ scores in two groups increased significantly after treatment (P<0.05), but RI of the middle cerebral artery and NIHSS scores decreased significantly (P<0.05). However, after treatment, the improvement effect of V_m, RI, NIHSS score and SSEQ score in the treatment group was significantly better than that in the control group (P<0.05). After treatment, the serum SOD level in both groups increased significantly compared with that before treatment (P<0.05), while the serum MDA and MBP levels decreased significantly (P<0.05). However, these indicators improved more significantly in the treatment group (P<0.05). Conclusion Dandeng Tongnao Capsules combined with vinpocetine has good overall efficacy in treatment of convalescent period of cerebral infarction, and can further improve the microcirculation of the body, correct the circulation disorder of the brain, and also can reduce the oxidative stress in the body, restore the damaged nerve function, and improve the self-efficacy of patients, which has a certain clinical application value.

R971