目的 探索脑栓通胶囊联合脑苷肌肽治疗急性脑梗死的疗效观察。方法 选取2017年5月-2019年6月洛阳市第一中医院收治的急性脑梗死患者144例，随机分成对照组和治疗组，每组各72例。对照组患者静脉滴注脑苷肌肽注射液，20 mL加入生理盐水250 mL，1次/d。治疗组患者在对照组的基础上口服脑栓通胶囊，3粒/次，3次/d。两组患者均治疗14 d。观察两组患者临床疗效，同时比较治疗前后两组患者脑血流动力学、脂蛋白相关磷脂酶A2（Lp-PLA2）和血栓弹力图指标。结果 治疗后，对照组和治疗组临床有效率分别为70.83%和87.50%，两组比较差异具有统计学意义（P<0.05）。治疗后，两组患者平均血流量（Q_m）和平均血流速度（V_m）、水平均明显上升（P<0.05），而外周阻力（Rv）和动态阻力（DR）水平显著降低（P<0.05），且治疗组明显优于对照组（P<0.05）。治疗后，两组患者Lp-PLA2和血栓弹力图指标中血细胞凝集块形成速率（α）和最大血块强度（MA）明显降低（P<0.05），两组患者血栓弹力图指标中凝血反应时间（R）和血细胞凝集块形成时间（K）明显提高（P<0.05），且治疗组患者明显好于对照组（P<0.05）。结论 脑栓通胶囊联合脑苷肌肽注射液治疗急性脑梗死，可明显提高临床疗效，改善脑血流动力学指标，降低血清Lp-PLA2水平，优化血栓弹力图指标。

Objective To explore the clinical efficacy of Naoshuantong Capsules combined with cattle encephalon glycoside and ignotin in treatment of acute cerebral infarction. Methods Patients (72 cases) with acute cerebral infarction in Luoyang Hospital of TCM from May 2017 to June 2019 were randomly divided into control and treatment groups, and each group had 72 cases. Patients in the control group were iv administered with Cattle Encephalon Glycoside and Ignotin Injection, 20 mL added into normal saline 250 mL, once daily. Patients in the treatment group were po administered with Naoshuantong Capsules on the basis of the control group, 3 grains/time, three times daily. Patients in two groups were treated for 14 d. After treatment, the clinical efficacy was evaluated, and the cerebral hemodynamics, Lp-PLA2 and thromboelastography indexes in two groups before and after treatment were compared. Results After treatment, the clinical efficacy and in the control and treatment groups was 70.83% and 87.50% respectively, and there were differences between two groups (P<0.05). After treatment, the Q_m and V_m levels in two groups were significantly increased (P<0.05), but the Rv and DR levels were significantly decreased (P<0.05), and these indexes in the treatment group were significantly better than those in the control group (P<0.05). After treatment, the Lp-PLA2, α and MA of thromboelastography in two groups were significantly decreased (P<0.05), but the R and Kof thromboelastography were significantly increased (P<0.05), and these indicators in the treatment group were significantly better than those in the control group (P<0.05). Conclusion Naoshuantong Capsules combined with cattle encephalon glycoside and ignotin in treatment of acute cerebral infarction can obviously improve the clinical efficacy, improve cerebral hemodynamic indexes, reduce the levels of serum Lp-PLA2, and optimize the thromboelastogram indexes.

R971

洛阳市医疗卫生科技计划项目（1940006A）