目的 探讨培元通脑胶囊联合马来酸桂哌齐特治疗老年急性脑梗死的临床疗效。方法 选取天津市静海区医院2017年8月-2019年8月收治的老年急性脑梗死患者76例，随机分为对照组（38例）和治疗组（38例）。对照组静脉滴注马来酸桂哌齐特注射液，320 mg加入5%葡萄糖或生理盐水250 mL，1次/d。治疗组在对照组的基础上口服药物培元通脑胶囊，3粒/次，3次/d。两组患者治疗14 d。观察两组患者临床疗效，同时比较治疗前后两组患者白细胞介素-1（IL-1）、白细胞介素-6（IL-6）、肿瘤坏死因子-α（TNF-α）水平及NIHSS评分和不良反应情况。结果 治疗后，对照组和治疗组临床有效率分别为65.79%和97.37%，两组比较差异具有统计学意义（P<0.05）。治疗后，两组患者IL-1、IL-6、TNF-α水平均明显降低（P<0.05），且治疗组明显低于对照组（P<0.05）。治疗7、14 d，治疗组患者NIHSS评分均低于对照组患者（P<0.05）。治疗中，对照组不良反应发生率为47.37%，显著高于治疗组的13.16%，两组比较差异具有统计学意义（P<0.05）。结论 培元通脑胶囊联合马来酸桂哌齐特注射液治疗老年急性脑梗死效果显著，能有效降低机体血清炎性因子水平，显著改善脑组织细胞缺血、缺氧症状。

Objective To explore the curative effect of Peiyuan Tongnao Capsules combined with cinepazide maleate in treatment of senile acute cerebral infarction. Methods Patients (76 cases) with acute cerebral infarction in Jinghai Hospital of Tianjin from August 2017 to August 2019 were randomly divided into control (38 cases) and treatment (38 cases) groups. Patients in the control group were iv administered with Cinepazide Maleate Injection, 320 mg added into 5% glucose injection or normal saline 250 mL, once daily. Patients in the treatment group were po administered with Peiyuan Tongnao 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 levels of IL-1, IL-6 and TNF-α, NIHSS scores and the adverse reactions in two groups before and after treatment were compared. Results After treatment, the clinical efficacy and in the control and treatment groups was 65.79% and 97.37% respectively, and there were differences between two groups (P<0.05). After treatment, the serum levels of IL-1, IL-6 and TNF-α in two groups were significantly decreased (P<0.05), and which in the treatment group were significantly lower than those in the control group (P<0.05). After treatment for 7 and 14 d, the NIHSS scores in the treatment group were significantly lower than those in the control group (P<0.05). During the treatment, the adverse reactions rate in the control group was 47.37%, which was significantly higher than 13.16% in treatment the group, with significant difference between two groups (P<0.05). Conclusion The effect of Peiyuan Tongnao Capsules combined with cinepazide maleate in treatment of senile acute cerebral infarction is significant, can effectively reduce the level of serum inflammatory factors, and significantly improve the symptoms of cerebral ischemia and hypoxia.

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