目的 探讨芪蛭通络胶囊联合脑苷肌肽注射液治疗脑梗死恢复期的临床疗效。方法 选取2018年3月—2019年10月新乡医学院第一附属医院收治的72例脑梗死恢复期患者，按照奇偶顺序法将患者分为对照组和治疗组，每组各36例。对照组静脉滴注脑苷肌肽注射液，将20 mL脑苷肌肽注射液溶入5%葡萄糖注射液稀释，1次/d，共治疗14 d。治疗组在对照组的基础上温水冲服芪蛭通络胶囊，2粒/次，2次/d，连续用药2个月。2个月后观察两组的临床疗效，比较两组的炎性因子指标、血液流变学指标、神经功能指标。结果 治疗后，治疗组的总有效率（94.44%）较对照组（69.44%）高（P<0.05）。治疗后，两组美国国立卫生院神经功能缺损评分（NIHSS）评分降低（P<0.05），且治疗组NIHSS评分低于对照组（P<0.05）。治疗后，两组血清脑源性神经营养因子（BDNF）水平升高，基质金属蛋白酶-9（MMP-9）水平均降低（P<0.05），且治疗组血清BDNF水平高于对照组，MMP-9水平低于对照组（P<0.05）。治疗后，两组纤维蛋白原、红细胞比容、低切黏度、高切黏度均降低（P<0.05），且治疗组血液流变学指标低于对照组（P<0.05）。治疗后，两组血清超敏C反应蛋白（hs-CRP）、白细胞介素-18（IL-18）水平均降低，胰岛素样生长因子-1（IGF-1）水平升高（P<0.05），且治疗组IGF-1水平高于对照组，hs-CRP、IL-18水平低于对照组（P<0.05）。结论 脑梗死恢复期患者在脑苷肌肽注射液治疗的基础上口服芪蛭通络胶囊可有效改善机体炎性反应、血液流变学指标水平，减轻神经功能损害，安全有效。

Objective To investigate the clinical effect of Qizhi Tongluo Capsules combined with Cattle Encephalon Glycoside and Ignotin Injection in treatment of cerebral infarction in convalescent stage. Methods Patients (72 cases) with cerebral infarction in convalescent stage in the First Affiliated Hospital of Xinxiang Medical University from March 2018 to October 2019 were randomly divided into control and treatment groups, and each group had 36 cases. Patients in the control group were iv administered with Cattle Encephalon Glycoside and Ignotin Injection, 20 mL added into 5% glucose solution, once daily, treated for 14 d. Patients in the treatment group were po administered with Qizhi Tongluo Capsules on the basis of the control group, 2 grains/time, twice daily, treated for 2 months. After treatment for 2 months, the clinical efficacies were evaluated, and inflammatory factor indexes, hemorheology indexes, and nerve function indexes in two groups were compared. Results After treatment, the total effective rate of the treatment group (94.44%) was higher than that of the control group (69.44%) (P<0.05). After treatment, the NIHSS score of two groups were decreased (P<0.05), and the NIHSS score of the treatment group was lower than that of the control group (P<0.05). After treatment, the serum level of BDNF in two groups were increased, but the serum level of MMP-9 in two groups were decreased (P<0.05). And the serum level of BDNF in the treatment group was higher than that in the control group, but the serum level of MMP-9 in the treatment group was lower than that in the control group (P<0.05). After treatment, the fibrinogen, hematocrit, low shear viscosity, and high shear viscosity of two groups were decreased (P<0.05), and the hemorheological indexes of the treatment group were lower than those of the control group (P<0.05). After treatment, the serum levels of hs-CRP and IL-18 in two groups were decreased, but the serum levels of IGF-1 in two groups were increased (P<0.05). And the level of IGF-1 in the treatment group was higher than that in the control group, but the levels of hs-CRP and IL-18 in the treatment group were lower than those in the control group (P<0.05). Conclusion It is safe and effective to take Qizhi Tongluo Capsules orally on the basis of Cattle Encephalon Glycoside and Ignotin Injection in treatment of cerebral infarction in convalescent stage, which can effectively improve the body's inflammatory reaction and hemorheology index level, reduce the damage of nerve function.

R971

河南省医学科技攻关计划联合共建项目（LHGJ20190439）