目的 探讨复方地龙胶囊联合注射用纤溶酶治疗血栓性脑梗死的临床疗效。方法 选择2019年9月—2020年9月在天津市北辰区中医医院治疗的94例急性脑梗死患者，根据用药的差别分为对照组（47例）和治疗组（47例）。对照组静脉滴注注射用纤溶酶，首次100单位加入生理盐水250 mL，1次/d，然后每次200单位加入生理盐水500 mL，1次/d；治疗组在对照组的基础上口服复方地龙胶囊，0.56 g/次，2次/d。两组患者均治疗10 d。观察两组患者临床疗效，比较治疗前后两组患者NIHSS、FIM、MoCA和MMSE评分及血清学指标同型半胱氨酸（Hcy）、可溶性血管细胞黏附因子1（sVCAM-1）、半乳糖凝集素3（GAL3）、血清趋化因子12（CXCL12）、神经特异性烯醇化酶（NSE）和神经胶质纤维酸性蛋白（GFAP）水平。结果 治疗后，对照组总有效率为80.85%，显著低于治疗组的97.87%（P<0.05）。治疗后，两组患者NIHSS评分显著下降，而FIM评分、MoCA评分和MMSE评分均显著升高（P<0.05），且治疗组改善最明显（P<0.05）。治疗后，两组血清Hcy、sVCAM-1、GAL3、CXCL12、NSE、GFAP水平均明显下降（P<0.05），且治疗组患者下降最显著（P<0.05）。结论 复方地龙胶囊联合注射用纤溶酶治疗血栓性脑梗死效果良好，可有效促进患者神经功能恢复，提高患者认知能力。

Objective To investigate the clinical efficacy of Compound Dilong Capsules combined with Fibrinogenase for injection in treatment of acute cerebral infarction. Methods Patients (94 cases) with thrombotic cerebral infarction in Tianjin Beichen Traditional Chinese Medicine Hospital from September 2019 to September 2020 were divided into control (47 cases) and treatment (47 cases) groups based on different treatments. Patients in the control group were iv administered with Fibrinogenase for injection, added 100 units to 250 mL normal saline for the first time, then added 200 units to 500 mL normal saline for the second time, once daily. Patients in the treatment group were po administered with Compound Dilong Capsules on the basis of the control group, 0.56 g/time, twice daily. Patients in two groups were treated for 10 d. After treatment, the clinical efficacy was evaluated, and the scores of NIHSS, FIM, MoCA, and MMSE, and the levels of serum Hcy, sVCAM-1, GAL3, CXCL12, NSE, and GFAP in two groups before and after treatment were compared. Results After treatment, the effective rate of the control group was 80.85%, which was significantly lower than 97.87% of the treatment group (P<0.05). After treatment, the NIHSS score were significantly decreased, while the FIM score, MoCA score and MMSE score were significantly increased in the two groups (P<0.05), and the improvement was the most obvious in the treatment group (P<0.05). After treatment, the serum levels of Hcy, sVCAM-1, GAL3, CXCL12, NSE, and GFAP were significantly decreased in two groups (P<0.05), especially in the treatment group (P<0.05). Conclusion Compound Dilong Capsules combined with Fibrinogenase for injection has a good effect in treatment of acute cerebral infarction, can effectively promote the recovery of neurological function, improve the cognitive ability of patients.

R971