目的 探讨通心络胶囊联合复方脑肽节苷脂注射液治疗急性脑梗死恢复期的临床疗效。方法 选取2020年6月—2021年6月在廊坊市中医医院接受治疗的105例急性脑梗死恢复期患者，根据用药差别将所有患者分为对照组52例，治疗组53例。对照组患者静脉滴注复方脑肽节苷脂注射液，20 mL同0.9%氯化钠注射液300 mL配伍，1次/d；治疗组在对照组基础上口服通心络胶囊，4粒/次，3次/d。两组均连续治疗2周。观察两组的临床疗效，比较两组相关量表评分、细胞因子水平、血栓弹力图指标和颈动脉超声指标的变化情况。结果 治疗后，治疗组患者总有效率为98.11%，显著高于对照组的80.77%（P<0.05）。治疗后，两组患者日常生活活动能力量表（ADL）评分、健康促进生活方式量表Ⅱ（HPLPⅡ）评分、肢体运动功能量表（FMA）评分均较治疗前显著升高，而美国国立卫生院卒中量表（NIHSS）评分显著降低（P<0.05）；并以治疗组患者改善的更明显（P<0.05）。治疗后，两组患者血清脑源性神经营养因子（BDNF）、转化生长因子-β1（TGF-β1）、基质细胞衍生因子-1（SDF-1）均较治疗前显著升高，而氧化应激骨桥蛋白（OPN）、高迁移率族蛋白B1（HMGB1）水平均显著降低（P<0.05）；并以治疗组改善的更明显（P<0.05）。治疗后，两组患者血栓弹力图反应时间（R值）、凝固时间（K值）均较治疗前显著降低，而凝固角（Angle角）、血栓最大幅度（MA值）均显著增加（P<0.05），并以治疗组患者改善更为明显（P<0.05）。治疗后，两组颈动脉管腔狭窄程度、CCA僵硬指数均较治疗前显著降低，而扩张指数、顺应指数均显著升高（P<0.05），并以治疗组改善更明显（P<0.05）。结论 通心络胶囊联合复方脑肽节苷脂注射液治疗急性脑梗死恢复期具有较好的临床疗效，可有效促进患者神经功能恢复，保护脑神经功能，提高患者运动功能，改善机体细胞因子表达，有着良好的临床应用价值。

Objective To explore the clinical efficacy of Tongxinluo Capsules combined with compound porcine cerebroside and ganglioside in treatment of convalescence of acute cerebral infarction. Methods A total of 105 patients with acute cerebral infarction convalescence who received treatment in Langfang Hospital of Traditional Chinese Medicine from June 2020 to June 2021 were selected, and all patients were divided into control group (n=52) and treatment group (n=53) according to medication difference. Patients in the treatment group were iv administered with Compound Porcine Cerebroside and Ganglioside Injection, 20 mL was compatible with 0.9% sodium chloride injection 300 mL, once daily. Patients in the treatment group were po administered with Tongxinluo Capsules on the basis of the control group, 4 tablet/time, three times daily. Patients in two groups were treated for 2 weeks. After treatment, the clinical efficacy was evaluated, and the scores of related scales, cytokine levels, thrombolysis indexes and carotid ultrasound indexes were compared between the two groups. Results After treatment, the total effective rate in the treatment group was 98.11%, significantly higher than that in the control group (80.77%, P < 0.05). After treatment, the scores of activities of Daily Living Scale (ADL), Health Promotion Lifestyle Scale Ⅱ (HPLP Ⅱ) and Limb Movement Function Scale (FMA) in two groups were significantly increased compared with before treatment, while the scores of National Institutes of Health Stroke Scale (NIHSS) were significantly decreased (P < 0.05). The improvement was more obvious in the treatment group (P < 0.05). After treatment, serum levels of brain-derived neurotrophic factor (BDNF), transforming growth factor -β1 (TGF-β1), and stromal cell derived factor-1 (SDF-1) in two groups were significantly increased compared with those before treatment. The levels of oxidative stress osteopontin (OPN), high mobility group protein B1 (HMGB1) were significantly decreased (P < 0.05). The improvement was more obvious in the treatment group (P < 0.05). After treatment, reaction time (R value) and coagulation time (K value) in two groups were significantly decreased compared with before treatment, while coagulation Angle (Angle) and maximum thrombus (MA value) were significantly increased (P < 0.05), and the improvement was more obvious in the treatment group (P < 0.05). After treatment, the degree of carotid artery stenosis and CCA stiffness index were significantly decreased in both groups, while the dilation index and compliance index were significantly increased (P < 0.05), and the improvement was more obvious in the treatment group (P < 0.05). Conclusion Tongxinluo Capsules combined with compound porcine cerebroside and ganglioside has good clinical effect in treatment of convalescence of acute cerebral infarction, and can effectively promote the recovery of patients' nerve function, protect the brain nerve function, improve patients' motor function and the expression of cytokines, which has a good clinical application value.

R971

廊坊市科技计划项目（2015013061）