目的 探讨丹膝颗粒联合曲克芦丁治疗急性脑梗死恢复期的临床疗效。方法 选取2018年6月—2023年6月国家电网公司北京电力医院脑神经内科收治的120例急性脑梗死恢复期患者，按照随机数字表法将所有患者分为对照组和治疗组，每组各60例。对照组患者静脉滴注曲克芦丁氯化钠注射液，0.48 g/次，1次/d。治疗组在对照组的治疗基础上口服丹膝颗粒，1袋/次，3次/d。两组用药20 d观察治疗情况。观察两组临床疗效，比较两组症状好转时间、神经行为认知状态检查表（NCSE）评分、日常生活活动能力量表（ADL）评分、脂蛋白相关磷脂酶A2（Lp-PLA2）、神经元特异性烯醇化酶（NSE）、脑源性神经营养因子（BDNF）、同型半胱氨酸（Hcy）水平及不良反应情况。结果 治疗后，治疗组总有效率是96.67%，显著高于对照组的83.33%（P＜0.05）。治疗后，治疗组头晕、眩晕、肢体麻木、中枢性面瘫好转时间均显著短于对照组（P＜0.05）。治疗后，两组NCSE评分、ADL评分均显著高于同组治疗前（P＜0.05）；且治疗后，治疗组NCSE评分、ADL评分高于对照组（P＜0.05）。治疗后，两组Lp-PLA2、NSE、Hcy水平均显著降低，而BDNF水平显著升高（P＜0.05）；治疗后治疗组Lp-PLA2、NSE、Hcy水平低于对照组，而BDNF水平高于对照组（P＜0.05）。治疗后，治疗组不良反应发生率是5.01%，显著低于对照组的13.33%（P＜0.05）。结论 丹膝颗粒联合曲克芦丁治疗脑梗死恢复期具有较好的临床疗效，显著提高患者神经行为认知能力和日常活动能力，降低机体炎症反应，值得临床借鉴应用。

Objective To investigate the therapeutic effect of Danxi Granules combined with troxerutin in treatment of convalescent period of acute cerebral infarction. Methods A total of 120 patients in the convalescence stage of acute cerebral infarction admitted to the Department of Neurology of State Grid Corporation Beijing Electric Power Hospital from June 2018 to June 2023 were selected, and all patients were divided into control group and treatment group according to random number table method, with 60 cases in each group. Patients in the control group were iv administered with Troxerutin and Sodium Chloride Injection, 0.48 g/time, once daily. Patients in the treatment group were po administered with Danxi Granules on the basis of the control group, 1 bag/time, three times daily. The two groups were treated for 20 d to observe the treatment. The clinical efficacy of the two groups was observed. Symptom improvement time, neurobehavioral cognitive status checklist (NCSE) score, Activities of daily Living Scale (ADL) score, lipoprotein-associated phospholipase A2 (Lp-PLA2), neuron-specific enolase (NSE), brain-derived neurotrophic factor (BDNF), homocysteine (Hcy) level and adverse reactions were compared between two groups. Results After treatment, the total effective rate of the treatment group was 96.67%, which was significantly higher than that of the control group (83.33%, P < 0.05). After treatment, the improvement time of dizziness, vertigo, limb numbness and central facial paralysis in treatment group was significantly shorter than that in control group (P < 0.05). After treatment, NCSE score and ADL score in two groups were significantly higher than before treatment (P < 0.05). After treatment, NCSE scores and ADL scores in treatment group were higher than those in control group (P < 0.05). After treatment, the levels of Lp-PLA2, NSE and Hcy in both groups were significantly decreased, but the levels of BDNF were significantly increased (P < 0.05). After treatment, the levels of Lp-PLA2, NSE and Hcy in treatment group were lower than those in control group, but the levels of BDNF were higher than those in control group (P < 0.05). After treatment, the incidence of adverse reactions in treatment group was 5.01%, which was significantly lower than that in control group (13.33%, P < 0.05). Conclusion Danxi Granules combined with troxerutin has good clinical effect in treatment of convalescent period of acute cerebral infarction, and can significantly improve the neurobehavioral cognitive ability and daily activity ability of patients, and reduce the inflammatory response of the body, which is worthy of clinical application.

R971

北京市科技计划项目（Z171100001017103）