目的 探讨养血清脑颗粒联合复方天麻蜜环糖肽片治疗脑动脉硬化症的临床疗效。方法 选取2015年5月-2016年5月在天津市南开医院接受治疗的脑动脉硬化症患者90例，随机分为对照组和治疗组，每组各45例。对照组口服复方天麻蜜环糖肽片，2片/次，3次/d。治疗组在对照组基础上口服养血清脑颗粒，1袋/d，3次/d。两组患者均治疗6周。观察两组的临床疗效，比较两组的血脂水平、血液流变学指标、血液动力学指标和血清学指标。结果 治疗后，对照组和治疗组的总有效率分别为80.00%、95.56%，两组比较差异有统计学意义（P<0.05）。治疗后，两组总胆固醇（TC）、三酰甘油（TG）、低密度脂蛋白胆固醇（LDL-C）水平均明显下降，而高密度脂蛋白胆固醇（HDL-C）水平明显升高，同组治疗前后比较差异有统计学意义（P<0.05）；且治疗组这些观察指标的改善程度明显优于对照组，两组比较差异具有统计学意义（P<0.05）。治疗后，两组血浆黏度（CP）、血细胞比容（HCT）、血小板聚集率（PAR）、纤维蛋白原（FIB）均显著降低，同组治疗前后比较差异有统计学意义（P<0.05）；且治疗组这些观察指标下降程度明显优于对照组，两组比较差异有统计学意义（P<0.05）。治疗后，两组大脑中动脉（MCA）和椎动脉（VA）的收缩期流速（Vs）均显著升高，而阻力指数（RI）和血管搏动指数（PI）均明显降低，同组治疗前后比较差异有统计学意义（P<0.05）；且治疗组这些观察指标的改善程度明显优于对照组，两组比较差异具有统计学意义（P<0.05）。治疗后，两组内皮素-1（ET-1）、基质金属蛋白酶（MMP-9）和血管紧张素Ⅱ（Ang-Ⅱ）水平均明显降低，同组治疗前后比较差异有统计学意义（P<0.05）；且治疗组这些观察指标的下降程度明显优于对照组，两组比较差异具有统计学意义（P<0.05）。结论 养血清脑颗粒联合复方天麻蜜环糖肽片治疗脑动脉硬化症具有较好的临床疗效，可明显改善血脂水平、血液流变学指标、血液动力学指标和血清学指标，具有一定的临床推广应用价值。

Objective To investigate the clinical effect of Yangxue Qingnao Granules combined with Compound Armillaria Mellea Polysaccharide and Polypeptide Tablets in treatment of cerebral atherosclerosis. Methods Patients (90 cases) with cerebral atherosclerosis in Tianjin Nankai Hospital from May 2015 to May 2016 were randomly divided into control and treatment groups, and each group had 45 cases. Patients in the control group were po administered with Compound Armillaria Mellea Polysaccharide and Polypeptide Tablets, 2 tablets/time, three times daily. Patients in the treatment group were po administered with Yangxue Qingnao Granules on the basis of the control group, 1 bag/time, three times daily. Patients in two groups were treated for 6 weeks. After treatment, the clinical efficacies were evaluated, and blood lipid level, blood rheology index, hemodynamic index, and serological index in two groups were compared. Results After treatment, the clinical efficacies in the control and treatment groups were 80.00% and 95.56%, respectively, and there was difference between two groups (P<0.05). After treatment, the levels of TC, TG, and LDL-C in two groups were significantly decreased, but the levels of HDL-C in two groups were significantly increased, and the difference was statistically significant in the same group (P<0.05). And the observational indexes in the treatment group were significantly better than those in the control group, with significant difference between two groups (P<0.05). After treatment, CP, HCT, PAR, and FIB in two groups were significantly decreased, and the difference was statistically significant in the same group (P<0.05). And the observational indexes in the treatment group were significantly lower than those in the control group, with significant difference between two groups (P<0.05). After treatment, the Vs of MCA and VA in two groups were significantly increased, but RI and PI in two groups were significantly decreased, and the difference was statistically significant in the same group (P<0.05). And the observational indexes in the treatment group were significantly better than those in the control group, with significant difference between two groups (P<0.05). After treatment, ET-1, MMP-9, and Ang-Ⅱ in two groups were significantly decreased, and the difference was statistically significant in the same group (P<0.05). And the observational indexes in the treatment group were significantly lower than those in the control group, with significant difference between two groups (P<0.05). Conclusion Yangxue Qingnao Granules combined with Compound Armillaria Mellea Polysaccharide and Polypeptide Tablets has clinical curative effect in treatment of cerebral atherosclerosis, can significantly improve blood lipid level, blood rheology index, hemodynamic index, and serological index, which has a certain clinical application value.