目的 观察参芎葡萄糖注射液联合脑苷肌肽治疗新生儿缺氧缺血性脑病的临床疗效。方法 收集2015年1月—2017年4月鄂州市中心医院新生儿科收治的新生儿缺氧缺血性脑病患儿67例，随机分为对照组（30例）和治疗组（37例），对照组患儿静脉滴注脑苷肌肽注射液，2 mL加入到0.9%氯化钠注射液50 mL中，1次/d。治疗组患儿在对照组的基础上静脉滴注参芎葡萄糖注射液，50 mL/次，1次/d。两组患儿均治疗14 d。观察两组患者临床疗效，比较治疗前后两组患者临床体征恢复情况、血清一氧化氮（NO）、内皮素-1（ET-1）、脂联素（APN）和胰岛素样生长因子-1（IGF-1）、神经行为评分（NBNA）和预后情况。结果 治疗后，对照组和治疗组临床总有效率分别为73.33%、83.78%，两组比较差异具有统计学意义（P < 0.05）。治疗组中、重度患儿意识障碍恢复时间、肌张力恢复时间均短于对照组，轻、中、重度患儿原始反射恢复时间均短于对照组，两组比较差异具有统计学意义（P < 0.05）。治疗后，两组患儿血清NO、APN和IGF-1水平均升高，ET-1水平降低，同组治疗前后比较差异有统计学意义（P < 0.05）；且治疗后治疗组上述指标均显著优于对照组，两组比较差异有统计学意义（P < 0.05）。两组NBNA评分均显著升高，同组治疗前后比较差异具有统计学意义（P < 0.05）；且治疗后治疗组NBNA评分显著高于对照组，两组比较差异有统计学意义（P < 0.05）。回访时，治疗组患儿MDI和PDI评分均显著高于对照组，两组比较差异有统计学意义（P < 0.05）。结论 参芎葡萄糖注射液联合脑苷肌肽治疗新生儿缺氧缺血性脑病临床效果显著，可有效改善患儿临床症状及减少后遗症的发生，并可有效改善血清指标，具有一定的临床推广应用价值。

Objective To observe the clinical effect of Shenxiong Glucose Injection combined with cattle encephalon glycoside and ignotin in treatment of hypoxic ischemic encephalopathy of newborn. Methods Patients (67 cases) with hypoxic ischemic encephalopathy of newborn in Department of Neonatology in Ezhou Central Hospital from January 2015 to April 2017 were randomly divided into control (30 cases) and treatment (37 cases) groups. Patients in the control group were iv administered with Cattle Encephalon Glycoside and Ignotin Injection, 2 mL added into normal saline 50 mL, once daily. Patients in the treatment group were iv administered with Shenxiong Glucose Injection, 50 mL/time, once daily. Patients in two groups were treated for 14 d. After treatment, the clinical efficacy was evaluated, recovery of clinical signs, NO, ET-1, APN, IGF-1, NBNA, and conditions of prognosis in two groups were compared. Results After treatment, the clinical efficacy in the control and treatment groups were 73.33% and 83.78%, respectively, and there was difference between two groups (P < 0.05). Consciousness recovery time and muscle tension recovery time of moderate and server children in the treatment group were shorter than those in the control group, with significant difference between two groups (P < 0.05). After treatment, NO, APN, and IGF-1 levels were increased, while ET-1 level was decreased, and the difference was statistically significant in the same group (P < 0.05). And those indexes in the treatment group were better than those in the control group, with significant difference between two groups (P < 0.05). After treatment, NBNA score in two groups were increased, and the difference was statistically significant in the same group (P < 0.05). And NBNA score in the treatment group was higher than that in the control group, with significant difference between two groups (P < 0.05). When the children were followed up, MDI and PDI scores in the treatment group were higher than those in the control group, with significant difference between two groups (P < 0.05). Conclusion Shenxiong Glucose Injection combined with cattle encephalon glycoside and ignotin has a good clinical efficacy in treatment of hypoxic ischemic encephalopathy of newborn, can significantly improve the clinical symptoms and prognosis, and can improve serum indexes, which has a certain clinical application value.

国家自然科学基金资助项目（81660794）；广西壮族自治区卫生和计划生育委员会科研课题（Z2016667）