目的 探讨脑梗死恢复期应用心脑宁胶囊联合长春西汀治疗的临床效果。方法 选取2015年3月—2019年4月北京京煤集团总医院收治的92例脑梗死恢复期患者，随机分为对照组和治疗组。对照组口服长春西汀片，1片/次，3次/d，饭后服用。治疗组在对照组基础上口服心脑宁胶囊，3粒/次，3次/d。两组均连续治疗3个月。对比两组临床疗效；治疗前后评估两组患者神经功能缺损情况[美国国立卫生研究院卒中量表（NIHSS）]、日常生活活动能力[改良Barthel指数（MBI）]及生活质量状况[Spitzer生活质量指数（SQLI）]，检测患者大脑中动脉血流动力学状态，测定血栓前状态相关指标[全血高切及低切黏度（HBV和LBV）、纤维蛋白原（FIB）、α颗粒膜蛋白-140（GMP-140）]及血清白介素（IL）-1β、神经元特异性烯醇化酶（NSE）水平。结果 治疗组总有效率为91.3%，显著高于对照组76.1%（P<0.05）。与治疗前相比，两组治疗后NIHSS评分均显著降低（P<0.05），MBI、SQLI评分则均显著升高（P<0.05）；但治疗组治疗后相关量表（NIHSS、MBI、SQLI）评分的改善效果均较对照组同期更显著（P<0.05）。与治疗前对比，两组治疗后大脑中动脉平均血流速度（V_m）均显著增快（P<0.05），而阻力指数（RI）、搏动指数（PI）值均显著降低（P<0.05）；且治疗后，治疗组大脑中动脉相关血流参数的改善效果均更显著（P<0.05）。两组治疗后HBV、LBV及血浆FIB、GMP-140浓度和血清IL-1β、NSE水平均显著低于治疗前（P<0.05），且治疗组上述指标改善更显著（P<0.05）。结论 心脑宁胶囊联合长春西汀治疗脑梗死恢复期的整体疗效确切，可明显改善患者脑血流动力学，纠正血栓前状态，减轻机体炎症反应，促进患者神经功能的恢复，具有一定的临床推广应用价值。

Objective To investigate the clinical effect of Xinnaoning Capsules combined with vinpocetine in treatment of cerebral infarction in convalescence. Methods 92 Cerebral infarction convalescent patients admitted to Beijing Coal Group General Hospital from March 2015 to April 2019 were selected and randomly divided into control group (n=46) and treatment group (n=46). The control group was po administered with Vinpocetine Tablets, 1 tablet/time, three times daily. The treatment group was po administered with Xinnaoning Capsules on the basis of the control group, 3 grains/time, three times daily. All patients were treated for 3 months. The clinical effects of the two groups were compared. Before and after treatment, neurological deficits (NIHSS), activities of daily living (MBI), and quality of life (SQLI) of the two groups were evaluated, and the hemodynamic state of the middle cerebral artery of the subjects was detected. The related indexes of prethrombotic state (HBV and LBV), fibrinogen (FIB), α granule membrane protein -140(GMP-140), serum interleukin (IL)-1β, neuron-specific enolase (NSE) levels were measured. Results The total effective rate of the treatment group was 91.3%, significantly higher than that of the control group 76.1% (P<0.05). Compared with before treatment, NIHSS scores in both groups decreased significantly after treatment (P<0.05), but MBI and SQLI scores increased significantly (P<0.05). However, the improvement effect of related scales (NIHSS, MBI, and SQLI) scores in the treatment group was more significant than that in the control group (P<0.05). Compared with before treatment, after treatment, the mean blood flow velocity (V_m) of middle cerebral artery in both groups increased significantly (P<0.05), while the resistance index (RI) and pulsatility index (PI) decreased significantly (P<0.05). After treatment, the improvement effect of blood flow parameters related to middle cerebral artery in the treatment group was more significant (P<0.05). After treatment, the concentrations of HBV, LBV, plasma FIB, GMP-140, serum IL-1β, NSE in the two groups were significantly lower than before treatment (P<0.05), and the above indexes in the treatment group were improved more significantly (P<0.05). Conclusion Xinnaoning Capsules combined with vinpocetine is effective in the treatment of cerebral infarction in convalescence, and can effectively improve the cerebral blood circulation disorder, and can correct the prethrombotic state of the body, antagonize the inflammatory reaction in antibodies, promote the recovery of neurological function, which has a certain clinical application value.

R971