目的 观察川蛭通络胶囊联合长春西汀注射液治疗脑梗死恢复期的临床疗效。方法 选取2018年10月-2020年10月安阳市人民医院收治的122例脑梗死恢复期患者，采用随机数字表法将所有患者分为对照组和治疗组，每组各61例。对照组静脉滴注长春西汀注射液，初始剂量20 mg/次，随后视患者个人耐受情况逐渐增加至30 mg/次，加入生理盐水250 mL，1次/d。治疗组患者在对照组治疗的基础上口服川蛭通络胶囊，0.5 g/次，3次/d。两组患者均连续治疗2周。观察两组临床疗效，比较两组日常生活能力、神经功能缺损程度、微循环指标、血清神经因子水平。结果 治疗后，对照组的总有效率为72.13%，治疗组的总有效率为91.80%，治疗组的总有效率高于对照组（P<0.05）。治疗后，两组Barthel指数（BI）评分显著升高，美国国立卫生研究院卒中量表（NIHSS）评分显著降低（P<0.05）；治疗后，治疗组BI评分较对照组高，NIHSS评分较对照组低（P<0.05）。治疗后，两组血小板最大聚集率（MAR）、纤维蛋白原（FIB）、D-二聚体（D-D）均显著降低，差异有统计学意义（P<0.05）；治疗后，治疗组MAR、FIB、D-D低于对照组，差异有统计学意义（P<0.05）。治疗后，两组神经生长因子（NGF）、脑源性神经营养因子（BDNF）水平均显著升高，差异有统计学意义（P<0.05）；治疗后，治疗组NGF、BDNF水平较对照组高（P<0.05）。结论 川蛭通络胶囊联合长春西汀注射液治疗脑梗死恢复期具有较好临床疗效，可改善神经功能缺损程度、日常生活能力和机体微循环，调节血清神经因子水平。

Objective To observe the clinical efficacy of Chuanzhi Tongluo Capsules combined with Vinpocetine Injection in treatment of convalescent cerebral infarction. Methods Patients (122 cases) with convalescent cerebral infarction in Anyang People's Hospital from October 2018 to October 2020 were divided into control and treatment groups according to random number table method, and each group had 61 cases. Patients in the control group were po administered with Vinpocetine Injection, the initial dose was 20 mg/time, then gradually increased to 30 mg/time according to the patient's personal tolerance, and the drug added into normal saline 250mL, once daily. Patients in the treatment group were po administered with Chuanzhi Tongluo Capsules on the basis of the control group, 0.5 g/time, three times daily. Patients in two groups were treated for 2 weeks. After treatment, the clinical efficacies were evaluated, and the daily living ability, neurological function deficit, microcirculation related indexes, and serum nerve factors in two groups were compared. Results After treatment, the total effective rate of the control group was 72.13%, that of the treatment group was 91.80%, and the total effective rate of the treatment group was higher than that of the control group (P<0.05). After treatment, the BI score in two groups were significantly increased, but the NIHSS score in two groups were significantly decreased (P<0.05). After treatment, the BI score of the treatment group was higher than that of the control group, but the NIHSS score of the treatment group was lower than that of the control group (P<0.05). After treatment, the MAR, FIB, and D-D in two groups were significantly decreased (P<0.05). After treatment, MAR, FIB, and D-D in the treatment group were lower than those in the control group (P<0.05). After treatment, the levels of NGF and BDNF in two groups were significantly increased (P<0.05). After treatment, the levels of NGF and BDNF in the treatment group were higher than those in the control group (P<0.05). Conclusion Chuanzhi Tongluo Capsules combined with Vinpocetine Injection has good clinical efficacy in treatment of convalescent cerebral infarction, can improve the degree of neurological deficit, daily living ability, and microcirculation, and regulate serum nerve factors.

R971

河南省科技发展计划项目（182300610427）