目的 探讨复方地龙胶囊联合胞二磷胆碱钠片治疗急性脑梗死恢复期的临床疗效。方法 选择2021年4月—2022年4月在天津市北辰医院诊治的82例急性脑梗死恢复期患者，根据用药的差别分为对照组（41例）和治疗组（41例）。对照组口服胞二磷胆碱钠片，0.2 g/次，3次/d；在此基础上，治疗组口服复方地龙胶囊，0.56 g/次，3次/d。两组患者均治疗4周。观察两组患者临床疗效，比较治疗前后两组患者NIHSS评分、FMMS评分、HPLPⅡ评分、AROM评分、SS-QOL评分和BBS评分，血清基质细胞衍生因子-1（SDF-1）、神经营养因子-3（NT-3）、同型半胱氨酸（Hcy）、氧化应激骨桥蛋白（OPN）和脑源性神经营养因子（BDNF）水平，脑血流灌注指标收缩期最大流速（PSV）、平均流速（TMV）和阻力指数（RI），血清纤维蛋白原、D-二聚体和血浆比黏度水平。结果 治疗后，治疗组临床有效率为97.56%，显著高于对照组（80.49%，P＜0.05）。治疗后，两组NIHSS评分明显降低，而FMMS评分、HPLPⅡ评分、AROM评分、SS-QOL评分和BBS评分明显升高（P＜0.05），且治疗组评分改善最为明显（P＜0.05）。治疗后，两组血清SDF-1、Hcy和OPN水平明显降低，而BDNF、NT-3水平明显升高（P＜0.05），并以治疗组改善最为明显（P＜0.05）。治疗后，两组脑血流灌注指标PSV和TMV明显升高，而RI明显降低（P＜0.05），并以治疗组改善最为明显（P＜0.05）。治疗后，两组血清纤维蛋白原、D-二聚体及血浆比黏度水平均明显降低（P＜0.05），并以治疗组下降的最为明显（P＜0.05）。结论 复方地龙胶囊联合胞二磷胆碱钠片治疗急性脑梗死恢复期可有效促进神经功能恢复，提高患者运动、平衡功能及健康行为改善。

Objective To investigate the clinical effect of Compound Dilong Capsules combined with citicoline sodium in treatment of the recovery period of acute cerebral infarction. Methods Patients (85 cases) in recovery period of acute cerebral infarction in Tianjin Beichen Hospital from April 2021 to April 2022 were divided into control (41 cases) and treatment (41 cases) group based on different treatment. Patients in the control group was po administered with Citicoline Sodium Tablets, 0.2 g/time, three times daily. Patients in the treatment group were po administered with Compound Dilong Capsules on the basis of the control group, 0.56 g/time, three times daily. Patients in two groups were treated for 4 weeks. After treatment, the clinical evaluation was evaluated, and the scores of NIHSS, FMMS, HPLPⅡ, AROM, SS-QOL and BBS, the levels of serum SDF-1, NT-3, Hcy, OPN and BDNF, cerebral blood flow perfusion indexes of PSV, TMV and RI, the levels of serum fibrinogen, D-dimer and plasma specific viscosity in two groups before and after treatment were compared. Results After treatment, the clinical effective rate of the treatment group was 97.56%, which was significantly higher than that of the control group (80.49%, P < 0.05). After treatment, the NIHSS score in two groups was significantly decreased, while the FMMS score, HPLP II score, AROM score, SS-QOL score and BBS score were significantly increased (P < 0.05), and the scores of the treatment group were significantly better than those in the control group (P < 0.05). After treatment, the serum levels of SDF-1, Hcy and OPN were significantly decreased, while the level of BDNF and NT-3 were significantly increased in two groups (P < 0.05), especially in the treatment group (P < 0.05). After treatment, the cerebral blood flow perfusion indexes PSV and TMV were significantly increased, while RI was significantly decreased in two groups (P < 0.05), the improvement in the treatment group was more obvious (P < 0.05). After treatment, the levels of serum fibrinogen, D-dimer and plasma specific viscosity were significantly decreased in two groups (P < 0.05), the decrease in the treatment group was more obvious (P < 0.05). Conclusion Compound Dilong Capsules combined with citicoline sodium in treatment of the recovery period of acute cerebral infarction can promote the recovery of neurological function, improve the motor and balance function of patients and improve their healthy behavior.

R971

天津市科技计划项目（SHGY-2020005）