目的 探讨偏瘫复原丸联合氯吡格雷治疗急性脑梗死恢复期患者的治疗效果。方法 选取2021年2月-2023年4月青海红十字医院收治的94例急性脑梗死患者,依据随机数表法分为对照组(47例)和治疗组(47例)。对照组患者口服硫酸氢氯吡格雷片,75 mg/次,1次/d。治疗组患者在对照组治疗基础上口服偏瘫复原丸,1丸/次,2次/d。两组患者均连续治疗4周。观察两组的临床疗效,比较两组治疗前后中医症状积分及血清炎症因子水平,比较两组患者的短期预后情况和不良反应情况。结果 治疗后,治疗组的总有效率为93.62%,显著高于对照组的78.72%(P<0.05)。治疗后,两组患者的头晕目眩、肢体麻木、舌质暗淡、气短乏力评分较治疗前明显降低(P<0.05),且治疗组中医症状积分均低于对照组(P<0.05)。治疗后,两组患者的血清C反应蛋白(CRP)、单核细胞趋化蛋白-1(MCP-1)、白细胞介素-6(IL-6)水平较治疗前明显降低(P<0.05),且治疗后,治疗组血清CRP、MCP-1、IL-6水平改善情况更为明显(P<0.05)。治疗组的短期预后良好率为82.98%,显著高于对照组的63.83%(P<0.05)。治疗后,治疗组不良反应发生率是6.38%,对照组是2.13%,两组不良反应发生率比较差异无统计学意义。结论 偏瘫复原丸联合氯吡格雷对急性脑梗死恢复期患者具有较好的治疗效果,可有效改善患者的中医症状、炎症状态以及短期预后情况,不良反应发生率低,且症状轻微。

Objective To explore the therapeutic effect of Piantan Fuyuan Pills combined with clopidogrel in treatment of convalescent period of acute cerebral infarction. Methods 94 Patients with acute cerebral infarction admitted to Qinghai Red Cross Hospital from February 2021 to April 2023 were selected and divided into control group (47 cases) and treatment group (47 cases) according to random number table method. Patients in the control group were po administered with Clopidogrel Bisulfate Tablets, 75 mg/time, once daily. Patients in the treatment group were po administered with Piantan Fuyuan Pills on the basis of the control group, 1 pill/time, twice daily. Both groups were treated continuously for 4 weeks. The clinical efficacy of the two groups was observed, the TCM symptom score and serum inflammatory factor levels were compared before and after treatment, and the short-term prognosis and adverse reactions were compared between the two groups. Results After treatment, the total effective rate of the treatment group was 93.62%, which was significantly higher than that of the control group (78.72%, P < 0.05). After treatment, the scores of dizziness, numbness of limbs, dull tongue, and shortness of breath in both groups were significantly lower than before treatment (P < 0.05), and the scores of TCM symptoms in the treatment group were lower than those in the control group (P < 0.05). After treatment, the levels of serum C-reactive protein (CRP), monocyte chemoattractant protein-1 (MCP-1), and interleukin-6 (IL-6) in both groups were significantly decreased compared with those before treatment (P < 0.05), and after treatment, the levels of serum CRP, MCP-1, and IL-6 in the treatment group were significantly improved (P < 0.05). The good short-term prognosis rate in the treatment group was 82.98%, which was significantly higher than that in the control group (63.83%) (P < 0.05). After treatment, the incidence of adverse reactions was 6.38% in the treatment group and 2.13% in the control group. There was no significant difference in the incidence of adverse reactions between the two groups. Conclusion Piantan Fuyuan Pills combined with clopidogrel has a good therapeutic effect in treatment of convalescent period of acute cerebral infarction, and can effectively improve TCM symptoms, inflammatory state and short-term prognosis with low incidence of adverse reactions and mild symptoms.

R971

青海省卫生健康系统指导性计划课题（2022-wjzdx-95）