目的 探讨川蛭通络胶囊联合复方脑肽节苷脂注射液治疗急性脑梗死恢复期的临床疗效。方法 选择郑州大学第五附属医院2022年1—12月收治的100例急性脑梗死恢复期患者，按随机数字表法分为对照组（50例）和治疗组（50例）。对照组静脉滴注复方脑肽节苷脂注射液，20 mL与300 mL生理盐水混合，1次/d。在对照组基础上，治疗组口服川蛭通络胶囊，0.5 g/次，3次/d。两组均持续治疗2周。比较两组的临床疗效、量表评分、血液流变学指标、神经细胞因子和血管内皮功能。结果 治疗组的总有效率（92.00%）高于对照组的总有效率（76.00%，P＜0.05）。治疗后，两组美国国立卫生研究院卒中量表（NIHSS）评分显著下降，日常生活能力量表评分（ADL）评分显著升高（P＜0.05），且治疗组NIHSS评分、ADL评分明显优于对照组（P＜0.05）。治疗后，两组患者红细胞沉降率、红细胞压积、全血黏度、血小板黏附率均显著下降（P＜0.05），且治疗组红细胞沉降率、红细胞压积、全血黏度、血小板黏附率低于对照组（P＜0.05）。治疗后，两组血清神经元特异性烯醇化酶（NSE）水平显著下降，血清脑源性神经营养因子（BDNF）、神经细胞因子神经营养因子（NTF）水平显著升高（P＜0.05），且治疗组血清神经细胞因子水平变化优于对照组（P＜0.05）。治疗后，两组血清内皮素-1（ET-1）、血管性血友病因子（vWF）水平下降，血清一氧化氮（NO）水平升高（P＜0.05），且治疗组血清血管内皮功能优于对照组（P＜0.05）。结论 川蛭通络胶囊联合复方脑肽节苷脂注射液对急性脑梗死恢复期患者有良好效果，能增强生活能力，改善血液流变学，改善神经功能，保护血管内皮。

Objective To explore the therapeutic effect of Chuanzhi Tongluo Capsules combined with Compound Porcine Cerebroside and Ganglioside Injection in treatment of acute cerebral infarction in recovery period. Methods Patients (100 cases) with acute cerebral infarction in recovery period in the Fifth Affiliated Hospital of Zhengzhou University from January to December 2022 were divided into control and treatment groups according to the random number table method, and each group had 50 cases. Patients in the control group were iv administered with Compound Porcine Cerebroside and Ganglioside Injection, 20 mL added into normal saline 300 mL, 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. The clinical efficacies, scale scores, hemorheological indicators, nerve cytokines, and vascular endothelial function in two groups were compared. Results The total effective rate of treatment group (92.00%) was higher than 76.00%t of control group (P < 0.05). After treatment, NIHSS scores in two groups was significantly decreased, and ADL scores in two groups was significantly increased (P < 0.05). And NIHSS score and ADL score in the treatment group were significantly better than those in the control group (P < 0.05). After treatment, the erythrocyte sedimentation rate, hematocrit, whole blood viscosity, and platelet adhesion rate of two groups were significantly decreased (P < 0.05), and the erythrocyte sedimentation rate, hematocrit, whole blood viscosity, and platelet adhesion rate in the treatment group were lower than those in the control group (P < 0.05). After treatment, the serum level of NSE in two groups was significantly decreased, but the serum levels of BDNF and NTF in two groups were significantly increased (P < 0.05). And the serum neurocytokine level in the treatment group was better than that in the control group (P < 0.05). After treatment, the serum levels of ET-1 and vWF in two groups were decreased, but the serum level of NO in two groups was increased (P < 0.05), and the serum vascular endothelial function in the treatment group was better than that in the control group (P < 0.05). Conclusion Chuanzhi Tongluo Capsules combined with Compound Porcine Cerebroside and Ganglioside Injection has clinical curative effect in treatment of acute cerebral infarction in recovery period, can enhance living ability, improve blood rheology, improve neurological function, and protect vascular endothelium.

R971

河南省医学科技攻关计划（联合共建）项目（LHG20190412）