目的 探讨川蛭通络胶囊联合硫酸氢氯吡格雷片治疗脑梗死恢复期的应用效果。方法 2023年1月—2024年7月珠海市中西医结合医院收治的102例脑梗死恢复期患者，以随机数字表法分为治疗组、对照组，每组51例。对照组以硫酸氢氯吡格雷片治疗，每次口服75 mg，每日1次，治疗组增加川蛭通络胶囊治疗，每次0.5 g，每日3次。治疗后评估两组临床疗效、神经细胞因子、血液流变学、血小板功能指标、量表评分和治疗安全性。结果 治疗组总有效率为92.16%，高于对照组的76.47%（P＜0.05）。治疗后，两组患者血清胶质纤维酸性蛋白（GFAP）、中枢神经特异性蛋白（S100β）、神经元烯醇化酶（NSE）下降（P＜0.05）；治疗组血清GFAP、S100β、NSE水平均低于对照组（P＜0.05）。治疗后，两组全血高切黏度、全血低切黏度、血浆黏度（PV）、纤维蛋白原（Fib）、血细胞比容（Hct）均明显低于同组治疗前（P＜0.05），且治疗后治疗组血液流变学指标水平明显优于对照组（P＜0.05）。治疗后，两组患者血小板计数（PLT）、平均血小板体积（MPV）、血小板分布宽度（PDW）、血小板聚集指数（PAG）下降（P＜0.05）；治疗后治疗组患者血小板参数均低于对照组（P＜0.05）。治疗后，两组患者美国国立卫生研究院脑卒中量表（NIHSS）评分较治疗前显著降低，脑卒中生活质量量表（SS-QOL）评分升高（P＜0.05）；治疗后治疗组NIHSS评分低于对照组，SS-QOL评分高于对照组（P＜0.05）。结论 川蛭通络胶囊联合硫酸氢氯吡格雷片治疗脑梗死恢复期效果良好，可降低神经细胞因子，改善血液流变学，抑制血小板聚集，提高生活质量。

Objective To investigate the efficacy and safety of Chuanzhi Tongluo Capsules combined with Clopidogrel Bisulfate Tablets in the treatment of cerebral infarction in the recovery period.Methods 102 Patients with cerebral infarction in the recovery period admitted to Zhuhai Hospital of Integrated Traditional Chinese and Western Medicine from January 2023 to July 2024 were randomly divided into treatment group and control group using random number table method, with 51 patients in each group. The control group treated with Clopidogrel Bisulfate Tablets, 75 mg orally once a day, while the treatment group was treated with Chuanzhi Tongluo Capsules on basis of control group, 0.5 g orally three times daily. Evaluate the clinical efficacy, neuronal cytokines, hemorheology, platelet function indicators, scale scores, and treatment safety of two groups after treatment.Results The total effective rate of treatment group was 92.16%, which was higher than 76.47% of control group (P < 0.05). After treatment, the levels of serum GFAP, S100β, and NSE in both groups decreased (P < 0.05). The levels of serum GFAP, S100β and NSE in treatment group were all lower than those in the control group (P < 0.05). After treatment, the whole blood high shear viscosity, whole blood low shear viscosity, PV, Fib, and Hct in both groups were significantly lower than those before treatment in the same group (P < 0.05), and the levels of hemorheological indicators in the treatment group after treatment were significantly better than those in the control group (P < 0.05). After treatment, PLT, MPV, PDW, and PAG of both groups decreased (P < 0.05). After treatment, the platelet parameters in the treatment group were all lower than those in the control group (P < 0.05). After treatment, NIHSS scores of two groups of patients were significantly lower than those before the treatment, and SS-QOL scores were increased (P < 0.05). After treatment, the NIHSS score of treatment group was lower than that of control group, and the SS-QOL score was higher than that of control group (P < 0.05).Conclusion The combination of Chuanzhi Tongluo Capsules and Clopidogrel Bisulfate Tablets has a good therapeutic effect on the recovery period of cerebral infarction. It can reduce the levels of brain injury markers, improve blood viscosity, inhibit platelet aggregation, improve prognosis scores, and has good treatment safety.

R971

广东省卫健委医学科学技术研究基金资助项目（A2023113）