目的 探讨消栓肠溶胶囊联合胞磷胆碱钠治疗脑梗死恢复期气虚血瘀证患者神经功能恢复及长期预后的影响。方法 纳入2023年1月—2025年2月南阳南石医院收治的80例脑梗死恢复期患者，依据随机数字表法分为对照组和治疗组，每组各40例。对照组口服胞磷胆碱钠胶囊，0.2 g/次，3次/d。治疗组在对照组基础上口服消栓肠溶胶囊，0.4 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神经损伤指标血清中神经胶质原纤维酸性蛋白（GFAP）、神经元特异性烯醇化酶（NSE）和S100B蛋白，血管内皮功能指标血清内皮素（ET）、血管性假血友病因子（vWF）、一氧化氮（NO）和人6-酮-前列腺素F1α（6-K-PGF1α），脑血流灌注收缩期峰值流速（PSV）、阻力指数（RI）和平均流速（TMV）水平。结果 治疗后，治疗组临床疗效明显优于对照组（95.00% vs 77.50%，P＜0.05）。治疗后，两组血清GFAP、NSE、S100B蛋白水平均比治疗前显著降低（P＜0.05），且治疗组血清蛋白下降幅度明显大于对照组（P＜0.05）。治疗后，两组患者血清ET和vWF水平比治疗前明显降低（P＜0.05），而NO和6-K-PGF1α水平明显升高（P＜0.05），且治疗组血清ET、vWF、NO和6-K-PGF1α水平显著好于对照组（P＜0.05）。治疗后，两组PSV和TMV值明显升高，而RI值明显降低（P＜0.05），且治疗组PSV、TMV和RI水平好于对照组（P＜0.05）。结论 脑梗死恢复期患者在基础治疗上，联合应用胞磷胆碱钠与消栓肠溶胶囊，利于提高治疗效果、增加脑血流灌注、促进神经功能恢复，改善血管内皮功能，且不会过度增加患者不适反应。

Objective To explore the effect of Xiaoshuan Enteric-coated Capsules combined with citicoline sodium in treatment of syndrome of qi deficiency and blood stasis in convalescent stage of cerebral infarction and long-term prognosis. Methods Patients (80 cases) with syndrome of qi deficiency and blood stasis in convalescent stage of cerebral infarction in Nanyang Nanshi Hospital from January 2023 to February 2025 were divided into control and treatment group by random number table method, and each group had 40 cases. Patients in the control group were po administered with Citicoline Sodium Capsules, 0.2 g/time, three times daily. Patients in the treatment group were po administered with Xiaoshuan Enteric-coated Capsules on the basis of the control group, 0.4 g/time, three times daily. Patients in two groups were treated for 4 weeks. After treatment, the clinical evaluations were evaluated, and the nerve injury indexes GFAP, NSE and S100B, vascular endothelial function indexes ET, vWF, NO and 6-K-PGF1α, cerebral blood perfusion PSV, TMV and RI levels in two groups before and after treatment were compared. Results After treatment, the clinical efficacy of the treatment group was significantly better than that of the control group (95.00% vs 77.50%, P < 0.05). After treatment, the serum GFAP, NSE, and S100B protein levels in two groups were significantly lower than those before treatment (P < 0.05), and the decrease in serum protein in the treatment group was significantly greater than that in the control group (P < 0.05). After treatment, the serum ET and vWF levels in two groups were significantly lower than those before treatment (P < 0.05), while the levels of NO and 6-K-PGF1α were significantly increased (P < 0.05). The serum ET, vWF, NO and 6-K-PGF1α levels in the treatment group were significantly better than those in the control group (P < 0.05). After treatment, the PSV and TMV values were significantly increased in two groups, while the RI values were significantly decreased (P < 0.05), and the PSV, TMV and RI levels in the treatment group were better than those in the control group (P < 0.05). Conclusion On the basis of basic treatment, Citicoline Sodium Capsules and Xiaoshuan Enteric-coated Capsules can improve the treatment effect, increase cerebral blood flow perfusion, promote the recovery of neurological function, improve vascular endothelial function, and will not excessively increase the discomfort reaction of patients with cerebral infarction in the recovery period.

R971

河南省医学科技攻关计划联合共建项目（LHGJ20230959）