目的 探讨珍龙醒脑胶囊联合依达拉奉右莰醇治疗急性脑梗死的临床疗效。方法 选取2022年3月—2024年11月榆林市中医医院收治的急性脑梗死患者146例，随机分为对照组和治疗组，每组各73例。对照组静脉滴注依达拉奉右莰醇注射用浓溶液，15 mL加入100 mL生理盐水，2次/d。治疗组在对照组基础上口服珍龙醒脑胶囊，0.6 g/次，2次/d。两组患者治疗2周。观察两组患者临床疗效，比较治疗前后两组患者美国国立卫生研究院卒中量表（NIHSS）和Barthel指数评分（BI），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）、超氧化物歧化酶（SOD）、谷胱甘肽过氧化物酶（GSH-Px）和丙二醛（MDA）水平。结果 治疗后，治疗组总有效率为91.78%，明显高于对照组的79.45%（P＜0.05）。治疗后，两组患者NIHSS评分比治疗前显著降低，而BI评分明显高于治疗前（P＜0.05），且治疗组评分明显好于对照组（P＜0.05）。治疗后，两组患者GFAP、S100β、NSE水平均显著降低（P＜0.05），且治疗组脑损伤标志物水平低于对照组（P＜0.05）。治疗后，两组患者SOD、GSH-Px明显高于治疗前，而MDA低于治疗前（P＜0.05），且治疗组氧化应激指标明显好于对照组（P＜0.05）。结论 珍龙醒脑胶囊联合依达拉奉右莰醇治疗急性脑梗死具有良好疗效，可改善神经功能，抑制脑损伤标志物的表达，改善机体氧化应激状态，且治疗安全性良好。

Objective To investigate the clinical efficacy of Zhenlong Xingnao Capsules combined with edaravone and dexborneol in treatment of acute cerebral infarction. Methods Patients (146 cases) with acute cerebral infarction in Yulin Traditional Chinese Medicine Hospital from March 2022 to November 2024 were randomly divided into control and treatment group, and each group had 73 cases. Patients in the control group were iv administered with Edaravone and Dexborneol Concentrated Solution for injection, 15 mL added into normal saline 100 mL, twice daily. Patients in the treatment group were po administered with Zhenlong Xingnao Capsules on the basis of the control group, 0.6 g/time, twice daily. Patients in two groups were treated for 2 weeks. After treatment, the clinical evaluations were evaluated, and the scores of NIHSS and BI, the levels of GFAP, S100β, NSE, SOD, GSH-Px and MDA in two groups before and after treatment were compared. Results After treatment, the total effective rate in the treatment group was 91.78%, which was significantly higher than 79.45% in the control group (P < 0.05). After treatment, the NIHSS score in two groups was significantly lower than that before treatment, while the BI score was significantly higher (P < 0.05), and the score in the treatment group was significantly better than that in the control group (P < 0.05). After treatment, the levels of GFAP, S100β, and NSE in two groups were significantly reduced (P < 0.05), and the levels of brain damage markers in the treatment group were lower than those in the control group (P < 0.05). After treatment, SOD and GSH-Px in two groups were significantly higher than before treatment, while MDA was lower (P < 0.05), and the oxidative stress indexes in the treatment group were significantly better than that in the control group (P < 0.05). Conclusion Zhenlong Xingnao Capsules combined with edaravone and dexborneol has a good effect on the treatment of acute cerebral infarction, which can alleviate the symptoms of patients, inhibit the expression of brain injury markers, improve the oxidative stress state, and the treatment is safe.

R971

陕西省卫生健康科研基金项目（2024D051）