目的 评估川蛭通络胶囊与阿托伐他汀钙联合用药治疗对急性脑梗死的临床效果。方法 研究纳入张家口市第一医院神经内科自2023年7月至2024年10月收治的急性脑梗死患者120例。依据治疗方案的不同将患者分为对照组（n=60）和治疗组（n=60）。对照组给予阿托伐他汀钙片（10 mg/次，每日1次）口服治疗；治疗组在阿托伐他汀钙治疗基础上，加服川蛭通络胶囊（2粒/次，每日3次）。所有患者均持续用药2周。观察两组疗效情况；比较两组治疗前后三酰甘油（TG）、高密度脂蛋白胆固醇（HDL-C）、总胆固醇（TC）、低密度脂蛋白胆固醇（LDL-C）、日常生活能力量表评分指数（Barthel）、美国国立卫生研究院卒中量表（NIHSS）评分、血清血管生成素样蛋白3（ANGPTL3）、神经胶质纤维酸性蛋白（GFAP）、血清可溶性细胞间黏附分子-1（sICAM-1）、成纤维细胞生长因子-23（FGF-23）水平。结果 在总有效率方面，治疗组（96.67%）显著高于对照组（83.33%），差异有统计学意义（P＜0.05）；在症状改善时间方面，治疗组患者手足麻木、口角歪斜、肢体无力及语言不利的改善时间均显著短于对照组（P＜0.05）；在血脂指标改善方面，治疗后，两组HDL-C水平显著升高，而LDL-C、TC、TG水平降低（P＜0.05）；治疗后，与对照组对比，治疗组LDL-C、TC、TG水平更低，且治疗组的HDL-C水平更高（P＜0.05）。在神经功能与生活能力评分方面，治疗后，两组NIHSS评分显著降低，而Barthel评分升高（P＜0.05）；治疗后，与对照组对比，治疗组NIHSS评分降低，且Barthel评分升高（P＜0.05）。在血清学指标方面，治疗后，两组患者血清ANGPTL3、GFAP、sICAM-1、FGF-23水平均较同组治疗前显著降低（P＜0.05）；治疗后，与对照组对比，治疗组ANGPTL3、GFAP、sICAM-1、FGF-23水平均较低（P＜0.05）。结论 川蛭通络胶囊与阿托伐他汀钙联用可显著提升急性脑梗死患者的临床治疗效果，加速神经功能缺损症状的缓解，并有效调控血清炎症标志物的水平。

Objective To investigate the clinical efficacy of Chuanzhi Tongluo Capsules combined with atorvastatin calcium in treatment of acute cerebral infarction. Methods A total of 120 patients with acute cerebral infarction admitted to the Department of Neurology of Zhangjiakou First Hospital from July 2023 to October 2024 were selected and divided into control group and treatment group according to differences in medication regimens, with 60 cases in each group. Patients in control group were given Atorvastatin Calcium Tablets, 10 mg each time, once daily. Patients in treatment group orally took Chuanzhi Tongluo Capsules on basis of control group, 2 capsules each time, 3 times daily. The treatment conditions of both groups were observed after two weeks of medication. The treatment conditions of both groups were observed after two weeks of medication. The therapeutic effects of two groups were observed, and the levels of TG, HDL-C, TC, LDL-C, Barthel score, NIHSS score, and serum ANGPTL3, GFAP, sICAM-1, and FGF-23 in two groups were compared between two groups. Results After drug intervention, the total effective rate of the treatment group was 96.67%, significantly higher than that of the control group (83.33%, P < 0.05). After drug intervention, the improvement time for numbness in hands and feet, crooked mouth corners, limb weakness and poor speech in the treatment group was significantly shorter than that in the control group (P < 0.05). After treatment, the levels of HDL-C in both groups increased significantly,and the levels of LDL-C, TC, and TG decreased (P < 0.05). After treatment, compared with the control group, the levels of LDL-C, TC and TG in the treatment group were lower, and the level of HDL-C in the treatment group was higher (P < 0.05). After treatment, the NIHSS scores of both groups decreased significantly, while the Barthel scores increased (P < 0.05). After treatment, compared with the control group, the NIHSS score of the treatment group decreased, and the Barthel score increased (P < 0.05). After treatment, the levels of ANGPTL3, GFAP, sICAM-1, and FGF-23 in both groups decreased significantly (P < 0.05). After treatment, compared with the control group, the levels of ANGPTL3, GFAP, sICAM-1, and FGF-23 in the treatment group were all lower (P < 0.05). Conclusion The combination of Chuanzhi Tongluo Capsules and atorvastatin calcium can significantly improve the clinical treatment effect of patients with acute cerebral infarction, accelerate the relief of neurological deficit symptoms, and effectively regulate the concentration of serum inflammatory markers.

R971

张家口市重点研发计划项目（2322105D）