目的 观察养血清脑颗粒联合盐酸法舒地尔注射液治疗蛛网膜下腔出血后脑血管痉挛的临床疗效。方法 选取2024年2月—2025年2月邯郸市中心医院收治的86例蛛网膜下腔出血后脑血管痉挛患者为研究对象，所有患者按随机数字表法分为对照组（43例）和治疗组（43例）。对照组静脉滴注盐酸法舒地尔注射液，每次30 mg溶于100 mL生理盐水，2次/d。治疗组在上述治疗基础上口服养血清脑颗粒，1袋/次，3次/d。两组均治疗14 d。对比两组的临床疗效、脑血流动力学、病情改善情况、血清生化指标。结果 治疗组的总有效率97.67%高于对照组的总有效率81.40%（P＜0.05）。治疗后，两组脑血管痉挛指数（VSI）、大脑中动脉平均流速（MCA-V_m）、大脑后动脉（PCA-V_m）、颈内动脉颅外段平均流速（VICA-V_m）下降（P＜0.05），且治疗组脑血流动力学指标低于对照组（P＜0.05）。治疗后，两组美国国立卫生研究院卒中量表（NIHSS）评分、改良Rankin量表（mRS）评分下降，简易精神状态量表（MMSE）、生活质量综合评定问卷（GQOLI-74）评分升高（P＜0.05），且治疗组NIHSS、mRS评分低于对照组，MMSE、GQOLI-74评分高于对照组（P＜0.05）。治疗后，两组血清可溶性Fms样酪氨酸激酶1（sFlt-1）、内皮素1（ET-1）、甘露聚糖结合凝集素（MBL）水平下降，血清富组氨酸糖蛋白（HRG）水平升高（P＜0.05），且治疗组血清sFlt-1、ET-1、MBL水平低于对照组，HRG水平高于对照组（P＜0.05）。结论 养血清脑颗粒联合盐酸法舒地尔注射液治疗蛛网膜下腔出血后脑血管痉挛可改善临床症状和脑血流动力学，调节血清生化指标。

Objective To observe the clinical efficacy of Yangxue Qingnao Granules combined with Fasudil Hydrochloride Injection in treatment of cerebral vasospasm after subarachnoid hemorrhage. Methods 86 Patients with cerebral vasospasm after subarachnoid hemorrhage admitted to Handan Central Hospital from February 2024 to February 2025 were selected as the study subjects. All patients were divided into control group (43 cases) and treatment group (43 cases) using a random number table method. The control group received iv administration of Fasudil Hydrochloride Injection, 30 mg each time dissolved in 100 mL physiological saline, twice daily. The treatment group received oral administration of Yangxue Qingnao Granules on the basis of the above treatment, 1 bag/time, 3 times daily. Two groups were treated for 14 days. The clinical efficacy, cerebral hemodynamics, disease improvement, and serum biochemical indicators of two groups were compared. Results The total effective rate of the treatment group was 97.67%, which was higher than 81.40% of the control group (P < 0.05). After treatment, the cerebral vasospasm index (VSI), mean velocity of the middle cerebral artery (MCA-V_m), posterior cerebral artery (PCA-V_m), and mean velocity of the extracranial segment of the internal carotid artery (VICA-V_m) decreased in two groups (P < 0.05), and the cerebral hemodynamic indicators in the treatment group were lower than those in the control group (P < 0.05). After treatment, the scores of the National Institutes of Health Stroke Scale (NIHSS) and the Modified Rankin Scale (mRS) in two groups decreased, while the scores of the Mini Mental State Scale (MMSE) and the Quality of Life Comprehensive Assessment Questionnaire (GQOLI-74) increased (P < 0.05). The NIHSS and mRS scores in the treatment group were lower than those in the control group, while the MMSE and GQOLI-74 scores were higher than those in the control group (P < 0.05). After treatment, the serum levels of soluble Fms like tyrosine kinase 1 (sFlt-1), endothelin-1 (ET-1), and mannan binding lectin (MBL) in two groups decreased, while the serum level of histidine rich glycoprotein (HRG) increased (P < 0.05). And the serum levels of sFlt-1, ET-1, and MBL in the treatment group were lower than those in the control group, while the serum level of HRG was higher than those in the control group (P < 0.05). Conclusion The combination of Yangxue Qingnao Granules and Fasudil Hydrochloride Injection can improve clinical symptoms and cerebral hemodynamics in treatment of cerebral vasospasm after subarachnoid hemorrhage, and regulate serum levels of biochemical indicators.

R971

河北省中医药类科学研究课题计划项目（2025400）