目的 探讨乐脉颗粒联合氯吡格雷治疗急性脑卒中恢复期患者的临床疗效及对患者神经功能、血管生成及炎症因子水平的影响。方法 回顾性纳入2020年10月—2021年3月于南阳市中心医院神经内科治疗的142例急性脑卒中恢复期患者作为研究对象，根据治疗方式不同将患者分为对照组和试验组，每组各71例。对照组患者给予硫酸氢氯吡格雷片口服，50 mg/次，1次/d；试验组在对照组的基础上口服乐脉颗粒，3 g/次，3次/d。两组患者均治疗1个月。比较两组临床疗效，比较两组患者治疗前后美国国立卫生研究院卒中量表（NIHSS）评分、脑卒中患者专用生活质量量表（SS-QOL）评分及血清血管内皮生长因子（VEGF）、血管生成素-I（Ang-I）、白细胞介素-17（IL-17）、转化生长因子-β（TGF-β）水平，观察两组治疗期间不良反应发生情况。结果 治疗后，对照组和试验组总有效率分别为85.92%和97.18%，与对照组比较，试验组总有效率显著升高（P<0.05）。治疗后，两组NIHSS评分和血清IL-17水平均较治疗前显著下降，SS-QOL评分及血清 VEGF、Ang-I和TGF-β水平均较治疗前显著升高，差异均具有统计学意义（P<0.05）；与对照组比较，治疗后试验组 NIHSS评分和IL-17水平均显著下降，SS-QOL评分、VEGF、Ang-I和TGF-β水平均显著升高，差异均具有统计学意义（P<0.05）。对照组和试验组不良反应总发生率分别为11.27%和16.90%，两组比较差异无统计学意义（P>0.05）。结论 乐脉颗粒联合氯吡格雷治疗急性脑卒中恢复期患者疗效更好，能有效改善患者神经功能并提高生活质量，可能机制与促进血管生成及调节Th17/Treg细胞平衡有关。

Objective To investigate the clinical efficacy of Lemai Granule combined with clopidogrel in the treatment of convalescent patients with acute stroke and its effects on neurological function, angiogenesis and inflammatory factors. Methods Total 142 convalescent patients with acute stroke treated in the Department of Neurology of Nanyang Central Hospital from October 2020 to March 2021 were included retrospectively. According to different treatment methods, the patients were divided into control group and experimental group, with 71 cases in each group. The patients in the control group were given Clopidogrel Bisulfate Tablets orally, 50 mg/time, once a day. The patients in the experimental group took Lemai Granule orally on the basis of the control group, 3 g/time, three times/d. Both groups were treated for one month. The clinical effects of the two groups were compared. The scores of National Institutes of Health Stroke Scale (NIHSS), special quality of life scale for stroke patients (SS-QOL), serum vascular endothelial growth factor (VEGF), angiopoietin-I (Ang-I), interleukin-17 (IL-17) and transforming growth factor-β (TGF-β) were compared before and after treatment. Results After treatment, the total effective rates of the control group and the experimental group were 85.92% and 97.18% respectively. Compared with the control group, the total effective rate of the treatment group was significantly higher (P<0.05). After treatment, NIHSS score and serum IL-17 level in the two groups were significantly lower than those before treatment, and SS-QOL score, serum VEGF, Ang-I and TGF-β levels were significantly higher than those before treatment (P<0.05). Compared with the control group, the NIHSS score and IL-17 level in the experimental group decreased significantly after treatment, and the SS-QOL score, VEGF, Ang-I and TGF-β levels increased significantly (P<0.05). The total incidence of adverse reactions in the control group and the experimental group were 11.27% and 16.90% respectively, and there was no significant difference between the two groups (P>0.05). Conclusion Lemai Granule combined with clopidogrel is more effective in the treatment of convalescent patients with acute stroke. It can effectively improve neurological function and quality of life. The possible mechanism is related to promoting angiogenesis and regulating Th17/Treg cell balance.

R971