目的 探究養(yǎng)血清腦顆粒聯(lián)合注射用尿激酶治療急性缺血性腦血管病的臨床療效。方法 選擇2014年5月—2017年5月上海市同仁醫(yī)院收治急性缺血性腦血管病的患者128例，將所有患者采用隨機(jī)數(shù)字表法分為對(duì)照組和治療組，每組各64例。對(duì)照組靜脈滴注注射用尿激酶，100萬(wàn)U（發(fā)病時(shí)間>3 h：劑量為150萬(wàn)U）加入到0.9%氯化鈉溶液100 mL中，滴注30 min內(nèi)完成。治療組在對(duì)照組基礎(chǔ)上口服養(yǎng)血清腦顆粒，4 g/次，3次/d。兩組患者均治療2周。觀察兩組的臨床療效，比較兩組的血液流變學(xué)、凝血功能和血管內(nèi)皮功能。結(jié)果 治療后，對(duì)照組和治療組的總有效率分別為75.00%、92.19%，兩組比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，兩組全血黏度（WBV）、血漿黏度（PV）、血細(xì)胞比容（HCT）、紅細(xì)胞沉降率（ESR）、紅細(xì)胞聚集指數(shù)（RF）水平均顯著降低，同組治療前后比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）；且治療組這些觀察指標(biāo)明顯低于對(duì)照組，兩組比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，兩組凝血酶原時(shí)間（PT）、部分凝血活酶時(shí)間（APTT）、凝血酶時(shí)間（TT）水平均顯著升高，纖維蛋白原（FIB）水平顯著下降，同組治療前后比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）；且治療組這些觀察指標(biāo)的改善程度明顯優(yōu)于對(duì)照組，兩組比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，兩組血管內(nèi)皮生長(zhǎng)因子（VEGF）、一氧化氮（NO）水平均顯著升高，內(nèi)皮素-1（ET-1）水平顯著降低，同組治療前后比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）；且治療組這些觀察指標(biāo)的改善程度明顯優(yōu)于對(duì)照組，兩組比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。結(jié)論 養(yǎng)血清腦顆粒聯(lián)合注射用尿激酶治療急性缺血性腦血管病具有較好的臨床療效，可改善患者的血液流變學(xué)、凝血功能及血管內(nèi)皮細(xì)胞功能，具有一定的臨床推廣使用價(jià)值。

Objective To investigate the clinical efficacy of Yangxue Qingnao Granules combined with Urokinase for injection in treatment of acute ischemic cerebrovascular disease. Methods Patients (128 cases) with acute ischemic cerebrovascular disease in Shanghai Tongren Hospital from May 2014 to May 2017 were randomly divided into control and treatment groups, and each group had 64 cases. Patients in the control group were iv administered with Urokinase for injection, 1 million U (When the time of onset was more than 3 h, the dose was 1 million 500 thousand U) added into normal saline 100 mL, complete infusion within 30 min. Patients in the treatment group were po administered with Yangxue Qingnao Granules on the basis of the control group, 4 g/time, three times daily. Patients in two groups were treated for 2 weeks. After treatment, the clinical efficacies were evaluated, and hemorheology, coagulation function, and vascular endothelial cell function in two groups were compared. Results After treatment, the clinical efficacies in the control and treatment groups were 75.00% and 92.19%, respectively, and there was difference between two groups (P < 0.05). After treatment, the levels of WBV, PV, HCT, ESR, and RF in two groups were significantly decreased, and the difference was statistically significant in the same group (P < 0.05). And the observational indexes in the treatment group were significantly lower than those in the control group, with significant difference between two groups (P < 0.05). After treatment, the levels of PT, APTT, and TT in two groups were significantly increased, but the levels of FIB in two groups were significantly decreased, and the difference was statistically significant in the same group (P < 0.05). And the observational indexes in the treatment group were significantly better than those in the control group, with significant difference between two groups (P < 0.05). After treatment, the levels of VEGF and NO in two groups were significantly increased, but the levels of ET-1 in two groups were significantly decreased, and the difference was statistically significant in the same group (P < 0.05). And the observational indexes in the treatment group were significantly better than those in the control group, with significant difference between two groups (P < 0.05). Conclusion Yangxue Qingnao Granules combined with Urokinase for injection has clinical curative effect in treatment of acute ischemic cerebrovascular disease, can improve hemorheology, coagulation function, and vascular endothelial cell function, which has a certain clinical application value.