目的 探討腦梗死恢復期應用心腦寧膠囊聯(lián)合長春西汀治療的臨床效果。方法 選取2015年3月—2019年4月北京京煤集團總醫(yī)院收治的92例腦梗死恢復期患者，隨機分為對照組和治療組。對照組口服長春西汀片，1片/次，3次/d，飯后服用。治療組在對照組基礎上口服心腦寧膠囊，3粒/次，3次/d。兩組均連續(xù)治療3個月。對比兩組臨床療效；治療前后評估兩組患者神經(jīng)功能缺損情況[美國國立衛(wèi)生研究院卒中量表（NIHSS）]、日常生活活動能力[改良Barthel指數(shù)（MBI）]及生活質量狀況[Spitzer生活質量指數(shù)（SQLI）]，檢測患者大腦中動脈血流動力學狀態(tài)，測定血栓前狀態(tài)相關指標[全血高切及低切黏度（HBV和LBV）、纖維蛋白原（FIB）、α顆粒膜蛋白-140（GMP-140）]及血清白介素（IL）-1β、神經(jīng)元特異性烯醇化酶（NSE）水平。結果 治療組總有效率為91.3%，顯著高于對照組76.1%（P<0.05）。與治療前相比，兩組治療后NIHSS評分均顯著降低（P<0.05），MBI、SQLI評分則均顯著升高（P<0.05）；但治療組治療后相關量表（NIHSS、MBI、SQLI）評分的改善效果均較對照組同期更顯著（P<0.05）。與治療前對比，兩組治療后大腦中動脈平均血流速度（V_m）均顯著增快（P<0.05），而阻力指數(shù)（RI）、搏動指數(shù)（PI）值均顯著降低（P<0.05）；且治療后，治療組大腦中動脈相關血流參數(shù)的改善效果均更顯著（P<0.05）。兩組治療后HBV、LBV及血漿FIB、GMP-140濃度和血清IL-1β、NSE水平均顯著低于治療前（P<0.05），且治療組上述指標改善更顯著（P<0.05）。結論 心腦寧膠囊聯(lián)合長春西汀治療腦梗死恢復期的整體療效確切，可明顯改善患者腦血流動力學，糾正血栓前狀態(tài)，減輕機體炎癥反應，促進患者神經(jīng)功能的恢復，具有一定的臨床推廣應用價值。

Objective To investigate the clinical effect of Xinnaoning Capsules combined with vinpocetine in treatment of cerebral infarction in convalescence. Methods 92 Cerebral infarction convalescent patients admitted to Beijing Coal Group General Hospital from March 2015 to April 2019 were selected and randomly divided into control group (n=46) and treatment group (n=46). The control group was po administered with Vinpocetine Tablets, 1 tablet/time, three times daily. The treatment group was po administered with Xinnaoning Capsules on the basis of the control group, 3 grains/time, three times daily. All patients were treated for 3 months. The clinical effects of the two groups were compared. Before and after treatment, neurological deficits (NIHSS), activities of daily living (MBI), and quality of life (SQLI) of the two groups were evaluated, and the hemodynamic state of the middle cerebral artery of the subjects was detected. The related indexes of prethrombotic state (HBV and LBV), fibrinogen (FIB), α granule membrane protein -140(GMP-140), serum interleukin (IL)-1β, neuron-specific enolase (NSE) levels were measured. Results The total effective rate of the treatment group was 91.3%, significantly higher than that of the control group 76.1% (P<0.05). Compared with before treatment, NIHSS scores in both groups decreased significantly after treatment (P<0.05), but MBI and SQLI scores increased significantly (P<0.05). However, the improvement effect of related scales (NIHSS, MBI, and SQLI) scores in the treatment group was more significant than that in the control group (P<0.05). Compared with before treatment, after treatment, the mean blood flow velocity (V_m) of middle cerebral artery in both groups increased significantly (P<0.05), while the resistance index (RI) and pulsatility index (PI) decreased significantly (P<0.05). After treatment, the improvement effect of blood flow parameters related to middle cerebral artery in the treatment group was more significant (P<0.05). After treatment, the concentrations of HBV, LBV, plasma FIB, GMP-140, serum IL-1β, NSE in the two groups were significantly lower than before treatment (P<0.05), and the above indexes in the treatment group were improved more significantly (P<0.05). Conclusion Xinnaoning Capsules combined with vinpocetine is effective in the treatment of cerebral infarction in convalescence, and can effectively improve the cerebral blood circulation disorder, and can correct the prethrombotic state of the body, antagonize the inflammatory reaction in antibodies, promote the recovery of neurological function, which has a certain clinical application value.

R971