目的 探討丹燈通腦膠囊聯(lián)合長春西汀治療腦梗死恢復(fù)期的臨床效果。方法 選取2018年1月—2019年6月北京懷柔醫(yī)院收治的100例腦梗死恢復(fù)期患者，隨機分為對照組和治療組，每組各50例。對照組口服長春西汀片，5 mg/次，3次/d，餐時服用。治療組在對照組基礎(chǔ)上口服丹燈通腦膠囊，4粒/次，3次/d。兩組均連續(xù)治療8周。比較兩組臨床療效，治療前后微循環(huán)相關(guān)指標[血小板最大聚集率（MAR）、血漿黏度（PV）、紅細胞變形指數(shù)（RDI）、纖維蛋白原（FIB）、D-二聚體（D-D）]、腦血流動力學(xué)參數(shù)[大腦中動脈平均血流速度（V_m）、阻力指數(shù)（RI）]、相關(guān)量表[美國國立衛(wèi)生院卒中量表（NIHSS）、腦卒中自我效能問卷（SSEQ）]評分及血清超氧化物歧化酶（SOD）、丙二醛（MDA）、髓鞘堿性蛋白（MBP）水平變化。結(jié)果 治療組總有效率90.0%顯著高于對照組74.0%，兩組總有效率比較差異有統(tǒng)計學(xué)意義（P<0.05）。兩組治療后MAR、PV、血漿FIB、D-D水平均顯著低于治療前（P<0.05），但RDI均顯著升高（P<0.05）；治療后，治療組以上微循環(huán)相關(guān)指標的改善效果均更顯著（P<0.05）。兩組治療后大腦中動脈V_m、SSEQ總分均顯著增多（P<0.05），但大腦中動脈RI和NIHSS評分均顯著降低（P<0.05）；但治療后，治療組大腦中動脈V_m、RI及NIHSS評分、SSEQ總分的改善效果均顯著優(yōu)于對照組（P<0.05）。治療后，兩組血清SOD水平較治療前均顯著增高（P<0.05），而血清MDA、MBP水平均顯著下降（P<0.05）；但治療組這些指標改善更顯著（P<0.05）。結(jié)論 丹燈通腦膠囊聯(lián)合長春西汀治療腦梗死恢復(fù)期的整體療效良好，能進一步改善機體微循環(huán)，糾正腦循環(huán)障礙，減輕體內(nèi)氧化應(yīng)激，恢復(fù)損傷神經(jīng)功能，提高患者自我效能感，具有一定的臨床推廣應(yīng)用價值.

Objective To investigate the clinical effect of Dandeng Tongnao Capsules combined with vinpocetine in treatment of convalescent period of cerebral infarction. Methods A total of 100 patients with convalescent period of cerebral infarction admitted to Beijing Huairou Hospital from January 2018 to June 2019 were randomly divided into control group (n=50) and treatment group (n=50). The control group was po administered with Vinpocetine Tablets, 5 mg/time, three times daily. The treatment group was po administered with Dandeng Tongnao Capsules on the basis of the control group, 4 grains/time, three times daily. All patients were treated for 8 weeks. The clinical efficacy was compared between the two groups. The changes of microcirculation related indicators [maximal platelet aggregation rate (MAR), plasma viscosity (PV), red blood cell deformation index (RDI), fibrinogen (FIB), D-dimer (D-D)], cerebral hemodynamic parameters [mean middle cerebral artery mean blood flow velocity (V_m), resistance index (RI)], related scale [National Institute of Health Stroke Scale (NIHSS), Stroke Self-Efficacy Questionnaire (SSEQ)] score and serum superoxide dismutase (SOD), malondialdehyde (MDA), myelin basic protein (MBP) before and after treatment in two groups were compared. Results The total effective rate of the treatment group 90.0% was significantly higher than that of the control group 74.0%, and there were differences between two groups (P<0.05). After treatment, MAR, PV, FIB and D-D levels in both groups were significantly lower than before treatment (P<0.05), but RDI levels were significantly higher in both groups (P<0.05). After treatment, the improvement of microcirculation-related indicators was more significant in the treatment group and above (P<0.05). The V_m of the middle cerebral artery and SSEQ scores in two groups increased significantly after treatment (P<0.05), but RI of the middle cerebral artery and NIHSS scores decreased significantly (P<0.05). However, after treatment, the improvement effect of V_m, RI, NIHSS score and SSEQ score in the treatment group was significantly better than that in the control group (P<0.05). After treatment, the serum SOD level in both groups increased significantly compared with that before treatment (P<0.05), while the serum MDA and MBP levels decreased significantly (P<0.05). However, these indicators improved more significantly in the treatment group (P<0.05). Conclusion Dandeng Tongnao Capsules combined with vinpocetine has good overall efficacy in treatment of convalescent period of cerebral infarction, and can further improve the microcirculation of the body, correct the circulation disorder of the brain, and also can reduce the oxidative stress in the body, restore the damaged nerve function, and improve the self-efficacy of patients, which has a certain clinical application value.

R971