目的 研究安宮牛黃丸聯(lián)合阿加曲班注射液治療急性腦梗死的臨床療效。方法 選取2017年10月-2019年10月在河南中醫(yī)藥大學(xué)第三附屬醫(yī)院治療的120例急性腦梗死患者為研究對(duì)象，將所有患者隨機(jī)分為對(duì)照組和治療組，每組各60例。對(duì)照組患者靜脈泵注阿加曲班注射液，10 mg溶于100 mL生理鹽水，持續(xù)靜脈泵注3 h，2次/d。治療組在對(duì)照組基礎(chǔ)上口服安宮牛黃丸，1丸/次，1次/d。兩組患者接受治療時(shí)間為4周。觀察兩組的臨床療效，比較兩組Barthel指數(shù)、美國(guó)國(guó)立衛(wèi)生研究院卒中量表（NHISS）評(píng)分、大腦平均血流速度和血液學(xué)指標(biāo)[神經(jīng)元特異性烯醇化酶（NSE）、腦源性神經(jīng)營(yíng)養(yǎng)因子（BDNF）、超敏C反應(yīng)蛋白（hs-CRP）、腫瘤壞死因子-α（TNF-α）和白細(xì)胞介素-8（IL-8）]。結(jié)果 治療后，治療組總有效率（95.00%）顯著高于對(duì)照組（83.33%）（P<0.05）。治療后，兩組Barthel指數(shù)顯著升高，NHISS評(píng)分顯著降低（P<0.05）；且治療組Barthel指數(shù)、NHISS評(píng)分改善較明顯（P<0.05）。治療后，兩組患者大腦中動(dòng)脈、大腦前動(dòng)脈、大腦后動(dòng)脈的平均血流速度均明顯升高（P<0.05）；且治療組患者平均血流速度升高較明顯（P<0.05）。治療后，兩組患者血清NSE水平明顯降低，BDNF水平明顯升高（P<0.05）；且治療組血清NSE、BDNF水平改善較明顯（P<0.05）。治療后，兩組患者血清hs-CRP、TNF-α、IL-8水平明顯降低（P<0.05）；且治療組患者血清hs-CRP、TNF-α和IL-8水平均降低較為明顯（P<0.05）。結(jié)論 安宮牛黃丸聯(lián)合阿加曲班注射液治療急性腦梗死具有較好的臨床療效，能夠改善患者神經(jīng)功能和生活質(zhì)量，調(diào)節(jié)血液學(xué)指標(biāo)，值得在臨床上推廣應(yīng)用。

Objective To study the efficacy of Angong Niuhuang Pills combined with Argatroban Injection in treatment of acute cerebral infarction. Methods Patients (120 cases) with acute cerebral infarction in the Third Affiliated Hospital of Henan University of Traditional Chinese Medicine from October 2017 to October 2019 were randomly divided into control and treatment groups, and each group had 60 cases. Patients in the control group were given Argatroban Injection, 10 mg added into normal saline 100 mL, continuous intravenous pumping for 3 h, twice daily. Patients in the treatment group were po administered with Angong Niuhuang Pills on the basis of the control group, 1 pill/time, once daily. Patients in two groups were treated for 4 weeks. After treatment, the clinical efficacies were evaluated, and Barthel index, NHISS scores, mean cerebral blood flow velocity, and serum indexes (serum levels of NSE, BDNF, hs-CRP, TNF-α, and IL-8) in two groups were compared. Results After treatment, the total effective rate of the treatment group (95.00%) was significantly higher than that of the control group (83.33%) (P<0.05). After treatment, Barthel index score was significantly increased in the two groups, but NHISS score was significantly decreased in the two groups (P<0.05). And the improvement of score scores in the treatment group was significant (P<0.05). After treatment, the mean blood flow velocity of middle cerebral artery, anterior cerebral artery and posterior cerebral artery in two groups were significantly increased (P<0.05). And the improvement of mean blood flow velocity in the treatment group was significant (P<0.05). After treatment, the serum levels of NSE in two groups were significantly decreased, but the serum levels of BDNF were significantly increased (P<0.05). And the improvement of serum levels in the treatment group was significant (P<0.05). After treatment, the serum levels of hs-CRP, TNF-α, and IL-8 in two groups were significantly decreased (P<0.05). And the serum inflammation indexes in the treatment group were significantly lower than those in the control group (P<0.05). Conclusion Angong Niuhuang Pills combined with Argatroban Injection has clinical curative effect in treatment of acute cerebral infarction, can improve the neurological function and quality of life of patients, regulate the serum index, which has a certain clinical application value.

R971

河南省中醫(yī)藥科學(xué)研究專項(xiàng)課題（2014ZY02096）