目的 探索腦栓通膠囊聯(lián)合腦苷肌肽治療急性腦梗死的療效觀察。方法 選取2017年5月-2019年6月洛陽市第一中醫(yī)院收治的急性腦梗死患者144例，隨機(jī)分成對(duì)照組和治療組，每組各72例。對(duì)照組患者靜脈滴注腦苷肌肽注射液，20 mL加入生理鹽水250 mL，1次/d。治療組患者在對(duì)照組的基礎(chǔ)上口服腦栓通膠囊，3粒/次，3次/d。兩組患者均治療14 d。觀察兩組患者臨床療效，同時(shí)比較治療前后兩組患者腦血流動(dòng)力學(xué)、脂蛋白相關(guān)磷脂酶A2（Lp-PLA2）和血栓彈力圖指標(biāo)。結(jié)果 治療后，對(duì)照組和治療組臨床有效率分別為70.83%和87.50%，兩組比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，兩組患者平均血流量（Q_m）和平均血流速度（V_m）、水平均明顯上升（P<0.05），而外周阻力（Rv）和動(dòng)態(tài)阻力（DR）水平顯著降低（P<0.05），且治療組明顯優(yōu)于對(duì)照組（P<0.05）。治療后，兩組患者Lp-PLA2和血栓彈力圖指標(biāo)中血細(xì)胞凝集塊形成速率（α）和最大血塊強(qiáng)度（MA）明顯降低（P<0.05），兩組患者血栓彈力圖指標(biāo)中凝血反應(yīng)時(shí)間（R）和血細(xì)胞凝集塊形成時(shí)間（K）明顯提高（P<0.05），且治療組患者明顯好于對(duì)照組（P<0.05）。結(jié)論 腦栓通膠囊聯(lián)合腦苷肌肽注射液治療急性腦梗死，可明顯提高臨床療效，改善腦血流動(dòng)力學(xué)指標(biāo)，降低血清Lp-PLA2水平，優(yōu)化血栓彈力圖指標(biāo)。

Objective To explore the clinical efficacy of Naoshuantong Capsules combined with cattle encephalon glycoside and ignotin in treatment of acute cerebral infarction. Methods Patients (72 cases) with acute cerebral infarction in Luoyang Hospital of TCM from May 2017 to June 2019 were randomly divided into control and treatment groups, and each group had 72 cases. Patients in the control group were iv administered with Cattle Encephalon Glycoside and Ignotin Injection, 20 mL added into normal saline 250 mL, once daily. Patients in the treatment group were po administered with Naoshuantong Capsules on the basis of the control group, 3 grains/time, three times daily. Patients in two groups were treated for 14 d. After treatment, the clinical efficacy was evaluated, and the cerebral hemodynamics, Lp-PLA2 and thromboelastography indexes in two groups before and after treatment were compared. Results After treatment, the clinical efficacy and in the control and treatment groups was 70.83% and 87.50% respectively, and there were differences between two groups (P<0.05). After treatment, the Q_m and V_m levels in two groups were significantly increased (P<0.05), but the Rv and DR levels were significantly decreased (P<0.05), and these indexes in the treatment group were significantly better than those in the control group (P<0.05). After treatment, the Lp-PLA2, α and MA of thromboelastography in two groups were significantly decreased (P<0.05), but the R and Kof thromboelastography were significantly increased (P<0.05), and these indicators in the treatment group were significantly better than those in the control group (P<0.05). Conclusion Naoshuantong Capsules combined with cattle encephalon glycoside and ignotin in treatment of acute cerebral infarction can obviously improve the clinical efficacy, improve cerebral hemodynamic indexes, reduce the levels of serum Lp-PLA2, and optimize the thromboelastogram indexes.

R971

洛陽市醫(yī)療衛(wèi)生科技計(jì)劃項(xiàng)目（1940006A）