目的 探討腦絡(luò)通膠囊聯(lián)合依達(dá)拉奉治療急性腦梗死的臨床效果。方法 選取2016年7月-2019年7月巴彥淖爾市醫(yī)院收治的86例急性腦梗死患者，隨機(jī)分為對照組（n=43）和治療組（n=43）。對照組靜脈滴注依達(dá)拉奉注射液，30 mg加入100 mL生理鹽水中充分稀釋后給藥，0.5 h內(nèi)滴完，2次/d。治療組患者在對照組基礎(chǔ)上口服腦絡(luò)通膠囊治療，2粒/次，3次/d。兩組均連續(xù)治療2周。觀察兩組的臨床療效，比較兩組治療前后美國國立衛(wèi)生研究院卒中量表（NIHSS）評分、單胺類神經(jīng)遞質(zhì)[5-羥色胺（5-HT）、去甲腎上腺素（NE）]、C反應(yīng)蛋白（CRP）、血清氧化應(yīng)激指標(biāo)、血清顱腦損傷標(biāo)志物的變化情況。結(jié)果 治療組總有效率95.3%較對照組81.4%顯著增高（P<0.05）。與治療前比較，兩組治療后NIHSS評分、5-HT、NE、CRP均顯著降低（P<0.05）；但治療組下降更顯著（P<0.05）。兩組治療后血清丙二醛（MDA）、8-羥基脫氧鳥苷（8-OHdG）水平均顯著低于治療前（P<0.05），而超氧化物歧化酶（SOD）水平均顯著增高（P<0.05）；且治療后，治療組這些血清氧化應(yīng)激相關(guān)指標(biāo)水平均顯著優(yōu)于對照組同期（P<0.05）。兩組治療后血清中樞神經(jīng)特異性蛋白（S100β）、基質(zhì)金屬蛋白酶（MMP）-9及神經(jīng)元特異性烯醇化酶（NSE）水平均較治療前顯著下降（P<0.05）；并均以治療組顱腦損傷各項(xiàng)標(biāo)志物的改善效果更為顯著（P<0.05）。結(jié)論 腦絡(luò)通膠囊聯(lián)合依達(dá)拉奉治療急性腦梗死具有較好的臨床療效，可明顯減輕患者顱腦損傷，抑制體內(nèi)氧化應(yīng)激，糾正相關(guān)單胺類神經(jīng)遞質(zhì)的代謝紊亂，降低機(jī)體炎癥反應(yīng)，促進(jìn)神經(jīng)功能恢復(fù)，具有一定的臨床推廣應(yīng)用價(jià)值。

Objective To investigate the clinical effect of Capsules combined with edaravone in treatment of acute cerebral infarction. Methods 86 Patients with acute cerebral infarction admitted to Bayannur City Hospital from July 2016 to July 2019 were randomly divided into control group (n=43) and treatment group (n=43). The control group was iv administered with Edaravone Injection, 30 mg added into normal saline 100 mL and diluted it thoroughly before giving the drug, and drop it within 0.5 h, twice daily. The treatment group was po administered with Naoluotong Capsules, 2 grains/time, three times daily. All patients were treated for 2 weeks. The clinical efficacy of two groups was observed, and the changes of NIHSS score, 5-HT, NE, CRP, serum oxidative stress indicators, and serum markers of craniocerebral injury before and after treatment were compared. Results The total effective rate of the treatment group 95.3% was significantly higher than that of the control group 81.4% (P<0.05). Compared with before treatment, NIHSS score, 5-HT, NE and CRP in both groups were significantly decreased after treatment (P<0.05). However, the reduction was more significant in the treatment group (P<0.05). The serum levels of MDA and 8-OHdG in both groups were significantly lower than those before treatment (P<0.05), but the levels of SOD were significantly higher in both groups (P<0.05). After treatment, these serum oxidative stress related indicators in the treatment group were significantly better than those in the control group (P<0.05). Serum levels of S100, MMP-9 and NSE in both groups decreased significantly after treatment (P<0.05). The improvement effect of various markers of craniocerebral injury in the treatment group was more significant (P<0.05). Conclusion Naoluotong Capsules combined with edaravone has good clinical efficacy in treatment of acute cerebral infarction, and can significantly reduce the brain injury of patients, and can inhibit the oxidative stress, correct the metabolic disorder of related monoamine neurotransmitters, and also can reduce the body's inflammatory response, and promote the recovery of nerve function, which has a certain clinical application value.

R971