目的 探討芪血通絡(luò)片聯(lián)合巴曲酶注射液治療急性腦梗死的臨床效果。方法 以2018年1月—2020年5月在開封市中心醫(yī)院進行治療的124例急性腦梗死患者為研究對象，根據(jù)住院號的奇偶性分為治療組（62例）和對照組（62例）。對照組給予巴曲酶注射液，首次10 BU巴曲酶注射液與0.9%氯化鈉注射液100 mL配伍，隔日一次，維持量為5 BU，隔日一次靜脈滴注；治療組除了給予巴曲酶注射液外還給予口服芪血通絡(luò)片，4片/次，3次/d。均治療14 d進行療效對比。同時對比兩組患者BI評分、ADL評分、MoCA評分、血清新蝶呤（Npt）、單核細胞趨化蛋白-1（MCP-1）、親環(huán)素A（CyPA）、可溶性血管細胞黏附分子-1（sVCAM-1）、基質(zhì)金屬蛋白酶-9（MMP-9）水平，血液流變學(xué)指標及腦血流動力學(xué)指標。結(jié)果 治療后，治療組在有效率上優(yōu)于對照組（96.77%比80.65%，P<0.05）。治療后，兩組NIHSS評分、mRS評分顯著降低，但ADL評分、MoCA評分、BI評分顯著升高（P<0.05）；且治療后治療組NIHSS評分、mRS評分低于對照組，而ADL評分、MoCA評分、BI評分高于對照組（P<0.05）。治療后，兩組血清Npt、MCP-1、CyPA、MMP-9、sVCAM-1水平均降低，且以治療組降低更顯著（P<0.05）。治療后，兩組Q_mean、V_mean顯著增加，但DR、ZCV及R顯著降低（P<0.05）；治療后，治療組Q_mean、V_mean高于對照組，但DR、ZCV及R顯著低于對照組（P<0.05）。治療后，兩組患者HCT、WBV、FIB及PV均明顯降低（P<0.05）；且治療后，治療組血流流變學(xué)指標低于對照組（P<0.05）。結(jié)論 急性腦梗死在給予巴曲酶注射液治療的同時還進行口服芪血通絡(luò)片不僅促進機體細胞因子改善，還促進腦血流動力學(xué)和血液流變學(xué)指標的改善，有利于腦神經(jīng)功能恢復(fù)，促進患者對認知功能的恢復(fù)，提高其生活質(zhì)量，有著很高應(yīng)用價值。

Objective To explore the clinical effect of Qixue Tongluo Tablets combined with batroxobin in treatment of acute cerebral infarction. Methods Patients (124 cases) with acute cerebral infarction in Kaifeng Central Hospital from January 2018 to May 2020 were randomly divided into control (62 cases) and treatment (62 cases) groups. Patients in the control group were iv administered with Batroxobin Injection, 10 BU added into normal saline 100 mL for the first time, and the maintain dose was 5 BU, once every two days. Patients in the treatment group were po administered with Qixue Tongluo Tablets on the basis of the control group, 4 tablets/time, three times daily. Patients in two groups were treated for 14 d. After treatment, the clinical efficacy was evaluated, and the BI scores, ADL scores, MoCA scores, the serum levels of Npt, MCP-1, CyPA, MMP-9 and sVCAM-1, Qmean, Vmean, DR, ZCV and R, and the levels of HCT, WBV, FIB and PV in two groups before and after treatment were compared. Results After treatment, the clinical efficacy in the control group was 80.65%, which was significantly lower than 96.77% in the treatment group, and there were differences between two groups (P<0.05). After treatment, NIHSS score and mRS score in both groups were significantly decreased, but ADL score, MoCA score and BI score were significantly increased (P<0.05). After treatment, NIHSS and mRS scores in the treatment group were lower than those in the control group, while ADL, MoCA and BI scores were higher than those in the control group (P<0.05). After treatment, serum Npt, MCP-1, CyPA, MMP-9, and sVCAM-1 levels in the two groups were all decreased, and the decrease was more significant in the treatment group (P<0.05). After treatment, Q_mean and V_mean were significantly increased in both groups, but DR, ZCV and R were significantly decreased (P<0.05). After treatment, Q_mean and V_mean of the treatment group were higher than those of the control group, but DR, ZCV and R were significantly lower than those of the control group (P<0.05). After treatment, HCT, WBV, FIB and PV were significantly reduced in both groups (P<0.05). After treatment, the blood flow rheology indexes of the treatment group were lower than those of the control group (P<0.05). Conclusion Qixue Tongluo Tablets combined with batroxobin in treatment of acute cerebral infarction can effectively improve the level of cytokines, promote the improvement of cerebral hemodynamics and hemorheology indicators, benefit to the recovery of brain nerve and cognitive function, and improve the quality of life.

R971

河南省科學(xué)技術(shù)項目（182102310445）