目的 探討芪龍膠囊聯(lián)合奧扎格雷鈉治療急性腦梗死的臨床研究。方法 選取2018年6月-2019年7月在安陽(yáng)市人民醫(yī)院住院治療的急性腦梗死患者127例為研究對(duì)象，所有患者隨機(jī)分成對(duì)照組（63例）和治療組（64例）。對(duì)照組患者iv奧扎格雷鈉注射液，80 mg/次，溶于5%葡萄糖溶液250 mL中，1次/d。治療組患者在對(duì)照組的基礎(chǔ)上口服芪龍膠囊，2粒/次，3次/d，飯前0.5 h服用。兩組均連續(xù)治療2周。觀察兩組的臨床療效，比較兩組治療前后改良愛(ài)丁堡-斯堪的納維亞卒中量表（MESSS）評(píng)分、血液流變學(xué)指標(biāo)、血清炎性因子水平的變化情況。結(jié)果 治療后，對(duì)照組總有效率85.71%，治療組總有效率96.88%，治療組總有效率顯著高于對(duì)照組（P<0.05）。治療后，兩組患者治療7、14 d的MESSS評(píng)分均顯著低于同組治療前水平（P<0.05）；治療7、14 d后，治療組的MESSS評(píng)分顯著低于對(duì)照組（P<0.05）。治療后，兩組患者血細(xì)胞比容、血小板聚集率、全血高切黏度、全血低切黏度均較治療前顯著降低（P<0.05）；治療后，治療組患者血液流變學(xué)指標(biāo)優(yōu)于對(duì)照組（P<0.05）。治療后，兩組患者白細(xì)胞介素6（IL-6）、腫瘤壞死因子α（TNF-α）、C反應(yīng)蛋白（CRP）水平均顯著降低（P<0.05）；治療后，治療組患者IL-6、TNF-α、CRP水平均低于對(duì)照組（P<0.05）。結(jié)論 芪龍膠囊聯(lián)合奧扎格雷鈉治療急性腦梗死具有較好的臨床療效，利于患者神經(jīng)功能的恢復(fù)，可有效改善血流變學(xué)及炎癥反應(yīng)情況，具有一定的臨床價(jià)值。

Objective To explore the clinical study of Qilong Capsules combined with ozagrel sodium in treatment of acute cerebral infarction. Methods A total of 127 patients with acute cerebral infarction who were hospitalized in Anyang People's Hospital from June 2018 to July 2019 were selected as the research subjects, and all patients were randomly divided into control group (63 cases) and treatment group (64 cases). Patients in the control group were iv administered with Sodium Ozagrel Injection, 80 mg/time, dissolved in 250 mL 5% glucose solution, once daily. Patients in the treatment group were po administered with Qilong Capsules half an hour before meals on the basis of the control group, 2 grains/time, 3 times daily. Both groups were treated continuously for 2 weeks. The clinical efficacy of the two groups was observed, and the changes of modified Edinburgh-Scandinavian Stroke Scale (MESSS) scores, hemorheology indexes and serum inflammatory factors were compared before and after treatment. Results After treatment, the total effective rate of the control group was 85.71%, the total effective rate of the treatment group was 96.88%, and the total effective rate of the treatment group was significantly higher than the control group (P<0.05). After treatment, the MESSS scores of 7 and 14 d of treatment in two groups were significantly lower than the level before treatment (P<0.05). After treatment, the MESSS scores of the treatment group were significantly lower than those of the control group on 7 and 14 d (P<0.05). After treatment, blood cell specific volume, platelet aggregation rate, whole blood high shear viscosity and whole blood low shear viscosity in two groups were significantly decreased compared with before treatment (P<0.05). After treatment, the hemorheological indexes in the treatment group were better than those in the control group (P<0.05). After treatment, the levels of IL-6, TNF-α, and CRP in two groups were significantly decreased (P<0.05). After treatment, the levels of IL-6, TNF-α, and CRP in treatment group were lower than those in control group (P<0.05). Conclusion Qilong Capsules combined with ozagrel sodium has good clinical effect in treatment of acute cerebral infarction, is beneficial to the recovery of patients' neurological function, and can effectively improve hemorheology and inflammatory response, which has certain clinical value.

R971

河南省醫(yī)學(xué)科學(xué)技術(shù)進(jìn)步獎(jiǎng)（2017-YJ-025-R01/15）