目的 探討龍生蛭膠囊聯(lián)合阿加曲班治療急性腦梗死的臨床療效。方法 選取2019年1月-2020年4月天津市中醫(yī)藥大學(xué)附屬南開中醫(yī)院收治的急性腦梗死患者146例，隨機分為對照組和治療組，每組各73例。對照組靜脈滴注阿加曲班注射液，60 mg加入生理鹽水500 mL，持續(xù)24 h，3~7 d后調(diào)整為20 mg加入生理鹽水100 mL，持續(xù)2~3 h，2次/d。治療組患者在對照組的基礎(chǔ)上，口服龍生蛭膠囊治療，5粒/次，療程為2周。觀察兩組患者臨床療效，比較治療前后兩組患者生活質(zhì)量、神經(jīng)功能缺損評分（NIHSS）、Barthel指數(shù)（BI）評分、勁動脈斑塊，及鈣調(diào)素（CAM）、腫瘤壞死因子-α（TNF-α）、正五聚體蛋白-3（PTX-3）、生長分化因子-15（GDF-15）和白細胞介素-6（1L-6）水平。結(jié)果 治療后，治療組的總有效率為93.15%，明顯高于對照組的79.45%（P<0.05）。治療后，兩組生理功能、情感功能和社會功能評分較治療前的明顯升高（P<0.05），治療組升高更明顯（P<0.05）。兩組患者在治療的第7天、第14天，NIHSS評分與BI評分較治療前明顯改善（P<0.05），治療組在治療的第14天，NIHSS評分與BI評分明顯好于對照組（P<0.05）；與對照組相比，治療組IMT厚度和斑塊面積降低更為顯著（P<0.05）。治療后，兩組CAM、TNF-α、PTX-3、GDF-15和1L-6水平較治療前顯著降低（P<0.05），而且與對照組相比，治療組下降更為明顯（P<0.05）。結(jié)論 龍生蛭膠囊聯(lián)合阿加曲班治療急性腦梗死效果顯著，能夠有效的提高患者的生活質(zhì)量，降低神經(jīng)功能缺損的嚴重程度和斑塊面積，有效的改善臨床指標。

Objective To investigate the curative effect of Longshengzhi Capsules combined with argatroban in treatment of ischemic stroke. Methods Patients (146) with ischemic stroke in Nankai Hospital of Traditional Chinese Medicine Affiliated to Tianjin University of Traditional Chinese Medicine from January 2019 to April 2020 were randomly divided into control and treatment groups, and each group had 73 cases. Patients in the control group were iv administered with Argatroban Injection, 60 mg added into normal saline 500 mL for 24 h, then adjusted the dose to 20 mg added into normal saline 100 mL for 2-3 h after 3-7 d, twice daily. Patients in the treatment group were po administered with Longshengzhi Capsules on the basis of the control group, 5 grains/time, the course of treatment was 2 weeks. After treatment, the clinical efficacy was evaluated, and the quality of life, NIHSS score, BI score, carotid plaque, and the levels of CAM, TNF-α, PTX-3, GDF-15, and IL-6 in two groups before and after treatment were compared. Results After treatment, the clinical effective rate of the treatment group was 93.15%, which was significantly higher than that of the control group (79.45%) (P<0.05). After treatment, the scores of physiological function, emotional function and social function in the two groups were significantly higher than those before treatment (P<0.05), especially in the treatment group (P<0.05). The NIHSS score and BI score in the two groups were significantly improved on the 7th and 14th day after treatment (P<0.05). On the 14th day of treatment, the NIHSS score and BI score of the treatment group were significantly better than those of the control group (P<0.05). Compared with the control group, the IMT thickness and plaque area in the treatment group decreased more significantly (P<0.05). After treatment, the levels of CAM, TNF-α, PTX-3, GDF-15, and IL-6 in the two groups were significantly lower than those before treatment (P<0.05), and the levels in the treatment group were more significantly lower than those in the control group (P<0.05). Conclusion The effect of Longshengzhi Capsules combined with argatroban in treatment of ischemic stroke is significant, can effectively improve the quality of life, reduce the severity of neurological impairment and plaque area, effectively improve clinical indicators.

R971

天津市醫(yī)藥衛(wèi)生科技發(fā)展計劃基金資助項目（20162011）