目的 探討天智顆粒聯(lián)合長春西汀注射液治療腦梗死恢復期的臨床療效。方法 選擇2019年9月—2020年9月在河南省直第三人民醫(yī)院治療的82例腦梗死恢復期患者，根據(jù)入院先后分為對照組（41例）和治療組（41例）。對照組靜脈滴注長春西汀注射液，初始劑量20 mg加入生理鹽水500 mL，根據(jù)病情增至30 mg，1次/d。治療組在對照組基礎上口服天智顆粒，5 g/次，3次/d。兩組均治療14 d。觀察兩組患者臨床療效，比較治療前后兩組患者臨床癥狀改善時間，NIHSS、FMA、ADL和MSS評分，血清泛素羧基末端水解酶-1（UCH-L1）、白細胞介素-23（IL-23）、神經元特異性烯醇化酶（NSE）、促血管生成素Ⅱ（Ang-2）和血管內皮生長因子（VEGF）水平。結果 經治療，對照組總有效率為80.49%，顯著低于治療組的97.56%（P<0.05）。治療后，治療組癥狀改善時間均早于對照組（P<0.05）。經治療，兩組NIHSS評分、FMA評分、ADL評分、MSS評分均顯著改善（P<0.05），且治療組改善最明顯（P<0.05）。經治療，兩組患者血清UCH-L1、IL-23和Ang-2水平顯著降低，而NSE和VEGF水平顯著升高（P<0.05），且治療組血清學指標水平明顯好于對照組（P<0.05）。結論 天智顆粒聯(lián)合長春西汀注射液治療腦梗死恢復期可有效改善患者臨床癥狀，促進腦神經功能及血清細胞因子的改善，有利于增強患者生活活動能力和運動功能。

Objective To investigate the clinical effect of Tianzhi Granules combined with vinpocetine in treatment of cerebral infarction in convalescent stage. Methods Patients (82 cases) with cerebral infarction in convalescent stage in the Third People's Hospital of Henan Province from September 2019 to September 2020 were divided into control (41 cases) and treatment (41 cases) groups based on visiting order. Patients in the control group were iv administered with Vinpocetine Injection, the initial dose was 20 mg added into 500 mL normal saline, and increased to 30 mg according to patient's condition, once daily. Patients in the treatment group were po administered with Tianzhi Granules on the basis of the control group, 5 g/time, three times daily. Patients in two groups were treated for 14 d. After treatment, the clinical efficacy was evaluated, and the improvement time of clinical symptoms, the scores of NIHSS, FMA, ADL and MSS, and the serum levels of UCH-L1, IL-23, Ang-2, NSE, and VEGF in two groups before and after treatment were compared. Results After treatment, the effective rate in the control group was 80.49%, which was significantly lower than 97.56% in the treatment group (P<0.05). After treatment, the improvement time of clinical symptoms in the treatment group was significantly earlier than that in the control group (P<0.05). After treatment, NIHSS score, FMA score, ADL score and MSS score in two groups were significantly improved (P<0.05), and especially in the treatment group (P<0.05). After treatment, the serum levels of UCH-L1, IL-23 and Ang-2 in two groups were significantly decreased, while the levels of NSE and VEGF were significantly increased (P<0.05), and the level of serum indexes in the treatment group was significantly better than that in the control group (P<0.05). Conclusion Tianzhi Granules combined with vinpocetine in treatment of cerebral infarction in convalescent stage can effectively improve the clinical symptoms, promote the improvement of brain nerve function and serum cytokines, which is conducive to enhance the living activity and motor function of patients.

R971

河南省醫(yī)學科技攻關計劃項目（201702177）