目的 探討腦絡(luò)通膠囊與尤瑞克林聯(lián)合治療急性腦梗死的臨床效果。方法 選取2017年12月—2020年12月太和縣人民醫(yī)院收治的104例急性腦梗死患者，隨機分為對照組和治療組，每組各52例。對照組靜脈滴注注射用尤瑞克林，1瓶/次，每次將0.15 PNA單位溶于100 mL生理鹽水，滴速1 mL/min，1次/d。在對照組基礎(chǔ)上，治療組口服腦絡(luò)通膠囊，1 g/次，3次/d。兩組患者治療2周。觀察兩組患者臨床療效，比較治療前后兩組患者血液流變學參數(shù)血漿黏度（PV）、紅細胞變形指數(shù)（EDI）和紅細胞聚集指數(shù)（EAI），腦血流動力學參數(shù)血流阻力指數(shù)（RI）、平均流速（V_mean）、最大流速（V_max）及最小流速（V_min），NIHSS評分，及血清內(nèi)皮素-1（ET-1）、丙二醛（MDA）、金屬基質(zhì)蛋白酶-9（MMP-9）和神經(jīng)元特異性烯醇化酶（NSE）水平。結(jié)果 治療后，治療組臨床有效率（94.23%）較對照組（80.77%）顯著提高（P＜0.05）。與治療前對比，治療后兩組NIHSS評分及PV和EAI均顯著降低（P＜0.05），EDI顯著升高（P＜0.05），均以治療組的改善更顯著（P＜0.05）。與治療前相比，治療后兩組RI均顯著降低（P＜0.05），V_mean、V_max和V_min則均顯著增大（P＜0.05），且治療組對以上腦血流動力學參數(shù)的改善效果較同期對照組更顯著（P＜0.05）。治療后，兩組血清ET-1、MDA、MMP-9和NSE濃度比治療前均顯著下降（P＜0.05），以治療組的改善更顯著（P＜0.05）。結(jié)論 急性腦梗死采取腦絡(luò)通膠囊與尤瑞克林聯(lián)合治療的效果確切，能有效改善患者腦部血流循環(huán)，糾正血管內(nèi)皮功能紊亂，減輕機體炎癥及氧化應(yīng)激損傷，保護腦組織，促進神經(jīng)功能恢復。

Objective To investigate the clinical effect of Naoluotong Capsules combined with ureikelin in treatment of acute cerebral infarction. Methods Patients (104 cases) with acute cerebral infarction in Taihe County People's Hospital from December 2017 to December 2020 were randomly divided into control and treatment group, and each had 52 cases. Patients in the control group were iv administered with Urinary Kallidinogenase for injection, 1 bottle/time, dissolved 0.15 PNA unit in 100 mL normal saline at a dripping rate of 1 mL/min each time, once daily. Patients in the treatment group were po administered with Naoluotong Capsules on the basis of the control group, 1 g/time, three times daily. Patients in two groups were treated for 2 weeks. After treatment, the clinical evaluation was evaluated, the hemorheological parameters PV, EDI and EAI, cerebral hemodynamic parameters V_mean, V_max,V_min and RI, and NIHSS scores, and the levels of serum ET-1, MDA, MMP-9 and NSE in two groups before and after treatment were compared. Results After treatment, the clinical effective rate of the treatment group (94.23%) was significantly higher than that of the control group (80.77%) (P < 0.05). Compared with before treatment, NIHSS score, PV and EAI were significantly decreased, and EDI was significantly increased in two groups after treatment (P < 0.05). Compared with before treatment, RI in two groups were significantly decreased, while V_mean, V_max and V_min were significantly increased in two groups (P < 0.05). The improvement of the above cerebral hemodynamic parameters in the treatment group was more significant than that in the control group (P < 0.05). After treatment, the concentrations of serum ET-1, MDA, MMP-9, and NSE in two groups were significantly lower than those before treatment (P < 0.05), especially in the treatment group (P < 0.05). Conclusion The combination of Naoluotong Capsules and urinary kallidinogenase is effective in treatment of acute cerebral infarction. It can effectively improve cerebral blood circulation, correct vascular endothelial dysfunction, reduce inflammation and oxidative stress injury, and protect brain tissue. promote the recovery of neurological function.

R971

阜陽市科技局課題(FK202081080)