目的 探討樂脈顆粒聯(lián)合吲哚布芬片治療急性腦梗死的臨床療效。方法 選取2019年1月—2021年12月在中國人民解放軍聯(lián)勤保障部隊第九八八醫(yī)院就診的96例急性腦梗死患者，根據(jù)隨機數(shù)字表法將96例患者分為對照組和治療組，每組各48例。對照組口服吲哚布芬片，100 mg/次，1次/d。治療組在對照組基礎(chǔ)上溫水沖服樂脈顆粒，6 g/次，3次/d。兩組患者連續(xù)治療4周。觀察兩組的臨床療效，比較兩組的神經(jīng)功能缺損評分、頸總動脈血流動力學(xué)指標和血清中基質(zhì)金屬蛋白酶-9（MMP-9）、白細胞介素-17（IL-17）、Toll樣受體4（TLR4）水平。結(jié)果 治療后，治療組的總有效率為95.83%，明顯高于對照組總有效率81.25%，組間比較差異有統(tǒng)計學(xué)意義（P＜0.05）。治療后，兩組患者的神經(jīng)功能缺損評分較治療前降低（P＜0.05），且治療組神經(jīng)功能缺損評分小于對照組（P＜0.05）。治療后，兩組頸總動脈平均血流速度（V_m）、平均血流量（Q_m）高于治療前，動態(tài)阻力（DR）低于治療前（P＜0.05）；治療組的頸總動脈V_m、Q_m高于對照組，DR低于對照組（P＜0.05）。治療后，兩組的血清MMP-9、IL-17、TLR4水平較治療前降低（P＜0.05）；治療組的血清MMP-9、IL-17、TLR4水平低于對照組，差異有統(tǒng)計學(xué)意義（P＜0.05）。結(jié)論 樂脈顆粒聯(lián)合吲哚布芬片治療急性腦梗死的療效確切，可改善神經(jīng)功能和頸總動脈血流動力學(xué)指標，降低炎癥損傷，且安全性良好。

Objective To investigate the effect of Lemai Granules combined with Indobufen Tablets in treatment of acute cerebral infarction.Methods Patients (96 cases) with acute cerebral infarction in PLA Joint Logistic Support Force 988 Hospital from January 2019 to February 2021 were divided into control and treatment groups according to the random number table method,and each group had 48 cases.Patients in the control group were po administered with Indobufen Tablets,100 mg/time,once daily.Patients in the treatment group were po administered with Lemai Granules on the basis of the control group,6 g/time,three times daily.Patients in two groups were treated for 4 weeks.After treatment,the clinical efficacies were evaluated,and neurological deficit score,common carotid artery hemodynamics,and the serum levels of MMP-9,IL-17,and TLR4 in two groups were compared.Results After treatment,the total effective rate of the treatment group was 95.83%,which was significantly higher than that of the control group (81.25%),and there was significant difference between two groups (P<0.05).After treatment,the neurological deficit score of two groups was lower than that before treatment (P<0.05),and the neurological deficit score of the treatment group was lower than that of the control group (P<0.05).After treatment,V_m and Q_m of common carotid artery in two groups were higher than before treatment,but DR in two groups was lower than before treatment (P<0.05).V_m and Q_m of common carotid artery in the treatment group were higher than those in the control group,but DR in the treatment group was lower than that in the control group (P<0.05).After treatment,the serum levels of MMP-9,IL-17,and TLR4 in two groups were significantly lower than those before treatment (P<0.05),and the serum levels of MMP-9,IL-17,and TLR4 in the treatment group were significantly lower than those in the control group (P<0.05).Conclusion Lemai Granules combined with Indobufen Tablets has definite curative effect in treatment of acute cerebral infarction,can improve neurological function and common carotid hemodynamic indexes,reduce inflammatory injury,with good safety.

R971

河南省醫(yī)學(xué)科技攻關(guān)計劃項目(2018020855)