目的 探討脈絡(luò)寧口服液聯(lián)合氯吡格雷治療腦梗死恢復(fù)期的臨床療效。方法 選取2019年3月—2022年3月太和縣人民醫(yī)院收治的82例腦梗死恢復(fù)期患者，按照隨機(jī)數(shù)字表法分為對(duì)照組和治療組，每組各41例。對(duì)照組口服硫酸氫氯吡格雷片，75 mg/次，1次/d。治療組在對(duì)照組基礎(chǔ)上口服脈絡(luò)寧口服液，20 mL/次，3次/d。兩組均連續(xù)治療8周。觀察兩組臨床療效，比較治療前后兩組相關(guān)量表[腦卒中專門化生存質(zhì)量量表（SS-QOL）、美國國立衛(wèi)生研究院卒中量表（NIHSS）、改良Barthel指數(shù)（MBI）]評(píng)分，血栓前狀態(tài)指標(biāo)[纖維蛋白原（FIB）、血小板最大聚集率（MAR）、血小板激活復(fù)合物-1（PAC-1）]，以及血清腫瘤壞死因子（TNF）-α、可溶性細(xì)胞間黏附分子-1（sICAM-1）、血管內(nèi)皮生長因子（VEGF）、神經(jīng)元特異性烯醇化酶（NSE）水平。結(jié)果 治療后，治療組總有效率為92.7%，顯著高于對(duì)照組的75.6%（P＜0.05）。與治療前相比，兩組治療后SS-QOL、MBI評(píng)分均顯著增加，NIHSS評(píng)分則均顯著降低（P＜0.05）；且治療后，治療組相關(guān)量表評(píng)分的改善效果均顯著優(yōu)于對(duì)照組（P＜0.05）。治療后，兩組血漿FIB、PAC-1、MAR均顯著低于治療前（P＜0.05），且均以治療組血栓前狀態(tài)指標(biāo)（FIB、PAC-1、MAR）的降低更顯著（P＜0.05）。相比治療前，兩組治療后血清TNF-α、sICAM-1、NSE水平均顯著下降，血清VEGF水平則均顯著上升（P＜0.05）；且均以治療組改善更顯著（P＜0.05）。結(jié)論 脈絡(luò)寧口服液聯(lián)合氯吡格雷治療腦梗死恢復(fù)期的整體療效確切，能有效促進(jìn)患者神經(jīng)功能和生活能力的恢復(fù)，提高生存質(zhì)量，并可進(jìn)一步糾正血栓前狀態(tài)以及良性調(diào)控血中TNF-α、sICAM-1、VEGF水平，且安全性好。

Objective To investigate the clinical effect of Mailuoning Oral Liquid combined with clopidogrel in treatment of cerebral infarction convalescence period. Methods A total of 82 convalesce cerebral infarction patients admitted to Taihe County People’s Hospital from March 2019 to March 2022 were selected and divided into control group and treatment group according to random number table method, with 41 cases in each group. Patients in the control group were po administered with Clopidogrel Hydrogen Sulphate Tablets, 75 mg/time, once daily. Patients in the treatment group were po administered with Mailuoning Oral Liquid on the basis of the control group, 20 mL/time, three times daily. Patients in two groups were treated for 8 weeks. After treatment, the clinical efficacy was evaluated, the scores of related scales [Stroke Specialized Quality of Life (SS-QOL), National Institutes of Health Stroke Scale (NIHSS), Modified Barthel Index (MBI)] scores, prethrombotic state indicators [fiber Proprotein (FIB), maximum platelet aggregation rate (MAR), platelet activation complex-1 (PAC-1)], and serum tumor necrosis factor-α (TNF-α), soluble intercellular adhesion molecule-1 (sICAM-1), vascular endothelial growth factor (VEGF), neuron-specific enolase (NSE) levels in two groups before and after treatment were compared. Results After treatment, the total effective rate of the treatment group was 92.7%, significantly higher than that of the control group (75.6%) (P < 0.05). Compared with before treatment, SS-QOL and MBI scores were significantly increased after treatment, while NIHSS scores were significantly decreased in both groups (P < 0.05). After treatment, the improvement effect of relevant scale scores in the treatment group was significantly better than that in the control group (P < 0.05). After treatment, plasma FIB, PAC-1, and MAR in two groups were significantly lower than before treatment (P < 0.05), and the reduction of pre-thrombotic status indexes (FIB, PAC-1 and MAR) in the treatment group was more significant (P < 0.05). Compared with before treatment, the serum levels of TNF-α, sICAM-1, and NSE in two groups were significantly decreased after treatment, while the serum levels of VEGF were significantly increased (P < 0.05). The improvement was more significant in treatment group (P < 0.05). Conclusion Mailuoning Oral Liquid combined with clopidogrel has a definite overall effect in treatment of convalescent cerebral infarction, and can effectively promote the recovery of neurological function and living ability, improve the quality of life, and can further correct the prethrombotic state and benign regulation of blood TNF-α, sICAM-1, VEGF expression with good safety.

R971

太和縣科技局科研課題（2019-08）