目的 探究川蛭通絡膠囊聯(lián)合替羅非班對48 h內腦梗死急性期患者的治療效果。方法 選取2022年6月—2023年6月在淄博市中心醫(yī)院治療的急性腦梗死患者103例，根據(jù)患者治療方案分成對照組（51例）和治療組（52例）。對照組靜脈滴注鹽酸替羅非班注射液，初始滴注速度0.4 µg/(kg∙min)，滴注30 min，隨后按0.1 µg/(kg∙min)的速度連續(xù)給藥；治療組在對照組基礎上口服川蛭通絡膠囊，2粒/次，3次/d。兩組患者治療14 d。觀察兩組患者臨床療效，比較治療前后兩組患者中醫(yī)證候評分、巴氏指數(shù)（Barthel）評分和美國國立衛(wèi)生研究院卒中量表（NIHSS）評分及血清超氧化物歧化酶（SOD）、谷胱甘肽過氧化酶（GSH-Px）、過氧化氫酶（CAT）、CX3C基序趨化因子配體1（CX3CL1）、堿性成纖維細胞生長因子（bFGF）和分揀蛋白（Sortilin）水平。結果 治療后，對照組和治療組臨床總有效率分別為78.43%和94.23%，兩組比較差異具有統(tǒng)計學意義（P＜0.05）。治療后，兩組患者中醫(yī)證候和NIHSS評分顯著下降，而Barthel指數(shù)評分則顯著升高（P＜0.05），且治療組評分明顯好于對照組（P＜0.05）。治療后，兩組患者氧化應激指標SOD、GSH-Px、CAT和bFGF水平顯著升高，而CX3CL1和Sortilin水平顯著降低（P＜0.05），且治療組在所有指標的改善上表現(xiàn)尤為突出（P＜0.05）。結論 川蛭通絡膠囊聯(lián)合替羅非班治療48 h內腦梗死急性期患者療效顯著，不僅能夠顯著改善患者神經(jīng)功能和獨立生活能力，同時還能夠促進血清學指標的恢復并有效改善氧化應激損害。

Objective To explore the therapeutic effect of Chuanzhi Tongluo Capsules combined with tirofiban in treatment of acute cerebral infarction within 48 h. Methods Patients (103 cases) with acute cerebral infarction in Zibo Central Hospital from June 2022 to June 2023 were divided into control (51 cases) and treatment (52 cases) group based on different treatments. Patients in the control group were administered with Tirofiban Hydrochloride Injection, the initial drip speed was 0.4 µg/(kg∙min) for 30 min, then the drug was administered continuously at a rate of 0.1 µg/(kg∙min). Patients in the treatment group were po administered with Chuanzhi Tongluo Capsules on the basis of the control group, 2 grains/time, three times daily. Patients in two groups were treated for 14 d. After treatment, the clinical evaluations were evaluated, the scores of TCM syndrome, Barthel index, and NIHSS, the levels of serum SOD, GSH-Px, CAT, CX3CL1, bFGF and Sortilin in two groups before and after treatment were compared. Results After treatment, the total clinical effective rate of the control group and the treatment group was 78.43% and 94.23% respectively, and the difference between the two groups was statistically significant (P < 0.05). After treatment, the TCM syndrome and NIHSS score in two groups were significantly decreased, while the Barthel index score was significantly increased (P < 0.05), and the scores of the treatment group was significantly better than that of the control group (P < 0.05). After treatment, the levels of oxidative stress indexes SOD,GSH-Px, CAT and bFGF in two groups were significantly increased, while the levels of CX3CL1 and Sortilin were significantly decreased (P < 0.05), and the improvement of all indexes in the treatment group was particularly prominent (P < 0.05). Conclusion The combination of Chuanzhi Tongluo Capsules and tirofiban has a significant therapeutic effect on the acute phase of cerebral infarction within 48 h, which can not only significantly improve the patient's neurological function and independent living ability, but also promote the recovery of serological indicators and effectively improve oxidative stress damage.

R971