目的 探討川蛭通絡(luò)膠囊聯(lián)合硫酸氫氯吡格雷片治療腦梗死恢復(fù)期的應(yīng)用效果。方法 2023年1月—2024年7月珠海市中西醫(yī)結(jié)合醫(yī)院收治的102例腦梗死恢復(fù)期患者，以隨機(jī)數(shù)字表法分為治療組、對(duì)照組，每組51例。對(duì)照組以硫酸氫氯吡格雷片治療，每次口服75 mg，每日1次，治療組增加川蛭通絡(luò)膠囊治療，每次0.5 g，每日3次。治療后評(píng)估兩組臨床療效、神經(jīng)細(xì)胞因子、血液流變學(xué)、血小板功能指標(biāo)、量表評(píng)分和治療安全性。結(jié)果 治療組總有效率為92.16%，高于對(duì)照組的76.47%（P＜0.05）。治療后，兩組患者血清膠質(zhì)纖維酸性蛋白（GFAP）、中樞神經(jīng)特異性蛋白（S100β）、神經(jīng)元烯醇化酶（NSE）下降（P＜0.05）；治療組血清GFAP、S100β、NSE水平均低于對(duì)照組（P＜0.05）。治療后，兩組全血高切黏度、全血低切黏度、血漿黏度（PV）、纖維蛋白原（Fib）、血細(xì)胞比容（Hct）均明顯低于同組治療前（P＜0.05），且治療后治療組血液流變學(xué)指標(biāo)水平明顯優(yōu)于對(duì)照組（P＜0.05）。治療后，兩組患者血小板計(jì)數(shù)（PLT）、平均血小板體積（MPV）、血小板分布寬度（PDW）、血小板聚集指數(shù)（PAG）下降（P＜0.05）；治療后治療組患者血小板參數(shù)均低于對(duì)照組（P＜0.05）。治療后，兩組患者美國國立衛(wèi)生研究院腦卒中量表（NIHSS）評(píng)分較治療前顯著降低，腦卒中生活質(zhì)量量表（SS-QOL）評(píng)分升高（P＜0.05）；治療后治療組NIHSS評(píng)分低于對(duì)照組，SS-QOL評(píng)分高于對(duì)照組（P＜0.05）。結(jié)論 川蛭通絡(luò)膠囊聯(lián)合硫酸氫氯吡格雷片治療腦梗死恢復(fù)期效果良好，可降低神經(jīng)細(xì)胞因子，改善血液流變學(xué)，抑制血小板聚集，提高生活質(zhì)量。

Objective To investigate the efficacy and safety of Chuanzhi Tongluo Capsules combined with Clopidogrel Bisulfate Tablets in the treatment of cerebral infarction in the recovery period.Methods 102 Patients with cerebral infarction in the recovery period admitted to Zhuhai Hospital of Integrated Traditional Chinese and Western Medicine from January 2023 to July 2024 were randomly divided into treatment group and control group using random number table method, with 51 patients in each group. The control group treated with Clopidogrel Bisulfate Tablets, 75 mg orally once a day, while the treatment group was treated with Chuanzhi Tongluo Capsules on basis of control group, 0.5 g orally three times daily. Evaluate the clinical efficacy, neuronal cytokines, hemorheology, platelet function indicators, scale scores, and treatment safety of two groups after treatment.Results The total effective rate of treatment group was 92.16%, which was higher than 76.47% of control group (P < 0.05). After treatment, the levels of serum GFAP, S100β, and NSE in both groups decreased (P < 0.05). The levels of serum GFAP, S100β and NSE in treatment group were all lower than those in the control group (P < 0.05). After treatment, the whole blood high shear viscosity, whole blood low shear viscosity, PV, Fib, and Hct in both groups were significantly lower than those before treatment in the same group (P < 0.05), and the levels of hemorheological indicators in the treatment group after treatment were significantly better than those in the control group (P < 0.05). After treatment, PLT, MPV, PDW, and PAG of both groups decreased (P < 0.05). After treatment, the platelet parameters in the treatment group were all lower than those in the control group (P < 0.05). After treatment, NIHSS scores of two groups of patients were significantly lower than those before the treatment, and SS-QOL scores were increased (P < 0.05). After treatment, the NIHSS score of treatment group was lower than that of control group, and the SS-QOL score was higher than that of control group (P < 0.05).Conclusion The combination of Chuanzhi Tongluo Capsules and Clopidogrel Bisulfate Tablets has a good therapeutic effect on the recovery period of cerebral infarction. It can reduce the levels of brain injury markers, improve blood viscosity, inhibit platelet aggregation, improve prognosis scores, and has good treatment safety.

R971

廣東省衛(wèi)健委醫(yī)學(xué)科學(xué)技術(shù)研究基金資助項(xiàng)目（A2023113）