目的 探討樂脈顆粒聯(lián)合氯吡格雷治療急性腦卒中恢復(fù)期患者的臨床療效及對患者神經(jīng)功能、血管生成及炎癥因子水平的影響。方法 回顧性納入2020年10月—2021年3月于南陽市中心醫(yī)院神經(jīng)內(nèi)科治療的142例急性腦卒中恢復(fù)期患者作為研究對象，根據(jù)治療方式不同將患者分為對照組和試驗組，每組各71例。對照組患者給予硫酸氫氯吡格雷片口服，50 mg/次，1次/d；試驗組在對照組的基礎(chǔ)上口服樂脈顆粒，3 g/次，3次/d。兩組患者均治療1個月。比較兩組臨床療效，比較兩組患者治療前后美國國立衛(wèi)生研究院卒中量表（NIHSS）評分、腦卒中患者專用生活質(zhì)量量表（SS-QOL）評分及血清血管內(nèi)皮生長因子（VEGF）、血管生成素-I（Ang-I）、白細(xì)胞介素-17（IL-17）、轉(zhuǎn)化生長因子-β（TGF-β）水平，觀察兩組治療期間不良反應(yīng)發(fā)生情況。結(jié)果 治療后，對照組和試驗組總有效率分別為85.92%和97.18%，與對照組比較，試驗組總有效率顯著升高（P<0.05）。治療后，兩組NIHSS評分和血清IL-17水平均較治療前顯著下降，SS-QOL評分及血清 VEGF、Ang-I和TGF-β水平均較治療前顯著升高，差異均具有統(tǒng)計學(xué)意義（P<0.05）；與對照組比較，治療后試驗組 NIHSS評分和IL-17水平均顯著下降，SS-QOL評分、VEGF、Ang-I和TGF-β水平均顯著升高，差異均具有統(tǒng)計學(xué)意義（P<0.05）。對照組和試驗組不良反應(yīng)總發(fā)生率分別為11.27%和16.90%，兩組比較差異無統(tǒng)計學(xué)意義（P>0.05）。結(jié)論 樂脈顆粒聯(lián)合氯吡格雷治療急性腦卒中恢復(fù)期患者療效更好，能有效改善患者神經(jīng)功能并提高生活質(zhì)量，可能機(jī)制與促進(jìn)血管生成及調(diào)節(jié)Th17/Treg細(xì)胞平衡有關(guān)。

Objective To investigate the clinical efficacy of Lemai Granule combined with clopidogrel in the treatment of convalescent patients with acute stroke and its effects on neurological function, angiogenesis and inflammatory factors. Methods Total 142 convalescent patients with acute stroke treated in the Department of Neurology of Nanyang Central Hospital from October 2020 to March 2021 were included retrospectively. According to different treatment methods, the patients were divided into control group and experimental group, with 71 cases in each group. The patients in the control group were given Clopidogrel Bisulfate Tablets orally, 50 mg/time, once a day. The patients in the experimental group took Lemai Granule orally on the basis of the control group, 3 g/time, three times/d. Both groups were treated for one month. The clinical effects of the two groups were compared. The scores of National Institutes of Health Stroke Scale (NIHSS), special quality of life scale for stroke patients (SS-QOL), serum vascular endothelial growth factor (VEGF), angiopoietin-I (Ang-I), interleukin-17 (IL-17) and transforming growth factor-β (TGF-β) were compared before and after treatment. Results After treatment, the total effective rates of the control group and the experimental group were 85.92% and 97.18% respectively. Compared with the control group, the total effective rate of the treatment group was significantly higher (P<0.05). After treatment, NIHSS score and serum IL-17 level in the two groups were significantly lower than those before treatment, and SS-QOL score, serum VEGF, Ang-I and TGF-β levels were significantly higher than those before treatment (P<0.05). Compared with the control group, the NIHSS score and IL-17 level in the experimental group decreased significantly after treatment, and the SS-QOL score, VEGF, Ang-I and TGF-β levels increased significantly (P<0.05). The total incidence of adverse reactions in the control group and the experimental group were 11.27% and 16.90% respectively, and there was no significant difference between the two groups (P>0.05). Conclusion Lemai Granule combined with clopidogrel is more effective in the treatment of convalescent patients with acute stroke. It can effectively improve neurological function and quality of life. The possible mechanism is related to promoting angiogenesis and regulating Th17/Treg cell balance.

R971