脑络通胶囊联合尤瑞克林治疗急性脑梗死的临床研究

目的 探讨脑络通胶囊与尤瑞克林联合治疗急性脑梗死的临床效果。方法 选取2017年12月—2020年12月太和县人民医院收治的104例急性脑梗死患者，随机分为对照组和治疗组，每组各52例。对照组静脉滴注注射用尤瑞克林，1瓶/次，每次将0.15 PNA单位溶于100 mL生理盐水，滴速1 mL/min，1次/d。在对照组基础上，治疗组口服脑络通胶囊，1 g/次，3次/d。两组患者治疗2周。观察两组患者临床疗效，比较治疗前后两组患者血液流变学参数血浆黏度（PV）、红细胞变形指数（EDI）和红细胞聚集指数（EAI），脑血流动力学参数血流阻力指数（RI）、平均流速（V_mean）、最大流速（V_max）及最小流速（V_min），NIHSS评分，及血清内皮素-1（ET-1）、丙二醛（MDA）、金属基质蛋白酶-9（MMP-9）和神经元特异性烯醇化酶（NSE）水平。结果 治疗后，治疗组临床有效率（94.23%）较对照组（80.77%）显著提高（P＜0.05）。与治疗前对比，治疗后两组NIHSS评分及PV和EAI均显著降低（P＜0.05），EDI显著升高（P＜0.05），均以治疗组的改善更显著（P＜0.05）。与治疗前相比，治疗后两组RI均显著降低（P＜0.05），V_mean、V_max和V_min则均显著增大（P＜0.05），且治疗组对以上脑血流动力学参数的改善效果较同期对照组更显著（P＜0.05）。治疗后，两组血清ET-1、MDA、MMP-9和NSE浓度比治疗前均显著下降（P＜0.05），以治疗组的改善更显著（P＜0.05）。结论 急性脑梗死采取脑络通胶囊与尤瑞克林联合治疗的效果确切，能有效改善患者脑部血流循环，纠正血管内皮功能紊乱，减轻机体炎症及氧化应激损伤，保护脑组织，促进神经功能恢复。

Clinical study on Naoluotong Capsules combined with ureikelin in treatment of acute cerebral infarction

Objective To investigate the clinical effect of Naoluotong Capsules combined with ureikelin in treatment of acute cerebral infarction. Methods Patients (104 cases) with acute cerebral infarction in Taihe County People''s Hospital from December 2017 to December 2020 were randomly divided into control and treatment group, and each had 52 cases. Patients in the control group were iv administered with Urinary Kallidinogenase for injection, 1 bottle/time, dissolved 0.15 PNA unit in 100 mL normal saline at a dripping rate of 1 mL/min each time, once daily. Patients in the treatment group were po administered with Naoluotong Capsules on the basis of the control group, 1 g/time, three times daily. Patients in two groups were treated for 2 weeks. After treatment, the clinical evaluation was evaluated, the hemorheological parameters PV, EDI and EAI, cerebral hemodynamic parameters V_mean, V_max,V_min and RI, and NIHSS scores, and the levels of serum ET-1, MDA, MMP-9 and NSE in two groups before and after treatment were compared. Results After treatment, the clinical effective rate of the treatment group (94.23%) was significantly higher than that of the control group (80.77%) (P < 0.05). Compared with before treatment, NIHSS score, PV and EAI were significantly decreased, and EDI was significantly increased in two groups after treatment (P < 0.05). Compared with before treatment, RI in two groups were significantly decreased, while V_mean, V_max and V_min were significantly increased in two groups (P < 0.05). The improvement of the above cerebral hemodynamic parameters in the treatment group was more significant than that in the control group (P < 0.05). After treatment, the concentrations of serum ET-1, MDA, MMP-9, and NSE in two groups were significantly lower than those before treatment (P < 0.05), especially in the treatment group (P < 0.05). Conclusion The combination of Naoluotong Capsules and urinary kallidinogenase is effective in treatment of acute cerebral infarction. It can effectively improve cerebral blood circulation, correct vascular endothelial dysfunction, reduce inflammation and oxidative stress injury, and protect brain tissue. promote the recovery of neurological function.