摘要：
Objective To investigate the clinical efficacy of Xueshuan Xinmaining Capsules combined with Nimodipine Injection in treatment of acute cerebral infarction. Methods Patients (200 cases) with acute cerebral infarction in Inner Mongolia Forestry General Hospital from January 2016 to December 2018 were randomly divided into control (102 cases) and treatment (98 cases) groups.Patients in the control group were iv administered with Nimodipine Injection, 12 mg added into 5％ Glucose Injection 500 mL, once daily. Patients in the treatment group were po administered with Xueshuan Xinmaining Capsules on the basis of the control group, 4 grains/time, three times daily. Patients in two groups were treated for 15 d. After treatment, the clinical efficacy was evaluated, and the NIHSS scores, CSS scores, BI, hemorheological indexes, and the levels of s100β, VE-cadherin, TpP, VEGF, CRP and NO in two groups were compared. Results After treatment, the clinical efficacies in the control and treatment groups were 78.43％ and 96.94％, respectively, and there was difference between two groups (P<0.05). After treatment, NIHSS and CSS in two groups were significantly decreased, but BI were significantly increased, and there were differences in the same group (P<0.05). And the scores in the treatment group after treatment were significantly better than those in the control group, with significant difference between two groups (P<0.05). After treatment, the whole blood viscosity of low-shear, high-shear, and plasma in two groups were significantly decreased, and the difference was statistically significant in the same group (P<0.05). And hemorheological indexes in the treatment group after treatment were significantly lower than those in the control group, with significant difference between two groups (P<0.05). After treatment, the levels of s100β, VE-cadherin, and TpP in two groups were significantly decreased, and the difference was statistically significant in the same group (P<0.05). And those indexes in the treatment group after treatment were significantly lower than those in the control group, with significant difference between two groups (P<0.05). After treatment, VEGF and NO levels in two groups were significantly increased, but CRP levels were significantly decreased, and there were differences in the same group (P<0.05).And the VEGF and NO levels in the treatment group after treatment were significantly higher than those in the control group, but CRP levels were significantly lower than those in the control group, with significant difference between two groups (P<0.05). Conclusion Xueshuan Xinmaining Capsules combined with Nimodipine Injection has good clinical efficacy in treatment of acute cerebral infarction, can promote the recovery of nerve function, improve the hemorheological indexes, and reduce inflammatory level, which has a certain clinical application value.%目的 探讨血栓心脉宁胶囊联合尼莫地平注射液治疗急性脑梗死的临床疗效.方法 选取2016年1月—2018年12月在内蒙古林业总医院进行治疗的200例急性脑梗死患者为研究对象,将所有患者随机分为对照组(102例)和治疗组(98例).对照组患者静脉滴注尼莫地平注射液,12 mg加入5％葡萄糖注射液500 mL中,1次/d.治疗组患者在对照组治疗的基础上口服血栓心脉宁胶囊,4粒/次,3次/d.两组患者均连续治疗15 d.观察两组患者的临床疗效,比较两组的美国国立卫生研究院卒中量表评分(NIHSS)、中国卒中量表评分(CSS)、Barthel指数评估量表评分(BI)、血液流变学指标、中枢神经特异蛋白(s100β)、血管内皮细胞钙黏蛋白(VE-cadherin)、血栓前体蛋白(TpP)、血管内皮生长因子(VEGF)、C反应蛋白(CRP)和一氧化氮(NO)水平.结果 治疗后,对照组和治疗组的总有效率分别为78.43％、96.94％,两组总有效率比较差异具有统计学意义(P<0.05).治疗后,两组患者NIHSS、CSS评分均显著降低,BI评分显著升高,同组治疗前后比较差异具有统计学意义(P<0.05);且治疗后,治疗组相关评分明显优于对照组,两组比较差异具有统计学意义(P<0.05).治疗后,两组低切全血黏度、高切全血黏度、血浆黏度均显著降低,同组治疗前后比较差异具有统计学意义(P<0.05);且治疗后,治疗组血液流变学指标水平明显低于对照组,两组比较差异具有统计学意义(P<0.05).治疗后,两组s100β、VE-cadherin和TpP水平均显著降低,同组治疗前后比较差异具有统计学意义(P<0.05);且治疗后,治疗组上述指标明显低于对照组,两组比较差异具有统计学意义(P<0.05).治疗后,两组血清VEGF、NO水平均显著升高,CRP显著降低,同组治疗前后比较差异具有统计学意义(P<0.05);且治疗后,治疗组VEGF、NO水平明显高于对照组,而CRP水平低于对照组,两组比较差异具有统计学意义(P<0.05).结论 血栓心脉宁胶囊联合尼莫地平注射液治疗急性脑梗死具有较好的临床疗效,可促进患者神经功能恢复,改善血液流变学指标,降低炎性水平,具有一定的临床推广应用价值.
