2023 年第 8 期 第 18 卷

益气通络颗粒联合氯吡格雷对缺血性脑血管病伴认知功能障碍患者的疗效研究

Study on the curative efficacy of Yiqi Tongluo granules combined with clopidogrel in patients with ischemic cerebrovascular disease accompanied by cognitive dysfunction

作者：史慧敏鲍军强

英文作者：Shi Huimin Bao Junqiang

单位：河北医科大学第一医院神经内科，石家庄050031

英文单位：Department of Neurology the First Hospital of Hebei Medical University Shijiazhuang 050031 China

关键词：缺血性脑血管病；益气通络颗粒；氯吡格雷；认知功能障碍

英文关键词：Ischemiccerebrovasculardisease;YiqiTongluogranules;Clopidogrel;Cognitivedysfunction

• 摘要：

• 目的 分析益气通络颗粒联合氯吡格雷对缺血性脑血管病伴认知功能障碍患者的疗效。方法 选取2019年1月至2021年12月于河北医科大学第一医院治疗的缺血性脑血管病伴认知功能障碍患者195例。完全随机分为氯吡格雷组、益气通络颗粒组和联合组，各65例。氯吡格雷组给予氯吡格雷口服治疗，益气通络颗粒组给予益气通络颗粒口服治疗，联合组给予益气通络颗粒联合氯吡格雷口服治疗。3组均连续治疗6个月。比较3组治疗前后凝血功能指标［纤维蛋白原（FIB）、活化部分凝血活酶时间（APTT）、凝血酶时间（TT）、凝血酶原时间（PT）］、血管生长因子指标［血管生成素1（Ang-1）、血管内皮生长因子（VEGF）］、脑血流灌注指标［脑血容量、脑血流量、平均通过时间（MTT）］、认知功能评价指标［蒙特利尔认知评估量表（MoCA）、简易智力状态检查量表（MMSE）、美国国立卫生研究院卒中量表（NIHSS）评分］和治疗总有效率。结果 治疗后，联合组FIB、APTT、MTT水平及NIHSS评分均低于氯吡格雷组和益气通络颗粒组，TT、PT、Ang-1、VEGF、脑血容量、脑血流量水平及MoCA、MMSE评分均高于氯吡格雷组和益气通络颗粒组，差异均有统计学意义（均P<0.05）。治疗后联合组总有效率高于氯吡格雷组和益气通络颗粒组［95.4%（62/65）比75.4%（49/65）、78.5%（51/65）］，差异均有统计学意义（均P<0.05）。结论 经益气通络颗粒、氯吡格雷联合治疗后，缺血性脑血管病伴认知功能障碍患者凝血功能、血管生长因子、脑血流灌注指标及认知功能得到明显改善，临床疗效显著。

• Objective To analyze the curative efficacy of Yiqi Tongluo granules combined with clopidogrel in patients with ischemic cerebrovascular disease accompanied by cognitive dysfunction. Methods  From January 2019 to December 2021, 195 patients with ischemic cerebrovascular disease accompanied with cognitive dysfunction treated at the First Hospital of Hebei Medical University were selected. According to the completely random method, patients were divided into clopidogrel group, Yiqi Tongluo granules group and combined group, with 65 cases in each group. The clopidogrel group was treated with clopidogrel orally, the Yiqi Tongluo granules group was treated with Yiqi Tongluo granules orally, and the combined group was treated with Yiqi Tongluo granules combined with clopidogrel orally. All three groups were treated continuously for 6 months. The coagulation function index ［fibrinogen (FIB), activated partial thromboplastin time (APTT), thrombin time (TT), prothrombin time (PT)］, vascular growth factor index［angiopoietin 1(Ang-1), vascular endothelial growth factor (VEGF)］, cerebral blood flow perfusion index［cerebral blood volume, cerebral blood flow, mean transit time (MTT)］, cognitive function evaluation index［Montreal Cognitive Assessment Scale(MoCA), Mini Mental State Examination Scale(MMSE), National Institutes of Health Stroke Scale (NIHSS) scores］ at before and after treatment and total efficacy rate of treatment were compared among the three groups. Results After treatment, the levels of FIB, APTT, MTT and NIHSS scores in the combined group were lower than those in the clopidogrel group and the Yiqi Tongluo granules group, and the levels of TT, PT, Ang-1, VEGF, cerebral blood volume, cerebral blood flow, and the scores of MoCA and MMSE in the combined group were higher than those in the clopidogrel group and the Yiqi Tongluo granules group (all P<0.05). After treatment, the total efficacy rate in the combined group was higher than that in the clopidogrel group and the Yiqi Tongluo granules group［95.4%(62/65) vs 75.4%(49/65), 78.5%(51/65)］(all P<0.05). Conclusion Combined treatment of Yiqi Tongluo granules and clopidogrel significantly improves the coagulation function, vascular growth factor, cerebral blood perfusion index and cognitive function of patients with ischemic cerebrovascular disease accompanied by cognitive dysfunction, with a significant clinical curative efficacy.