尿激酶联合真方白丸子治疗风痰阻络型急性缺血性脑卒中45 例

探讨尿激酶联合真方白丸子对风痰阻络型急性缺血性脑卒中（AIS）的疗效。方法：将90 例风痰阻络型AIS患者随机分为治疗组和对照组，每组各45 例。对照组给予尿激酶静脉溶栓治疗，治疗组在对照组基础上联合真方白丸子治疗，疗程均为14 d。比较2组治疗前后的卒中量表(NIHSS)评分、改良Rankin量表（mRS）评分、中医证候总积分、血浆纤维蛋白原（FIB）、D-二聚体（D-D），评价综合疗效，记录不良反应发生情况。结果：综合疗效总有效率治疗组为93.33%（42/45），对照组为84.44%（38/45），2组比较，差异有统计学意义（P＜0.05）。治疗后，2组患者的NIHSS评分、mRS评分、中医证候总积分、FIB、D-D均较治疗前下降，且治疗组下降幅度大于对照组，差异有统计学意义(P＜0.05)。不良反应发生率治疗组为6.66%（3/45），对照组为11.10%(5/45)，2组比较，差异无统计学意义(P＞0.05)。结论：尿激酶静脉溶栓后联合真方白丸子对风痰阻络型AIS患者疗效较佳，可促进患者神经功能的恢复，降低FIB、D-D水平，且治疗安全性较好。

Clinical effect of urokinase combined with Zhenfang Baiwanzi in treatment of acute ischemic stroke with syndrome of wind-phlegm blocking collaterals：An analysis of 45 cases

Objective：To investigate the clinical effect of urokinase combined with Zhenfang Baiwanzi in the treatment of acute ischemic stroke (AIS) with syndrome of wind-phlegm blocking collaterals.Methods：A total of 90 AIS patients with syndrome of wind-phlegm blocking collaterals were randomly divided into treatment group and control group，with 45 patients in each group.The patients in the control group were given urokinase for intravenous thrombolytic therapy，while those in the treatment group were given Zhenfang Baiwanzi in addition to the treatment in the control group；the course of treatment was 14 days for both groups.The two groups were compared in terms of National Institutes of Health Stroke Scale (NIHSS) score，modified Rankin Scale (mRS) score，traditional Chinese medicine (TCM) syndrome score，plasma fibrinogen (FIB)，and D-dimer (D-D）.Overall response was evaluated，and adverse reactions were recorded.Results：There was a significant difference in overall response rate between the treatment group and the control group ［93.33% (42/45) vs 84.44% (38/45)，P＜0.05］.After treatment，both groups had significant reductions in NIHSS score，mRS score，TCM syndrome score，FIB，and D-D，and the treatment group had significantly greater reductions than the control group (P＜0.05）.There was no significant difference in the incidence rate of adverse events between the treatment group and the control group ［6.66% (3/45) vs 11.10% (5/45)，P>0.05］.Conclusion：Urokinase combined with Zhenfang Baiwanzi has a good clinical effect in the treatment of AIS patients with syndrome of wind-phlegm blocking collaterals and can promote the recovery of neurological function and reduce the levels of FIB and D-D，with a favorable safety profile.