摘要目的：评价白芍总苷胶囊结合尿激酶治疗急性缺血性脑梗死(acute cerebral ischemic stroke, ACIS)的疗效。方法将符合入选标准的152例ACIS患者采用随机数字表法分为对照组77例、观察组75例。对照组静脉注射尿激酶溶栓，观察组在对照组基础上口服或鼻饲白芍总苷胶囊。全部患者均经溶栓治疗24 h，排除脑出血或凝血机制障碍后，给予抗血小板聚集、降血脂、营养神经、改善循环等治疗。2组均连续治疗14 d。依据美国国立卫生研究院卒中量表(National Institute of Health Stroke Scale, NIHSS)进行神经功能缺损评分，采用改良的Rankin量表(Modified Rankin Scale, mRS)评价神经功能的恢复状况，采用日常生活能力指数量表(Barthel)评价患者的日常生活能力。结果治疗后7 d，NIHSS评分下降≥4分者观察组28例(37.3%)、对照组12例(15.6%)，2组比较差异有统计学意义(χ2＝8.181，P＝0.004)；观察组NIHSS评分[(8.3±2.2)分比(9.9±2.5)分，t＝4.192]低于对照组(P＜0.05)。治疗后14 d， mRS评分≤4分者观察组68例(90.7%)、对照组51例(66.2%)，2组比较差异有统计学意义(χ2＝11.945， P＝0.001)；观察组 mRS 评分[(2.3±0.9)分比(2.9±1.1)分，t＝3.684]低于对照组(P＜0.01)，Barthel 指数[(88.7±16.2)分比(77.5±15.2)分，t＝4.401]高于对照组(P＜0.01)。结论白芍总苷胶囊结合尿激酶溶栓治疗可有效改善ACIS患者神经功能缺损状态，提高患者日常生活能力，疗效优于单纯使用尿激酶。

abstractsObjective To evaluated the effect of Total Glucosides of Paeony (TGP)combined with urokinase for the patients with acute cerebral ischemic stroke.MethodsA total of 152 patients with ACIS were divided into the control group (77 patients) and the observation group (75 patients) by completely randomized grouping method. Patients in the control group were treated with Urokinase by intravenous, and the observation group were treated with TGP combined with Urokinase. All patients were treated with thrombolysis treatment with in the 24 h after the exclusion of cerebral hemorrhage by brain CT and coagulation mechanism disorder. In the following 14 days, they were given the treatment of anti platelet aggregation, lowering blood lipid, trophic nerve and improving circulation. The National Institutes of Health Stroke Scale(NIHSS), the modified Rankin scale(mRS) and the daily life ability index(Barthel) were measured.ResultsThere were 28 (37.3%) patients with the NIHSS scores decreasing 4 points in observation group and 12 (15.6%) in control group after treatment of 7 days,and there was significant difference between two groups (χ2=8.181,P=0.004). There were 68 (90.7%) patients with mRS score less than 4 points in observation group and 51 (15.6%) in control group after treatment of 14 days,and there was significant difference between two groups (χ2=11.945,P=0.001). The NIHSS scores in the observation group was lower than control group (8.3 ± 2.2vs. 9.9 ± 2.5;t=4.192,P<0.05). The mRS score in the&nbsp;observation group was lower than control group (2.3 ± 0.9vs. 2.9 ± 1.1;t=3.684,P<0.01), and the Barthel index in the observation group was higher than the control group (88.7 ± 16.2vs. 77.5 ± 15.2;t=4.401,P<0.01). ConclusionsThe TGP capsules combined with Urokinase intravenous thrombolysis could improve the neurological deficit, and the ability of daily life of ACIS patients.