目的 心肌肥厚是一种缓慢发展的有效代偿功能,是对血流动力学或心肌损伤的适应性反应,是导致心衰的独立风险因素.已有报道显示,经异丙肾上腺素(isoproterenol,ISO)诱导的心肌肥厚大鼠模型,其给药途径和诱导剂量差异很大,模型动物病理表型发展进程不均一.方法 综合以往方法的先进性、模型表型的均一性、方法稳定性及复制的难易性等因素,本文利用皮下植入渗透泵的方式,采用低剂量长时程给予ISO(4 mg/kg,持续28 d)诱导构建心肌肥厚大鼠模型,并利用超声影像、病理组织学染色、免疫荧光染色及Real-time PCR等技术对模型表型进行评估.结果 模型大鼠病理表型典型.整体表型,包括增大的心脏体积、心室壁厚度及心重指数;细胞表型,包括增大的心肌细胞,严重的心肌纤维化,心肌纤维断裂、溶解,线粒体脊消失、空泡化,心肌Z线、M线以及闰盘扭曲模糊等;分子表型,包括心肌肥厚标志物心钠肽(atrial natriuretic peptide,ANP)及脑钠肽(brain natriuretic peptide,BNP)显著升高.结论 本文建立的心肌肥厚大鼠模型,方法稳定易复制,表型特征典型,更适于基因功能分析及相关药物筛选等科学研究.

Objective:To investigate the clinical efficacy and safety of intravenous thrombolysis with different doses of alteplase in the treatment of acute cerebral infarction in older adult patients.Methods:A total of 65 older adult patients with acute cerebral infarction (onset within 4.5 hours, age ≥ 75 years) who underwent intravenous thrombolysis in Wenzhou Central Hospital from February 2021 to February 2022 were included in this study. They were randomly assigned to undergo intravenous thrombolysis with either low dose alteplase (0.6 mg/kg, low dose group, n = 32) or standard dose alteplase (0.9 mg/kg, standard dose group, n = 33). The National Institutes of Health Neurological Stroke Scale score before and 24 and 48 hours after treatment, modified Rankin scale score before and 7, 14 and 90 days after treatment, serum C-reactive protein (CRP), neuron-specific enolase (NSE) and tumor necrosis factor-α (TNF-α) levels before and 24 hours after treatment, 24-hour incidence of intracranial hemorrhage, 24-hour incidence of symptomatic intracranial hemorrhage, and 90-day mortality were compared between the two groups. Results:Compared with before treatment, the National Institutes of Health Neurological Stroke Scale scores in each group were significantly decreased at 24 and 48 hours after treatment (low dose group, t24 h = 6.78, t48 h = 7.86; standard dose group: t24 h = 8.09, t48 h = 10.13, all P < 0.001). Compared with before treatment, the modified Rankin scale score in each group was significantly decreased at 7, 14 and 90 days after treatment (low-dose group: t7 d = 5.19, t14 d = 8.47, t90 d = 9.85; standard dose group: t7 d = 6.83, t14 d = 7.74, t90 d = 13.66, all P < 0.001). At 24 hours after treatment, serum levels of CRP, NSE, TNF-α in each group were significantly decreased (low-dose group: tCRP = 5.13 , tNSE = 4.22, tTNF-α = 34.29; standard dose group: tCRP = 4.87, tNSE = 5.53, tTNF-α = 31.98, all P < 0.001). At each time point after treatment, there were no significant differences in these indices between the two groups (all P > 0.05). The 24-hour incidence of intracranial hemorrhage in the low dose group was significantly lower than that in the standard dose group ( χ2 = 4.58, P = 0.032). There were no significant differences in incidence of symptomatic intracranial hemorrhage and 90-day mortality between the two groups (all P > 0.05). Conclusion:Intravenous thrombolysis with low dose alteplase (0.6 mg/kg) for the treatment of acute cerebral infarction in older adult patients exhibits equivalent clinical efficacy to that with standard dose alteplase (0.9 mg/kg), and the former is much safer than the latter.

目的 本文利用瘦素受体(LEPR)敲除大鼠,分析瘦素受体基因敲除后大鼠脑中小胶质细胞形态与功能的改变,探究瘦素受体在小胶质细胞中的功能作用.方法 采用RT-PCR,蛋白印迹法,免疫组化法和免疫荧光法,观察大鼠瘦素受体敲除后体内外小胶质细胞活化状态.结果 瘦素受体在小胶质细胞表达,基因敲除可以完全剔除小胶质细胞中LEPR蛋白;LEPR敲除增强大鼠LPS对刺激的炎症反应,存活率降低了75％;LEPR敲除大鼠脑中的活化的小胶质细胞比例明显增加;LEPR敲除的原代小胶质细胞不仅分泌更多炎性因子也增强了吞噬能力;Western blot发现PI3K/AKT在瘦素受体敲除大鼠脑组织蛋白中磷酸化明显增强.结论 瘦素受体敲除后,大鼠小胶质细胞向促炎促吞噬的方向发展,揭示了LEPR/Leptin可能通过小胶质细胞调节神经炎症.

目的 建立Marcksl1基因敲除小鼠,初步探究该基因缺失对造血系统发育的影响.方法 利用CRISPR/Cas9技术构建Marcksl1基因敲除小鼠,通过PCR技术以及Sanger测序方法鉴定小鼠基因型.通过将敲除小鼠与野生型小鼠杂交,分析敲除小鼠的传代情况.通过杂合子小鼠相互杂交,分析发育不同阶段纯合子、杂合子和野生型小鼠的占比.分离小鼠胎肝,利用血常规以及流式细胞术分析该基因缺失对造血系统的影响.结果 PCR结合Sanger测序结果表明Marcksl1基因敲除小鼠构建成功.对不同阶段胚胎小鼠基因型鉴定和数量统计,发现小鼠Marcksl1基因敲除造成的胚胎死亡发生于胚胎发育后期.通过血常规与流式细胞分析,结果表明Marcksl1基因缺失在E15.5 d时不影响白细胞,红细胞以及血小板数量,但胎肝中造血干细胞比例显著增多.结论 本研究成功建立Marcksl1基因敲除小鼠,并发现该基因缺失影响造血干细胞占比.本研究为进一步了解该基因在胚胎发育和造血系统中的功能提供动物模型.

目的 构建Prpf40b基因敲除大鼠,为该基因的生物学研究建立工具动物,同时初步探究该基因缺失后对心脏发育的影响.方法 利用CRISPR/Cas9技术构建Prpf40b基因敲除大鼠,测序及PCR技术鉴定敲除大鼠构建成功及仔代大鼠基因型.通过超声影像技术分析敲除大鼠心脏结构形态和功能改变,随后通过病理组织学观察分析该基因敲除后对大鼠心肌显微形态的组织学影响.结果 经PCR鉴定和测序比对,确认Prpf40b基因敲除大鼠构建成功.经超声影像学分析,与同窝阴性大鼠相比2月龄敲除大鼠心脏结构形态未见明显异常,而12月龄敲除大鼠收缩期及舒张期时心室腔内径及容积显著减小,同时射血分数显著减小.经病理组织学分析,与同窝阴性大鼠相比12月龄敲除大鼠心肌出现排列不齐,心肌纤维粗细不均及肌浆网扩张等现象.结论 Prpf40b基因缺失可诱发大鼠心脏整体结构形态改变及心肌组织学异常.

目的:分析脑白质疏松(LA)相关的危险因素.方法:选取2019年7月至2020年12月温州市人民医院神经内科188例住院患者,根据是否存在LA分为病例组(78例)和对照组(110例).分别收集两组年龄、性别、高血压病、糖尿病、血生化、尿微量白蛋白等指标.对两组资料进行单因素比较,对有意义因素进行多因素logistic回归分析.结果:单因素分析中病例组年龄、同型半胱氨酸、高血压病、尿微量白蛋白阳性显著高于对照组,差异有统计学意义(P<0.05);经过多因素logistic回归分析显示年龄(OR=1.163,95％CI=1.107～1.221,P<0.001)、尿微量白蛋白阳性(OR=2.599,95％CI=1.132～5.966,P=0.024)、高血压病(OR=2.767,95％CI=1.223～6.261,P=0.015)仍是LA的独立危险因素.结论:年龄、尿微量白蛋白阳性、高血压病与LA独立相关.

目的:观察米氮平与唑吡坦治疗原发性失眠的临床效果.方法:选择2019年8月～2020年9月期间某院收治的60例原发性失眠患者作为研究对象,根据患者的入院时间将其分成对照组(2019年8月～2020年2月入院)和观察组(2020年3月～2020年9月入院)各30例.对照组采用唑吡坦治疗,观察组采用米氮平与唑吡坦治疗,对比两组治疗前后匹兹堡睡眠质量指数量表(PSQI)、汉密尔顿焦虑量表(HAMA)、汉密尔顿抑郁量表(HAMD)以及疗效.结果:治疗后,对照组与观察组的PSQI评分分别为(9.34±1.25)分、(5.60±1.03)分,观察组明显低于对照组(P<0.05);对照组与观察组的HAMA评分分别为(19.65±4.18)分、(7.44±2.07)分,HAMD评分分别为(26.59±5.20)分、(18.21±3.54)分,观察组的HAMA、HAMD评分明显低于对照组(P<0.05);观察组的治疗总有效率为93.33％,明显高于对照组的70.00％(P<0.05).结论:采用米氮平与唑吡坦治疗原发性失眠,可以减轻失眠症状,改善焦虑、抑郁状态,提高疗效.

原发性中枢神经系统血管炎(primary angiitis of the central nervous system,PACNS)是指主要局限于脑实质、脊髓和软脑膜中小血管的罕见的免疫炎症性疾病,其临床和神经影像学表现多样,已被纳入许多疾病的鉴别诊断中.诊断PACNS并非易事,但是血管造影与脑组织活检的互补有助于诊断PACNS.中国的PACNS病例报道还较少,PACNS的诊断和治疗水平与国外先进水平之间还存在较大差距,因此亟待加强中国的医疗工作者对PACNS的认识.为此,本文围绕PACNS诊断和治疗中国专家共识的内容进行解读,同时结合PACNS的临床诊治经验,以期提高对PACNS的认识水平.

目的 探讨CT血管成像(CT angiography,CTA)对脑动静脉畸形(cerebral arteriovenous malformations,AVM)并脑内血肿在急诊术前诊断和显微手术评估中的作用.方法 选取2018年1月至2019年1月徐州医科大学附属医院和福建医科大学附属宁德市医院收治的32例AVM合并脑内血肿患者,所有患者均进行血肿清除术和AVM显微切除术治疗,在术前对患者进行CTA检查,比较CTA结果和手术诊断的情况、治疗前后神经功能变化情况.结果 CTA检查结果和手术结果对于AVM部位诊断结果一致,准确率为100.00％;CTA对供血动脉的诊断率为95.08％,对引流静脉诊断率为77.78％,CTA对供血动脉的诊断效果高于引流静脉,差异有显著性(χ2=6.742,P<0.05);CTA对各部位血管团大小的诊断具有较好的一致性(P>0.05).显微手术治疗后,患者日常生活能力量表分级显著好转(P<0.05).结论 通过CTA检查能够对AVM合并脑血肿患者进行较好的诊断,对急诊手术具有较大的参考价值,通过显微手术治疗能够显著改善患者的神经功能水平.

Parkinson's disease (PD), known as a neurodegenerative disorder, shows typical pathology of neuroinflammation, which might be the result of the imbalance between regulatory T cells (Treg) and T helper 17 (Th17) cells. The present study aimed to investigate the modulating effect of Ad-MSCs on peripheral blood mononuclear cells (PBMCs) derived from PD patients. CD4 + peripheral blood T cells were isolated and co-cultured with Ad-MSCs at a ratio of 4:1 under Th17 or Treg polarizing conditions, respectively, for 4 days. Our results showed that Ad-MSCs specifically inhibited the differentiation of IL-17-producing CD4 + T cells collected from PBMCs of PD patients evidenced by the decreased expression of RORγt- the key transcription factor for Th17 cells, IL-6R, and IL-23R. In the meantime, Ad-MSCs and induced a functional CD4 + CD25 + Foxp3 + T regulatory cell phenotype evidenced by the secretion of IL-10. Furthermore, levels of LIF protein and its receptor mRNA were significantly increased under both polarizing conditions. These findings suggest that the regulation of the Th17/Treg balance by Ad-MSCs was correlated with the increase in LIF secretion. Therefore, Ad-MSCs are an important player in ­modulating inflammatory responses and a potential therapeutics for PD patients.

目的 探讨帕金森病(Parkinson's disease,PD)患者不同脑区白质疏松(leukoaraiosis,LA)对认知功能的影响.方法 收集2015年1月-2017年1月于温州医科大学附属第一医院神经内科住院的PD患者87例,采用MMSE和MoCA量表评估认知功能.运用UPDRS-Ⅲ评价PD患者运动功能,Hoehn-Yahr分期进行病情分级.根据认知评分和诊断标准,将PD患者分为3组:认知功能正常组(PD-NC)、轻度认知功能障碍组(PD-MCI)和痴呆组(PD-D),入组者均行头颅MRI(3.0 T)检查,运用Scheltens量表对侧脑室旁、深部白质评分.结果 3组间不同部位白质疏松比较,额叶、深部白质、侧脑室旁、LA总分差异有统计学意义(均P＜0.05).顶叶、枕叶、颞叶、基底节、幕下白质疏松评分差异无统计学意义(均P＞0.05),PD-MCI组与PD-NC组相比较,额叶LA评分差异有统计学意义.侧脑室旁LA评分PD-D组与其余两组相比较,差异有统计学意义.回归分析结果显示,MMSE与教育程度(P＜0.001)、H-Y分期(P=0.008)、深部白质(P＜0.001)显著相关,教育程度呈正相关,H-Y分期和深部白质呈负相关.MMSE与深部白质关系最显著(β=-1.034).结论 PD认知功能与LA具有相关性,尤其是额叶、深部白质,PD患者MMSE与深部白质关系最为显著.

目的 研究维甲酸相关孤核受体α (RORα)调控小胶质细胞M1/M2表型转换在脑梗死发病中的作用机制.方法 ①定向诱导原代小胶质细胞向M1/M2型转化,Western blot检测细胞内RORα及M1标记物诱导型一氧化氮合酶(iNOS)、M2标记物精氨酸酶1(Arg-1)的表达.②建立大脑中动脉栓塞(MCAO)小鼠模型,Western blot检测各个时间点(6h、24 h、3天和7天)脑组织中iNOS、Arg-1、RORα的表达.③小鼠侧脑室注射RORα-siRNA,72 h后构建MCAO模型,缺血再灌注后3天,神经行为学评分(Longa评分)对脑功能进行评估,取脑组织,Western blot检测脑组织中iNOS、Arg-1、RORα的表达.④侧脑室注射RORα过表达慢病毒,于7天后构建MCAO模型,缺血再灌注后3天,神经行为学评分(Longa评分)评估小鼠脑功能.结果 脂多糖/γ干扰素(LPS/IFN-γ)可诱导小胶质细胞向M1型转化,白细胞介素4/白细胞介素13(IL-4/IL-13)可诱导小胶质细胞向M2型转化,与对照组比较,RORα在M2型小胶质细胞中表达显著升高,在M1型小胶质细胞表达显著降低(P＜0.01).脑缺血再灌注后,与假手术组比较,iNOS在6h明显升高并达到高峰,随后表达逐渐下降,Arg-1在3天、7天逐渐升高,RORα在脑缺血再灌注后3天达到最高,7天时明显降低,说明脑缺血损伤后早期以M1型小胶质细胞为主,脑缺血损伤晚期以M2型小胶质细胞为主,RORα在脑缺血损伤中期即M1/M2型小胶质细胞共存期呈现高表达.下调RORα表达后,MCAO小鼠神经行为学评分显著升高,脑功能损伤较为严重.下调RORα后,Arg-1、RORα蛋白表达量显著下降,而iNOS蛋白表达明显增加;上调RORα表达后MCAO小鼠神经行为学评分明显下降,脑功能损伤得到改善;过表达RORα后,Arg-1的表达量显著升高,而iNOS的表达明显较少.结论 RORα可通过调控小胶质细胞由M2型向M1转化参与脑梗死后脑损伤机制.

目的:评估以家庭为中心的教育干预在癫痫患儿中的应用价值.方法:选取癫痫患儿75例,按入院时间分为对照组(n=37)和干预组(n=38).对照组患儿予以病房常规治疗和护理,干预组患儿在此基础上实施以家庭为中心的教育干预.评估两组患儿入院时及出院后3、6个月癫痫知识掌握情况、服药依从性及躯体健康状况.结果:出院后3、6个月,两组患儿对癫痫知识的掌握情况均明显改善(P<0.05),但干预组改善情况更为显著(P<0.05).出院后3、6个月,干预组服药依从性评分明显增加,且出院后6个月显著高于对照组(P<0.05).两组出院后6个月躯体健康状况较入院时明显改善(P<0.05),但组间比较差异无统计学意义(P>0.05).干预组出院后6个月脑电图明显改善,且优于对照组(P<0.05).结论:对癫痫患儿实施以家庭为中心的教育干预有助于提高其对癫痫知识的掌握情况及服药依从性,改善躯体健康状况,且远期效果显著.

目的 探讨载脂蛋白E(ApoE)基因多态性与高脂血症患者降脂疗效的相关性,指导临床合理用药.方法 选取高脂血症患者100例,每晚睡前口服阿托伐他汀20mg降脂治疗,治疗4周,治疗前后检测血清血脂指标.计算治疗前后LDL-C下降率,以LDL-C在治疗前后下降率40％为界,分为他汀治疗高疗效组56例和他汀治疗低疗效组44例.采用实时荧光定量PCR法检测ApoE基因.结果 100例高脂血症患者共检出E2/3、E2/4、E3/3、E3/4 4种基因型和82、ε3、ε4 3种等位基因,E2/2、E4/4 2种基因型未检出.E2型基因组、E4型基因组与E3型基因组TC、HDL-C、LDL-C水平比较差异均有统计学意义(均P＜0.05),其中E4型基因组TC、LDL-C水平最高.他汀治疗低疗效组E3/3基因型检出率、ε3等位基因检出率均低于他汀治疗高疗效组,E3/4基因型检出率、ε4等位基因检出率均高于他汀治疗高疗效组,两组比较差异均有统计学意义(均P＜0.05). 结论 ApoE基因多态性与高脂血症患者降脂疗效相关性较大,84等位基因影响阿托伐他汀降脂疗效.

The two pictures of B and C in Figure 3 are the same, but apparently, the author presented them as two groups. Reference: Phosphorylated Glycogen Synthase Kinase-3ß (GSK-3ß) Improves Cognition in Rats with Diabetes-Associated Cognitive Decline Boxi Ke, Rong Lu, Xu Zhang Med Sci Monit 2019;25: 3336-3343 10.12659/MSM.914653.

目的 通过对心肌组织特异性Isca1敲除大鼠进行磁共振分析及病理学分析,探究心肌特异性敲除Isca1对大鼠心脏结构影响.方法 繁育心肌组织特异性Isca1敲除大鼠,PCR技术鉴定大鼠基因型及基因敲除效率,对新出生0.5 d及2.5 d心肌组织特异性Isca1敲除大鼠进行核磁共振影像分析,对新出生2.5 d心肌组织特异性Isca1敲除大鼠心肌组织进行H&E染色及透射电镜分析.结果 心肌组织特异性Isca1敲除大鼠敲除效率大于78％;与野生型相比,0.5 d心肌组织特异性Isca1敲除大鼠心脏未见显著扩张;2.5 d心肌组织特异性Isca1敲除大鼠心脏右室呈扩张趋势;2.5 d心肌组织特异性Isca1敲除大鼠肌纤维排列不齐,出现排列紊乱,无层次或极向,部分心肌纤维出现溶解断裂,肌节和Z线模糊,出现肌膜损伤,线粒体嵴断裂,肿胀明显.结论 心肌组织特异性Isca1敲除造成新生大鼠心脏结构异常.

As clinical research goes deep, new research evidence emerges continuously. In order to maintain the timeliness and advancement of the consensus, we have revised the Consensus on Nutritional Support for Neurological Diseases, issued in 2011, including 3 new evidences, 3 revised evidence levels according to the latest evidence level standards, 1 new recommendation and 1 revised recommendation. In addition, we have revised the Consensus on the Operational Standards of Nutritional Support for Neurological Diseases, issued in 2011, including 9 new evidences, 2 updated evidences, 7 revised evidence levels according to the latest evidence level standards, 4 new recommendations, 3 updated recommendations and 2 revised recommendations. In order to comprehensively and systematically reflect the management and regulation of nutritional support for neurological disease, we have merged the two consensuses.

目的 探讨亲环蛋白D (CypD)在癫痫大鼠模型海马组织中的表达及意义.方法 用氯化锂-匹罗卡品腹腔注射40只6～8周龄的SD大鼠建立癫痫模型,最终取20只癫痫发作级别达ⅣV级以上的大鼠纳入实验.将癫痫发作的SD大鼠按照随机数字表法分为癫痫组和CypD抑制剂环孢素A(CsA)处理组(CsA组),每组10只,另取10只SD大鼠作为对照组.CsA组大鼠腹腔注射6mg/kg CsA,癫痫组和对照组腹腔注射等体积0.9％氯化钠注射液.采用PCR检测CypD mRNA相对表达量.采用Western blot检测CypD、Caspase-3、细胞色素C(Cyt-C)相对表达量.采用TUNEL染色法检测海马组织细胞凋亡数,采用WST-1法检测超氧化物歧化酶(SOD)、钼酸铵法检测过氧化氢酶(CAT)、TBA法检测丙二醛(MDA)含量.结果 与对照组比较,癫痫组CypD mRNA与蛋白相对表达量,海马组织细胞凋亡数和Cyt-C、Caspase-3相对表达量、MDA含量均较高,SOD、CAT含量降低,差异均有统计学意义(P＜0.05).与癫痫组比较,CsA组CypD蛋白、mRNA相对表达量、海马组织细胞凋亡数、Cyt-C、Caspase-3相对表达量、MDA含量降低(P＜0.05);SOD、CAT含量明显增高,差异均有统计学意义(P＜0.05).结论 CypD在氯化锂-匹罗卡品诱发的癫痫大鼠海马组织中表达量增加,具有促进海马组织线粒体凋亡途径启动的作用.

Objective To investigate the correlation between NOTCH3 polymorphic locus rs1043994 and white matter lesions (WML). Methods The enrolled subjects were elderly in the outpatient clinic for health check-up from January 2015 to January 2017. According to the results of cranial MR examination, 337 elderly people were divided into the WML group (n=172) and normal control group (n=165). The inclusion criteria were: (1) age ≥ 50 years old; (2) those who can cooperate with head MRI examination; (3) those who understand the study and agree to retain blood samples for SNP testing. Exclusion criteria were: (1) previous neurological diseases such as cerebrovascular disease, intracranial infection, dementia, and trauma; (2) having a history of mental illness; (3) suffering from serious diseases such as liver and kidney dysfunction, heart disease, tumors. The clinical data of the subjects were collected and the peripheral venous blood was extracted for DNA extraction. The cognitive function was evaluated by the Mini-mental State Examination. The genotyping of the subjects was carried out by restriction endonuclease. The correlation between rs1043994 polymorphism and WML was analyzed by Logistic regression. Results There was no significant difference in gender, education level, diabetes, hyperlipidemia, smoking, uric acid and Hcy between the two groups (P>0.05). Compared with the control group, the WML group had a higher average age and a higher proportion of hypertension (P<0.05), and the Mini-mental State Examination scores between the two groups were statistically significant different (P<0.01). The genotypes (AA, AG, GG) frequency and allele (A, G) frequency distribution of rs1043994 were statistically different between the two groups (P<0.05). Multivariate Logistic regression analysis showed that age (P=0.001), hypertension (P=0.012) and AA genotype (P=0.019) were independent risk factors of WML (P<0.05). The risk of WML in AA genotype is 2.512 times higher than that in AG/GG genotype. Conclusions The rs1043994 polymorphism of NOTCH3 gene is associated with WML in the elderly population, and the A allele is a susceptibility gene for WML. The rs1043994 polymorphism of the NOTCH3 gene may be a genetic risk factor for WML in the Chinese elderly population.

目的 观察采用自拟祛风化痰中药颗粒剂联合吞咽治疗仪治疗急性脑梗死(ACI)后并发吞咽功能障碍(SFD)的临床疗效.方法 ACI后并发SFD患者86例按照就诊顺序随机分为两组,基础组给予常规西医内科治疗及康复训练与吞咽治疗仪进行治疗,联合组在基础组的治疗上再加入自拟祛风化痰中药颗粒剂鼻饲;两组治疗均10d为1个疗程,治疗3个疗程,在治疗前及每个疗程治疗后分别设立1次随访.结果 从SSA评分、VFSS评分、SWAL-QOL评分、洼田饮水试验、中医证候疗效等几方面比较,联合组均优于基础组(P＜0.05).结论 采用自拟祛风化痰中药颗粒剂联合吞咽治疗仪治疗ACI后并发SFD患者的临床应用疗效显著.