目的：观察鞘膜内注射神经生长因子（ＮＧＦ）联合中药“神脑康胶囊”治疗重型脑梗死的临床疗效，以及对患者神经功能和脂蛋白的影响。方法：１０６ 例重型脑梗死患者随机分为２ 组。治疗组（５６ 例）鞘膜内注射ＮＧＦ２ ０００ ＢＵ，每周１ 次，同时静注ＮＧＦ１ ０００ ＢＵ，每日１ 次，并口服中药“神脑康胶囊”，每次３ 粒，每日３ 次；对照组（５０ 例）静滴ＮＧＦ２ ０００ ＢＵ，每日１ 次；疗程均为４ 周。治疗前后观察高密度脂蛋白（ＨＤＬ）、低密度脂蛋白（ＬＤＬ）、甘油三酯（ＴＧ）、总胆固醇（ＴＣ）的变化，并对患者进行神经功能缺损评分的比较。结果：治疗组治疗后神经功能缺损评分〔（２１０±１６）分〕与对照组〔（３００±１２）分〕比较显著降低（Ｐ＜ ００１）；临床总有效率（８９３％ ）显著高于对照组（５８０％ ，χ２＝ １００９，Ｐ＜ ００１）；与对照组治疗后比较，治疗组治疗后ＨＤＬ升高显著（Ｐ＜ ００１），ＬＤＬ、ＴＧ、ＴＣ下降显著（Ｐ＜ ００５ 或Ｐ＜ ００１）。结论：鞘膜内注射ＮＧＦ联合中药神脑康治疗重型脑梗死能明显改善神能功能缺损程度，提高临床疗效，并能使患者的脂代谢紊乱得到改善 Objective: To observe the clinical effect of intrathecal nerve injection (NGF) combined with traditional Chinese medicine “Shennaokang Capsule” in treating severe cerebral infarction and its effect on neurological function and lipoprotein. Methods: 106 patients with severe cerebral infarction were randomly divided into two groups. The treatment group (56 cases) was intrathecal injected with NGF2 000 BU, once a week, while intravenous NGF1 000 BU, once daily, and oral administration of traditional Chinese medicine “Shen Nai Kang Capsule”, 3 capsules each time, 3 times a day ; Control group (50 cases) intravenous infusion of NGF2 000 BU, 1 day; course of treatment were 4 weeks. The changes of high density lipoprotein (HDL), low density lipoprotein (LDL), triglyceride (TG) and total cholesterol (TC) were observed before and after treatment. The neurological deficit scores of the patients were compared. Results: After treatment, the score of neurological deficit (210 ± 16) in treatment group was significantly lower than that in control group 〔(300 ± 12) points〕 (P0.01) The effective rate (893%) was significantly higher than that of the control group (580%, χ2 = 1009, P <001). Compared with the control group, HDL increased significantly after treatment in the treatment group (P < 0  01), LDL, TG, TC decreased significantly (P <0  05 or P <0  01). Conclusion: Intrathecal injection of NGF combined with Shennaikang in treatment of severe cerebral infarction can significantly improve the neurological deficit, improve clinical efficacy and improve the disorder of lipid metabolism in patients