目的 探討培元通腦膠囊聯(lián)合丁苯酞治療急性腦梗死的臨床療效。方法 選取2016年6月-2017年6月在開(kāi)封市中心醫(yī)院治療的急性腦梗死患者102例，隨機(jī)分為對(duì)照組（51例）和治療組（51例）。對(duì)照組患者靜脈滴注丁苯酞氯化鈉注射液，100 mL/次，2次/d；治療組在對(duì)照組的基礎(chǔ)上口服培元通腦膠囊，1.8 g/次，3次/d。兩組均經(jīng)過(guò)2周治療。評(píng)價(jià)兩組患者臨床療效，同時(shí)比較治療前后兩組患者NIHSS、mRS和MBI評(píng)分以及血清學(xué)指標(biāo)和腦血流動(dòng)力學(xué)指標(biāo)。結(jié)果 治療后，對(duì)照組臨床總有效率為80.39%，顯著低于治療組的94.12%，兩組比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，兩組患者NIHSS和mRS評(píng)分明顯降低，MBI評(píng)分明顯升高，同組比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）；且治療組NIHSS、mRS和MBI評(píng)分改善水平顯著優(yōu)于對(duì)照組（P<0.05）。治療后，兩組血清可溶性相關(guān)凋亡誘導(dǎo)配體（sTRAIL）、人高遷移率族蛋白B1（HMGB1）、單核細(xì)胞趨化蛋白-1（MCP-1）和可溶性細(xì)胞間黏附分子-1（sICAM-1）水平均顯著降低，腦源性神經(jīng)營(yíng)養(yǎng)因子（BDNF）水平顯著升高，同組比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）；且治療組患者上述血清學(xué)指標(biāo)改善程度明顯好于比對(duì)照組（P<0.05）。治療后，兩組雙側(cè)大腦中動(dòng)脈V_p和V_m均顯著增高，DVp和DVm均顯著降低，同組比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）；且治療組患者上述腦血流動(dòng)力學(xué)指標(biāo)改善水平比對(duì)照組更顯著（P<0.05）。結(jié)論 培元通腦膠囊聯(lián)合丁苯酞治療急性腦梗死可有效改善機(jī)體細(xì)胞因子水平和腦血流動(dòng)力學(xué)指標(biāo)，有利于神經(jīng)功能恢復(fù)，提高日常生活能力。

Objective To investigate the clinical effect of Peiyuan Tongnao Capsules combined butylphthalide in treatment of acute cerebral infarction. Methods Patients (102 cases) with acute cerebral infarction in Kaifeng Central Hospital from June 2016 to June 2017 were randomly divided into control (51 cases) and treatment (51 cases) groups. Patients in the control group were iv administered with Butylphthalide and Sodium Chloride Injection, 100 mL/time, twice daily. Patients in the treatment group were po administered with Peiyuan Tongnao Capsules on the basis of the control group, 1.8 g/time, three times daily. Patients in two groups were treated for 2 weeks. After treatment, the clinical efficacy was evaluated, and the NIHSS, mRS and MBI scores, serological indexes, and cerebral hemodynamic indexes in two groups before and after treatment were compared. Results After treatment, the clinical efficacy in the control group was 80.39%, which was significantly lower than 94.12% in the treatment groups, and there were differences between two groups (P<0.05). After treatment, the NIHSS and mRS scores in two groups was significantly decreased, but MBI score was significantly increased, and the difference was statistically significant in the same group (P<0.05). And the improvement of NIHSS, mRS and MBI scores in the treatment group was obviously better than those in the control group (P<0.05). After treatment, the sTRAIL, HMGB1, MCP-1, and sICAM-1 levels in two groups were significantly decreased, but BDNF levels were significantly increased, and the difference was statistically significant in the same group (P<0.05). And the serological indexes levels in the treatment group were obviously better than those in the control group (P<0.05). After treatment, the V_p and V_m in two groups were significantly increased, DVp and DVm were significantly increased, and the difference was statistically significant in the same group (P<0.05). And the improvement of the cerebral hemodynamic indexes in the treatment group was obviously better than those in the control group (P<0.05). Conclusion Peiyuan Tongnao Capsules combined butylphthalide can effectively improve the level of cytokines and cerebral hemodynamic indexes in treatment of acute cerebral infarction, which is beneficial to the recovery of neurological function and improve the ability of daily living.