目的 探討益氣通絡(luò)顆粒聯(lián)合硫酸氫氯吡格雷片治療急性腦梗死恢復(fù)期的臨床療效。方法 選取2019年1月—2020年1月在河南省直第三人民醫(yī)院治療的84例急性腦梗死恢復(fù)期患者，隨機(jī)分為對(duì)照組（42例）和治療組（42例）。對(duì)照組患者口服硫酸氫氯吡格雷片，2片/次，1次/d。治療組在對(duì)照組的基礎(chǔ)上口服益氣通絡(luò)顆粒，1袋/次，3次/d。兩組患者治療1個(gè)月。觀察兩組患者臨床療效，比較治療前后兩組患者美國(guó)國(guó)立衛(wèi)生研究院卒中量表（NIHSS）和應(yīng)用日常生活能力量表（ADL）評(píng)分，白細(xì)胞介素-18（IL-18）、高遷移率族蛋白B1（HMGB1）、可溶性血管黏附分子1（sVCAM-1）、腫瘤壞死因子-α（TNF-α）、血漿黏度、血小板聚集率、全血高切黏度和全血低切黏度，及血栓彈力圖參數(shù)R值、K值、Angle角和MA值。結(jié)果 治療后，對(duì)照組總有效率為78.57%，顯著低于治療組的97.62%（P<0.05）。治療后，兩組患者NIHSS評(píng)分明顯降低，而ADL評(píng)分明顯升高（P<0.05），且治療組明顯好于對(duì)照組（P<0.05）。治療后，兩組患者IL-18、HMGB1、sVCAM-1、TNF-α水平明顯下降（P<0.05），且治療組均顯著低于對(duì)照組患者（P<0.05）；治療后，兩組患者血漿黏度、血小板聚集率、全血高切黏度、全血低切黏度指標(biāo)均顯著降低（P<0.05），且治療組明顯低于對(duì)照組患者（P<0.05）；治療后，兩組患者血栓彈力圖中R值、K值指標(biāo)均低于治療前，而Angle角、MA值指標(biāo)均高于治療前（P<0.05），且治療組明顯好于對(duì)照組（P<0.05）。結(jié)論 益氣通絡(luò)顆粒聯(lián)合硫酸氫氯吡格雷片治療急性腦梗死恢復(fù)期，可有效改善神經(jīng)功能缺損狀態(tài)和日常生活活動(dòng)的能力，降低炎性因子水平，改善血液流變學(xué)情況。

Objective To explore the effect of Yiqi Tongluo Granules combined with clopidogrel in treatment of acute cerebral infarction.Methods Patients (84 cases) with acute cerebral infarction in the Third People's Hospital of Henan Province from January 2019 to January 2020 were randomly divided into control (42 cases) and treatment (42 cases) groups. Patients in the control group were po administered with Clopidogrel Bisulfate Tablets, 2 tablets/time, once daily. Patients in the treatment group were po administered with Yiqi Tongluo Granules on the basis of the control group, 1 bag/time, three times daily. Patients in two groups were treated for 1 month. After treatment, the clinical efficacy was evaluated, and the scores of NIHSS and ADL, the levels of IL-18, HMGB1, sVCAM-1, TNF-α, plasma viscosity, platelet aggregation rate, whole blood high shear viscosity and whole blood low shear viscosity, and thromboelastogram parameters of R value, K value, Angle and MA value in two groups before and after treatment were compared.Results After treatment, the clinical effective rate of the control group was 78.57%, which was significantly lower than 97.62% of the treatment group (P<0.05). After treatment, the NIHSS score in two groups was significantly decreased, while the ADL score was significantly increased (P<0.05). After treatment, the NIHSS score and ADL score in treatment group were significantly decreased, better than those in the control group (P<0.05). After treatment, the levels of IL-18, HMGB1, sVCAM-1 and TNF-α in two groups were significantly decreased (P<0.05), and the levels in the treatment group were significantly lower than those in the control group (P<0.05). After treatment, the plasma viscosity, platelet aggregation rate, whole blood high shear viscosity and whole blood low shear viscosity in two groups were significantly decreased (P<0.05), and which in the treatment group were significantly lower than those in the control group (P<0.05). After treatment, the R value and K value of thromboelastogram parameters in the two groups were lower than those before treatment, while the Angle angle and MA value were higher than those before treatment (P<0.05), and the treatment group was significantly better than the control group (P<0.05).Conclusion Yiqi Tongluo Granules combined with clopidogrel in treatment of acute cerebral infarction can effectively improve the state of neurological impairment and activities of daily living, reduce the level of inflammatory factors and improve hemorheology.

R971