目的 探討腦安滴丸聯(lián)合硫酸氫氯吡格雷片治療急性腦梗死的臨床療效。方法 選擇2020年4月—2021年12月天津中醫(yī)藥大學(xué)附屬北辰區(qū)中醫(yī)醫(yī)院（天津市北辰區(qū)中醫(yī)醫(yī)院）收治的86例急性腦梗死患者，所有患者按隨機(jī)數(shù)字表法分為對(duì)照組和治療組，每組各43例。對(duì)照組患者口服氯吡格雷片，1片/次，1次/d。治療組在對(duì)照組治療的基礎(chǔ)上口服腦安滴丸，20粒/次，2次/d。兩組患者連續(xù)治療4周。觀察兩組的臨床療效，比較兩組的美國國立衛(wèi)生研究院卒中量表（NIHSS）評(píng)分、斑塊面積、血流動(dòng)力學(xué)、血清指標(biāo)。結(jié)果 治療后，治療組的總有效率為95.35%，明顯高于對(duì)照組的總有效率81.40%，組間比較差異具有顯著性（P<0.05）。治療后，兩組的NIHSS評(píng)分、斑塊面積均顯著降低（P<0.05）；治療組的NIHSS評(píng)分、斑塊面積均低于對(duì)照組，差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，兩組的搏動(dòng)指數(shù)、阻力指數(shù)低于治療前，平均血流速度高于治療前（P<0.05），且治療組搏動(dòng)指數(shù)、阻力指數(shù)低于對(duì)照組，平均血流速度高于對(duì)照組，組間比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，兩組的血清白細(xì)胞介素-6（IL-6）、內(nèi)皮素-1（ET-1）、血管緊張素Ⅱ（ANG Ⅱ）水平明顯低于治療前（P<0.05），且治療組的血清IL-6、ET-1、Ang Ⅱ水平明顯低于對(duì)照組（P<0.05）。結(jié)論 腦安滴丸聯(lián)合硫酸氫氯吡格雷片治療急性腦梗死的療效確切，可降低斑塊面積，減輕神經(jīng)功能缺損，改善血流動(dòng)力學(xué)和血管內(nèi)皮功能，且安全性良好。

Objective To investigate the clinical efficacy of Naoan Dropping Pills combined with Clopidogrel Hydrogen Sulphate Tablets in treatment of acute cerebral infarction. Methods Patients (86 cases) with acute cerebral infarction in Tianjin Beichen Traditional Chinese Medicine Hospital from April 2020 to December 2021 were divided into control and treatment groups according to the random number table method, and each group had 43 cases. Patients in the control group were po administered with Clopidogrel Hydrogen Sulphate Tablets, 1 tablet/time, once daily. Patients in the treatment group were po administered with Naoan Dripping Pills on the basis of the control group, 20 grains/time, twice daily. Patients in two groups were treated for 4 weeks. After treatment, the clinical efficacies were evaluated, and the NIHSS scores, plaque area, hemodynamics indexes, and serum indexes in two groups were compared. Results After treatment, the total effective rate of the treatment group was 95.35%, which was significantly higher than that of the control group 81.40% (P < 0.05). After treatment, the NIHSS scores and plaque area were significantly decreased in two groups (P < 0.05), and the NIHSS scores and plaque area in the treatment group were lower than those in the control group (P < 0.05). After treatment, the pulsatility index and resistance index of two groups were lower than those before treatment, but the average blood flow velocity was higher than that before treatment (P < 0.05). The pulsatility index and resistance index of the treatment group were lower than those of the control group, but the average blood flow velocity was higher than that of the control group, and the difference between two groups was statistically significant (P < 0.05). After treatment, the serum levels of IL-6, ET-1, and Ang Ⅱ in two groups were significantly lower than those before treatment (P < 0.05), and the serum levels of IL-6, ET-1, and Ang Ⅱ in the treatment group were significantly lower than those in the control group (P < 0.05). Conclusion Naoan Dripping Pills combined with Clopidogrel Hydrogen Sulphate Tablets has clinical efficacy in treatment of acute cerebral infarction, can reduce plaque area, alleviate nerve function defect, and improve vascular endothelial function and hemodynamics with good safety.

R971

天津市北辰區(qū)科技發(fā)展計(jì)劃項(xiàng)目（2015-SHGY-23）