目的 探討銀杏二萜內(nèi)酯葡胺聯(lián)合曲克蘆丁治療急性腦梗死患者的臨床療效。方法 選取2020年1月—2020年10月于河南省人民醫(yī)院治療的182例急性腦梗死患者，隨機(jī)分為對(duì)照組和治療組，每組各91例。對(duì)照組靜脈滴注注射用曲克蘆丁，0.48 g加入5%葡萄糖注射液250 mL，1次/d；治療組患者在對(duì)照組基礎(chǔ)上靜脈滴注銀杏二萜內(nèi)酯葡胺注射液，25 mg加入生理鹽水250 mL，1次/d。兩組患者均連續(xù)治療2周。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）、改良Barthel指數(shù)（MBI），腦血流速度，血清氧化應(yīng)激和神經(jīng)損傷指標(biāo)水平。結(jié)果 治療后，對(duì)照組臨床有效率為82.42%，顯著低于治療組的92.31%（P<0.05）。治療后，兩組患者NIHSS評(píng)分較治療前顯著下降，而MBI評(píng)分顯著提高（P<0.05），且治療組患者改善更顯著（P<0.05）。治療后，兩組大腦前動(dòng)脈（ACA）、中動(dòng)脈（MCA）、后動(dòng)脈（PCA）、基底動(dòng)脈（BA）、椎動(dòng)脈（VA）血流速度較治療前均顯著提高（P<0.05），且治療組升高更明顯（P<0.05）。治療后，兩組超氧化物歧化酶（SOD）和谷胱甘肽過氧化物酶（GSH-Px）水平較治療前均顯著升高，而丙二醛（MDA）水平顯著下降（P<0.05），且治療組患者上述血清氧化應(yīng)激指標(biāo)水平改善更明顯（P<0.05）。治療后，兩組神經(jīng)肽Y（NPY）、神經(jīng)元特異性烯醇化酶（NSE）水平較治療前均顯著下降（P<0.05），且治療組患者下降更明顯（P<0.05）。結(jié)論 銀杏二萜內(nèi)酯葡胺注射液聯(lián)合曲克蘆丁可顯著改善急性腦梗死患者臨床癥狀，改善腦血流速度，有效抑制氧化應(yīng)激反應(yīng)，減輕腦損傷，臨床療效佳，且安全性高。

Objective To investigate the clinical efficacy of Yinxing Ertie Neizhi Puan combined with troxerutin in treatment of acute cerebral infarction. Methods Patients (182 cases) with acute cerebral infarction in Henan Provincial People's Hospital from January 2020 to October 2020 were randomly divided into control and treatment groups, and each group had 91 cases. Patients in the control group were iv administered with Troxerutin for injection, 0.48 g added into 5% glucose injection 250 mL, once daily. Patients in the treatment group were iv administered with Yinxing Ertie Neizhi Puan Injection on the basis of the control group, 25 mg added into normal saline 250 mL, once daily. Patients in two groups were treated for 2 weeks. After treatment, the clinical efficacy was evaluated, and the NIHSS score, the MBI score, the cerebral blood flow velocity, the serum oxidative stress indexes, and the levels of nerve injury markers in two groups before and after treatment were compared. Results After treatment, the clinical effective rate in the control group was 82.42%, which was significantly lower than 92.31% in the treatment group (P < 0.05). After treatment, the NIHSS score in two groups was significantly lower than that before treatment, while the MBI score was significantly higher than that before treatment (P < 0.05), and the improvement was more significant in the treatment group (P < 0.05). After treatment, the levels of ACA, MCA, PCA, BA and VA in two groups were significantly higher than those before treatment (P < 0.05), especially in the treatment group (P < 0.05). After treatment, the levels of SOD and GSH-Px in two groups were significantly higher than those before treatment, while the level of MDA were significantly decreased (P < 0.05), and the above-mentioned serum oxidative stress indexes were improved more significantly in the treatment group (P < 0.05). After treatment, the levels of NPY and NSE in two groups were significantly lower than those before treatment (P < 0.05), especially in the treatment group (P < 0.05). Conclusion Yinxing Ertie Neizhi Puan combined with troxerutin can significantly improve the clinical symptoms of patients with acute cerebral infarction, can improve cerebral blood flow velocity, effectively inhibit oxidative stress reaction, reduce brain injury, and has good clinical effect and high safety.

R971