目的 觀察蘇合香丸聯(lián)合氯吡格雷治療急性腦梗死的臨床療效。方法 選取2020年12月—2022年1月保定市第二醫(yī)院收治的98例急性腦梗死患者，隨機數(shù)字表法將所有患者分為對照組和治療組，每組各49例。對照組口服硫酸氫氯吡格雷片，75 mg/次，1次/d。治療組在對照組基礎上口服蘇合香丸，1丸/次，2次/d。兩組療程均為2周。觀察兩組的臨床療效，比較兩組卒中相關量表評分，血小板相關參數(shù)[血小板最大聚集率（MAR）、血漿血小板α顆粒膜糖蛋白（CD62p）、溶酶體膜糖蛋白（CD63）、血栓素B₂（TXB₂）水平]及血漿纖維蛋白原（FIB）、D-二聚體（D-D）、S100β蛋白和腦源性神經營養(yǎng)因子（BDNF）水平。結果 治療后，治療組總有效率是95.9%，顯著高于對照組的83.7%（P＜0.05）。治療后兩組歐洲卒中量表（ESS）評分均顯著增加，美國國立衛(wèi)生研究院卒中量表（NIHSS）評分均顯著減少（P＜0.05）；且均以治療組改善更顯著（P＜0.05）。治療后，兩組MAR和血漿CD62p、CD63、TXB₂水平比治療前均顯著降低（P＜0.05）；且治療后，治療組MAR及血漿CD62p、CD63、TXB₂水平均顯著低于對照組（P＜0.05）。治療后兩組血漿FIB、D-D和S100β蛋白水平均顯著下降，血漿BDNF水平均顯著上升（P＜0.05）；且均以治療組的改善更顯著（P＜0.05）。結論 蘇合香丸聯(lián)合氯吡格雷治療急性腦梗死的整體效果確切，能有效抑制血小板過度激活，糾正患者血栓前狀態(tài)，促進神經功能恢復，且安全性較好，值得臨床推廣應用。

Objective To observe the clinical efficacy of Suhexiang Pills combined with clopidogrel in treatment of acute cerebral infarction.Methods A total of 98 patients with acute cerebral infarction admitted to The NO.2 Hospital of Baoding from December 2020 to January 2022 were selected. All patients were divided into control group and treatment group by random number table method, with 49 cases in each group. Patients in the control group were po administered with Clopidogrel Hydrogen Sulphate Tablets, 75 mg/time, once daily. Patients in the treatment group were po administered with Suhexiang Pills on the basis of the control group, 1 pill/time, twice daily. The treatment course of both groups was 2 weeks. The clinical efficacy of the two groups was observed, and the scores of stroke related scales between the two groups, platelet related parameters[platelet maximum aggregation rate (MAR), plasma platelet α granulosa membrane glycoprotein (CD62p), lysosomal membrane glycoprotein (CD63), thromboxane B₂ (TXB₂) levels] and plasma fibrinogen (FIB), D-dimer (D-D), S100β protein and brain-derived neurotrophic factor (BDNF) levels were compared. Results After treatment, the total effective rate of treatment group was 95.9%, significantly higher than that of control group 83.7% (P < 0.05). After treatment, the European Stroke Scale (ESS) score was significantly increased, and the National Institutes of Health Stroke Scale (NIHSS) score was significantly decreased in both groups (P < 0.05). The improvement was more significant in the treatment group (P < 0.05). After treatment, MAR and plasma LEVELS of CD62p, CD63 and TXB₂ in two groups were significantly lower than those before treatment (P < 0.05). After treatment, MAR and plasma levels of CD62p, CD63 and TXB₂ in the treatment group were significantly lower than those in the control group (P < 0.05). After treatment, the plasma FIB, D-D and S100β protein levels in both groups were significantly decreased, and the plasma BDNF level was significantly increased (P < 0.05). The improvement was more significant in the treatment group (P < 0.05). Conclusion Suhexiang Pills combined with clopidogrel has a definite overall effect in treatment of acute cerebral infarction, and can effectively inhibit platelet hyperactivation, correct patients' pre-thrombotic state, and promote the recovery of neurological function, which is safe and worthy of clinical application.

R971

保定市科技計劃項目(1951ZF019)