目的 探討腦得生丸聯(lián)合依達(dá)拉奉注射液治療急性腦梗死的臨床療效。方法 選取2020年6月—2022年5月安陽市人民醫(yī)院收治的150例急性腦梗死患者，采用隨機(jī)數(shù)字表法將所有患者分為對照組和治療組，每組各75例。對照組靜脈滴注依達(dá)拉奉注射液，30mg溶于0.9%氯化鈉注射液100mL，每次30min滴注完畢，2次/d。治療組在對照組的基礎(chǔ)上口服腦得生丸，1袋/次，3次/d。兩組均治療14d。觀察兩組臨床療效，比較兩組美國國立衛(wèi)生研究院卒中量表（NIHSS）評分、Barthel指數(shù)評分、血液流變學(xué)指標(biāo)、腦神經(jīng)損傷標(biāo)志物、腦血流動力學(xué)指標(biāo)。結(jié)果 治療后，治療組的總有效率為94.67%，明顯高于對照組的總有效率84.00%，組間比較差異具有顯著性（P＜0.05）。治療后，兩組的Barthel指數(shù)顯著升高，NIHSS評分顯著下降（P＜0.05），且治療組Barthel指數(shù)顯著高于對照組，NIHSS評分顯著低于對照組（P＜0.05）。治療后，兩組的收縮期峰值血流速度（V_s）、平均血流速度（V_m）、舒張期血流速度（V_d）均顯著升高，阻力指數(shù)（RI）顯著下降（P＜0.05），且治療組V_s、V_m、V_d均顯著高于對照組，RI顯著低于對照組（P＜0.05）。治療后，兩組血小板壓積、纖維蛋白原、全血低切黏度、紅細(xì)胞沉降率、全血高切黏度均顯著下降（P＜0.05），且治療組血小板壓積、纖維蛋白原、全血低切黏度、紅細(xì)胞沉降率、全血高切黏度均顯著低于對照組（P＜0.05）。治療后，兩組的血清S100β蛋白（S100β）、神經(jīng)元特異性烯醇化酶（NSE）水平均顯著下降（P＜0.05），且治療組血清S100β、NSE水平明顯低于對照組（P＜0.05）。結(jié)論 腦得生丸聯(lián)合依達(dá)拉奉注射液治療急性腦梗死具有較好的臨床療效，可減輕神經(jīng)功能損傷，促進(jìn)患者生活自理能力的恢復(fù)，改善血液流變學(xué)、腦血流動力學(xué)和降低血清S100β、NSE水平。

Objective To explore the clinical efficacy of Naodesheng Pills combined with Edaravone Injection in treatment of acute cerebral infarction. Methods Patients (150 cases) with acute cerebral infarction in the People's Hospital of Anyang City from June 2020 to May 2022 were divided into control and treatment groups according to random number table method, and each group had 75 cases. Patients in the control group were iv administered with Edaravone Injection, 30 mg added into 0.9% sodium chloride injection 100 mL, 30 min infusion completed, twice daily. Patients in the treatment group were po administered with Naodesheng Pills on the basis of the control group, 1 bag/time, three times daily. Patients in two groups were treated for 14 d. After treatment, the clinical efficacies were evaluated, and NIHSS scores, Barthel index scores, hemorheology indexes, brain nerve injury markers, and cerebral hemodynamics indexes in two groups were compared. Results After treatment, the total effective rate of the treatment group was 94.67%, which was significantly higher than that of the control group (84.00%), and there was a significant difference between two groups (P<0.05). After treatment, Barthel indexes of two groups were significantly increased, but the NIHSS scores of two groups were significantly decreased (P<0.05), and Barthel index of the treatment group was significantly higher than that of the control group, but NIHSS score of the treatment group was significantly lower than that of the control group (P<0.05). After treatment, the V_s, V_m, and V_d of two groups were significantly increased, but the RI of two groups was significantly decreased (P<0.05). The V_s, V_m, and V_d of the treatment group were significantly higher than those of the control group, but the RI of the treatment group was significantly lower than that of the control group (P<0.05). After treatment, the platelet hematocrit, fibrinogen, whole blood low shear viscosity, erythrocyte sedimentation rate, and whole blood high shear viscosity in two groups were significantly decreased (P<0.05), and the platelet hematocrit, fibrinogen, whole blood low shear viscosity, erythrocyte sedimentation rate, and whole blood high shear viscosity in the treatment group were significantly lower than those in the control group (P<0.05). After treatment, the serum levels of S100β and NSE in two groups were significantly decreased (P<0.05), and the serum levels of S100β and NSE in the treatment group were significantly lower than those in the control group (P<0.05). Conclusion Naodesheng Pills combined with Edaravone Injection has clinical curative effect in treatment of acute cerebral infarction, can reduce the neurological damage, promote the recovery of the patient's self-care ability, improve hemorheology, cerebral hemodynamics, and reduce the serum levels of S100β and NSE.

R971

河南省醫(yī)學(xué)科技攻關(guān)計劃聯(lián)合共建項(xiàng)目（LHG20191270）