目的 探討通塞脈片聯(lián)合依達(dá)拉奉右莰醇治療急性腦梗死的臨床療效。方法 選取2020年10月—2022年6月鄭州市第三人民醫(yī)院神經(jīng)內(nèi)科診治的96例急性腦梗死患者，按照隨機(jī)數(shù)字表法分為對(duì)照組和治療組，每組各48例。對(duì)照組患者靜脈滴注依達(dá)拉奉右莰醇注射用濃溶液，30 mg/次，2次/d，加入100 mL生理鹽水中稀釋后，30 min內(nèi)滴完。治療組在對(duì)照組的基礎(chǔ)上口服通塞脈片，5片/次，3次/d。兩組均用藥14 d。觀察兩組的治療效果，比較兩組癥狀改善時(shí)間、美國國立衛(wèi)生研究院卒中量表（NIHSS）評(píng)分、日常生活能力量表評(píng)分（Barthel指數(shù)）和血清炎性因子水平。結(jié)果 治療后，治療組總有效率97.92%，顯著高于對(duì)照組的83.33%（P<0.05）。經(jīng)治療，治療組出現(xiàn)頭暈、失語、肢體偏癱、神志不清改善時(shí)間均顯著短于對(duì)照組（P<0.05）。治療后，兩組NHISS評(píng)分顯著降低，而Barthel評(píng)分顯著升高（P<0.05）；治療后，治療組NHISS評(píng)分低于對(duì)照組，而Barthel評(píng)分高于對(duì)照組（P<0.05）。治療后，兩組血清五聚素3（PTX3）、白細(xì)胞介素-6（IL-6）、脂蛋白相關(guān)磷脂酶A2（Lp-PLA2）、白細(xì)胞介素-1β（IL-1β）水平均較治療前顯著降低（P<0.05）；治療后，治療組血清PTX3、IL-6、Lp-PLA2、IL-1β水平均低于對(duì)照組（P<0.05）。治療后，治療組不良反應(yīng)發(fā)生率6.28%，顯著低于對(duì)照組的12.47%（P<0.05）。結(jié)論 通塞脈片聯(lián)合依達(dá)拉奉右莰醇治療急性腦梗死具有較好的臨床療效，可顯著改善患者臨床癥狀，降低腦神經(jīng)受損程度，提高患者日常生活能力，同時(shí)還可有效降低炎性反應(yīng)，值得臨床借鑒。

Objective To investigate the clinical study of Tongsaimai Tablets combined with edaravone and dexborneol in treatment of acute cerebral infarction. Methods A total of 96 patients with acute cerebral infarction diagnosed and treated in the Department of Neurology of the Third People's Hospital of Zhengzhou from October 2020 to June 2022 were selected and divided into control group and treatment group according to random number table method, with 48 cases in each group. Patients in the control group were iv administered with Edaravone and Dexborneol Concentrated Solution for injection, 30 mg/time, twice daily, added 150 mL normal saline for dilution and finished the drip within 30 min. Patients in the treatment group were po administered with Tongsaimai Tablets on the basis of the control group, 5 tablets/time, there times daily. Both groups were treated for 14 d. The therapeutic effects of the two groups were observed, and the symptom improvement time, National Institutes of Health Stroke Scale score (NIHSS), Daily Living Ability Scale score (Barthel index) and serum inflammatory factors levels were compared between the two groups. Results After treatment, the total effective rate of the treatment group was 97.92%, which was significantly higher than that of the control group (83.33%, P < 0.05). After treatment, the improvement times of dizziness, aphasia, hemiplegia, and confusion in the treatment group were significantly shorter than those in the control group (P < 0.05). After treatment, NHISS score was significantly decreased, while Barthel score was significantly increased in both groups (P < 0.05). After treatment, NHISS score in the treatment group was lower than that in the control group, while Barthel score was higher than that in the control group (P< 0.05). After treatment, serum pentamylin 3 (PTX3), interleukin-6 (IL-6), lipoprotein-associated phospholipase A2 (Lp-PLA2) and interleukin-1β (IL-1β) levels in two groups were significantly decreased compared with before treatment (P < 0.05). After treatment, the levels of PTX3, IL-6, Lp-PLA2, and IL-1β in treatment group were lower than those in control group (P < 0.05). After treatment, the incidence of adverse reactions in the treatment group was 6.28%, significantly lower than that in the control group (12.47%) (P < 0.05). Conclusion Tongsaimai Tablets combined with edaravone and dexborneol has good clinical effect in treatment of acute cerebral infarction, and can significantly improve the clinical symptoms of patients, reduce the degree of neurological damage, improve patients' daily life ability, and also effectively reduce inflammatory response, which is worth clinical reference.

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