目的 探討天丹通絡(luò)片聯(lián)合丁苯酞氯化鈉注射液治療急性腦梗死的臨床療效。方法 選取2020年8月—2022年5月首都醫(yī)科大學(xué)附屬北京友誼醫(yī)院平谷醫(yī)院收治的86例急性腦梗死患者，按隨機(jī)數(shù)字表法將所有患者分為對(duì)照組和治療組，每組各43例。對(duì)照組靜脈滴注丁苯酞氯化鈉注射液，100 mL/次，2次/d。治療組患者在對(duì)照組治療基礎(chǔ)上口服天丹通絡(luò)片，5片/次，3次/d。兩組療程均為14 d。觀察兩組的臨床療效，比較治療前后兩組美國(guó)國(guó)立衛(wèi)生研究院卒中量表（NIHSS）評(píng)分、血小板參數(shù)[血小板分布寬度（PDW）、平均血小板體積（MPV）]，凝血指標(biāo)[纖維蛋白原（FIB）、D-二聚體（D-D）]，外周血血小板與淋巴細(xì)胞比值（PLR）、中性粒細(xì)胞與淋巴細(xì)胞比值（NLR）及血清同型半胱氨酸（HCY）、超敏C反應(yīng)蛋白（hs-CRP）水平。結(jié)果 治療后，治療組總有效率是95.35%，較對(duì)照組的81.40%顯著提高（P＜0.05）。治療后，兩組NIHSS評(píng)分均顯著降低（P＜0.05）；治療后，治療組NIHSS評(píng)分顯著低于對(duì)照組（P＜0.05）。治療后，兩組PDW、MPV和血漿FIB、D-D水平均顯著降低（P＜0.05）；且治療后，治療組PDW、MPV和血漿FIB、D-D水平均顯著低于對(duì)照組（P＜0.05）。治療后，兩組外周血PLR、NLR和血清Hcy、hs-CRP水平均顯著下降（P＜0.05）；且治療后，治療組外周血PLR、NLR和血清Hcy、hs-CRP水平均顯著低于對(duì)照組（P＜0.05）。結(jié)論 天丹通絡(luò)片聯(lián)合丁苯酞氯化鈉注射液治療急性腦梗死的整體效果確切，可減輕患者神經(jīng)功能缺損、促進(jìn)側(cè)支循環(huán)建立，并能進(jìn)一步改善血液高凝狀態(tài)及下調(diào)外周血PLR、NLR和血清HCY、hs-CRP水平。

Objective To investigate the clinical effect of Tiandan Tongluo Tablets combined with butylphthalide in treatment of acute cerebral infarction. Methods A total of 86 patients with acute cerebral infarction admitted to Pinggu Hospital, Beijing Friendship Hospital Affiliated to Capital Medical University from August 2020 to May 2022 were selected and divided into control group and treatment group according to random number table method, with 43 cases in each group. Patients in the control group were iv administered with Butylphthalide and Sodium Chloride Injection, 100 mL/time, twice daily. Patients in the treatment group were po administered with Tiandan Tongluo Tablets on the basis of the control group, 5 tablets/time, three times daily. Patients in two groups were treated for 14 d. After treatment, the clinical efficacy was evaluated, and the National Institutes of Health Stroke Scale (NIHSS) score, regional leptomeningial collateral circulation (rLMC) score, platelet parameters [platelet distribution width (PDW), mean platelet volume (MPV)], coagulation indexes [fibrinogen (FIB), D-dimer (D-D)], peripheral blood platelet to lymphocyte ratio (PLR), neutrophil to lymphocyte ratio (NLR), serum homocysteine (HCY), high sensitive C-reactive protein (hs-CRP) levels in two groups before and after treatment 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, NIHSS scores in both groups were significantly decreased (P < 0.05). After treatment, the NIHSS score in the treatment group was significantly lower than that in control group (P < 0.05). After treatment, the levels of PDW, MPV, plasma FIB and D-D were significantly decreased in both groups (P <0.05). After treatment, the levels of PDW, MPV, plasma FIB and D-D in the treatment group were significantly lower than those in control group (P < 0.05). After treatment, the levels of peripheral blood PLR, NLR and serum HCY and hs-CRP in two groups were significantly decreased (P < 0.05). After treatment, the levels of peripheral blood PLR, NLR, serum HCY and hs-CRP in treatment group were significantly lower than those in control group (P < 0.05). Conclusions Tiandan Tongluo Tablets combined with butylphthalide has a definite overall effect in treatment of acute cerebral infarction, and can alleviate the neurological impairment, promote the establishment of collateral circulation, further improve the blood hypercoagulability, and lower the levels of PLR, NLR, HCY and hs-CRP in peripheral blood.

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