目的 探討通塞脈片聯(lián)合硫酸氫氯吡格雷片治療急性腦梗死的臨床療效。方法 選取2020年1月—2023年3月阜陽市中醫(yī)醫(yī)院收治的108例急性腦梗死患者，按隨機(jī)數(shù)字法將患者分對(duì)照組（54例）和治療組（54例）。對(duì)照組患者口服硫酸氫氯吡格雷片，75 mg/次，1次/d。在對(duì)照組的基礎(chǔ)上，治療組口服通塞脈片，5片/次，3次/d。兩組患者均治療14 d。觀察兩組患者臨床療效，比較治療前后兩組患者癥狀好轉(zhuǎn)時(shí)間，美國國立衛(wèi)生研究院卒中量表（NIHSS）和Fugl-Meyer運(yùn)動(dòng)功能表（FMA）評(píng)分，血清炎性因子白細(xì)胞介素-6（IL-6）和同型半胱氨酸（Hcy）水平及不良反應(yīng)。結(jié)果 治療后；治療組患者總有效率（98.15%）明顯高于對(duì)照組（83.33%，P＜0.05）。治療后，治療組癥狀好轉(zhuǎn)時(shí)間均早于對(duì)照組（P＜0.05）。治療后，兩組NIHSS評(píng)分明顯降低，而FMA評(píng)分明顯升高（P＜0.05），且治療組評(píng)分明顯好于對(duì)照組（P＜0.05）。治療后，兩組患者血清炎性因子IL-6、Hcy水平明顯降低（P＜0.05），且治療組明顯低于對(duì)照組（P＜0.05）。治療后，治療組不良反應(yīng)總發(fā)生率（5.56%）明顯低于對(duì)照組（12.96%，P＜0.05）。結(jié)論 通塞脈片聯(lián)合硫酸氫氯吡格雷片治療急性腦梗死療效確切，可有效改善臨床癥狀，糾正腦神經(jīng)損傷狀態(tài)，并減弱機(jī)體炎性反應(yīng)，增強(qiáng)患者運(yùn)動(dòng)功能。

Objective To explore the therapeutic effect of Tongsaimai Tablets combined with clopidogrel bisulfate in treatment of acute cerebral infarction. Methods Patients (108 cases) with acute cerebral infarction from January 2020 to March 2023 were randomly divided into control (54 cases) and treatment (54 cases) group. Patients in the control group were po administered with Clopidogrel Bisulfate Tablets, 75 mg/time, once daily. Patients in the treatment group were po administered with Tongsaimai 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 evaluation was evaluated, and the symptom relief times, the scores of FMA and NIHSS, the levels of IL-6 and Hcy, and adverse reaction in two groups before and after treatment were compared. Results After treatment, the clinical effective rate of patients in the treatment group (98.15%) was significantly higher than that in the control group (83.33%, P < 0.05). After treatment, the time of symptom improvement in the treatment group was significantly earlier than that in the control group (P < 0.05). After treatment, the NIHSS score in two groups was significantly decreased, while the FMA score was significantly increased (P < 0.05), and these scores in the treatment group were significantly better than those in the control group (P < 0.05). After treatment, the levels of serum inflammatory factors IL-6 and Hcy in the treatment group were significantly lower than those in the control group (P < 0.05), which in the treatment group was significantly lower than that in the control group (P < 0.05). After treatment, the incidence of adverse reactions in the treatment group (5.56%) was significantly lower than that in the control group (12.96%, P < 0.05). Conclusion The curative effect of clopidogrel bisulfate combined with Tongsaimai Tablets in treatment of acute cerebral infarction is definite, which can effectively improve the clinical symptoms, correct the state of cerebral nerve injury, weaken the inflammatory response and enhance the motor function of patients.

R971

安徽省中醫(yī)藥科技項(xiàng)目（2021M081）