目的 探討血栓通注射液聯(lián)合艾地苯醌治療急性腦梗死的臨床療效。方法 選取2022年3月—2025年1月北京中醫(yī)藥大學(xué)東方醫(yī)院收治的82例急性腦梗死患者的病例資料，進(jìn)行回顧性分析，按治療方法分成對(duì)照組和治療組（各41例）。對(duì)照組給予艾地苯醌片治療，30 mg/次，3次/d，餐后溫水送服。治療組在此基礎(chǔ)上聯(lián)合血栓通注射液靜脈滴注治療，將5 mL加入0.9%氯化鈉注射液250 mL稀釋后使用，2次/d。兩組療程14 d。觀察兩組臨床療效，比較治療前后中文版腦卒中上肢能力量表（SULCS）、美國國立衛(wèi)生研究院卒中量表（NIHSS）、36項(xiàng)健康調(diào)查簡(jiǎn)表（SF-36）評(píng)分、凝血功能指標(biāo)[血漿纖維蛋白（原）降解產(chǎn)物（FDP）、纖溶酶–抗纖溶酶復(fù)合物（PAP）、血小板聚集率（PAgT）]和血清8-異前列腺素F2α（8-iso-PGF2α）、丙二醛（MDA）、內(nèi)皮素-1（ET-1）、內(nèi)皮型一氧化氮合成酶（eNOS）、基質(zhì)金屬蛋白酶-9（MMP-9）、基質(zhì)細(xì)胞衍生因子1（SDF-1）水平。結(jié)果 治療組總有效率是95.12%，顯著高于對(duì)照組的80.49%（P＜0.05）。治療后，兩組SULCS、SF-36評(píng)分都高于組內(nèi)治療前，NIHSS評(píng)分都低于組內(nèi)治療前（P＜0.05）；治療后相關(guān)評(píng)分均以治療組改善更明顯（P＜0.05）。治療后，兩組FDP、PAP、PAgT水平都低于組內(nèi)治療前（P＜0.05）；治療后，凝血功能指標(biāo)均以治療組更低（P＜0.05）。治療后，兩組8-iso-PGF2α、MDA、ET-1、MMP-9水平都低于組內(nèi)治療前，eNOS、SDF-1水平都高于組內(nèi)治療前（P＜0.05）；治療后，均以治療組改善更顯著（P＜0.05）。結(jié)論 急性腦梗死應(yīng)用血栓通注射液聯(lián)合艾地苯醌治療，能有效改善患者的凝血功能和血管內(nèi)皮功能，抑制氧化應(yīng)激及炎癥損害，進(jìn)一步保護(hù)神經(jīng)功能，促進(jìn)上肢功能狀態(tài)恢復(fù)和生活質(zhì)量好轉(zhuǎn)。

Objective To investigate the clinical efficacy of Xueshuantong Injection combined with idebenone in treatment of acute cerebral infarction. Methods The case data of 82 patients with acute cerebral infarction admitted to Dongfang Hospital of Beijing University of Chinese Medicine from March 2022 to January 2025 were selected for retrospective analysis and divided into control group and treatment group (41 cases in each group) according to treatment methods. Patients in control group were treated with Idebenone Tablets, 30 mg each time, 3 times daily, taken with warm water after meals. Patients in treatment group were combined with intravenous drip treatment of Xueshuantong Injection on the basis of control group, 5 mL was added to 250 mL of 0.9% sodium chloride injection for dilution and used twice daily. The treatment courses of two groups were 14 d. The clinical efficacy of two groups was observe. The changes of SULCS score, NIHSS score, SF-36 score, and coagulation function indicators (FDP, PAP, and PAgT), 8-iso-PGF2α, MDA, ET-1, eNOS, MMP-9, and SDF-1 in two groups before and after treatment were compared. Results After treatment, the total effective rate of treatment group was 95.12%, significantly higher than that of control group (80.49%) (P < 0.05). After treatment, the SULCS and SF-36 scores of both groups were higher than those before treatment within the same groups, and the NIHSS scores were lower than those before treatment within the same groups (P < 0.05). After treatment, the relevant scores improved more significantly in treatment group (P < 0.05). After treatment, the levels of FDP, PAP and PAgT in both groups were lower than those before treatment within the same groups (P < 0.05). After treatment, the coagulation function indicators were all lower in treatment group (P < 0.05). After treatment, the levels of 8-iso-PGF2α, MDA, ET-1, and MMP-9 in both groups were lower than those before treatment within the same groups, and the levels of eNOS and SDF-1 were higher than those before treatment within the same groups (P < 0.05). After the treatment, the improvement was more significant in treatment group (P < 0.05). Conclusion The application of Xueshuantong Injection combined with idebenone in treatment of acute cerebral infarction can effectively improve the coagulation function and vascular endothelial function, inhibit oxidative stress and inflammatory damage, further protect nerve function, and promote the recovery of upper limb function and life quality.

R971

國家中醫(yī)藥管理局十一五重點(diǎn)專項(xiàng)專病（040104001003）