目的 探討刺五加注射液聯(lián)合注射用尤瑞克林治療急性腦梗死的臨床療效。方法 將2020年4月—2025年2月在貴州中醫(yī)藥大學第二附屬醫(yī)院就診的79例急性腦梗死患者納入，按隨機數(shù)字表法將患者分為對照組（39例）和治療組（40例）。對照組患者靜脈滴注注射用尤瑞克林，1次/d，每次1瓶加入100 mL生理鹽水充分稀釋。治療組在對照組基礎上靜脈注射刺五加注射液，1次/d，7 mg/kg加入生理鹽水充分稀釋。兩組在完成2周治療統(tǒng)計療效。比較兩組患者的治療效果、美國國立衛(wèi)生研究院卒中量表（NIHSS）評分、Berg平衡量表（BBS）評分、改良Barthel指數(shù)（MBI）評分、腦血流動力學和血清指標。結(jié)果 治療組的總有效率明顯比對照組高，差異有統(tǒng)計學意義（95.00% vs 79.49%，P＜0.05）。兩組治療后的NIHSS評分顯著降低，BBS、MBI評分顯著升高（P＜0.05）；治療組的BBS評分低于對照組，BBS、MBI評分高于對照組（P＜0.05）。兩組治療后的外周阻力（Rv）降低，腦血管儲備能力（CVR）、平均血流速度（MFV）均明顯升高（P＜0.05），治療組的Rv低于對照組，CVR、MFV高于對照組（P＜0.05）。兩組治療后的血清前蛋白轉(zhuǎn)化酶枯草溶菌素9（PCSK9）、同型半胱氨酸（Hcy）、正五聚蛋白3（PTX3）、神經(jīng)元特異性烯醇化酶（NSE）水平均明顯降低（P＜0.05），治療組的血清PCSK9、Hcy、PTX3、NSE水平均低于對照組（P＜0.05）。結(jié)論 刺五加注射液聯(lián)合注射用尤瑞克林可提高急性腦梗死的臨床療效，減輕神經(jīng)損傷，提高平衡能力和日常生活能力，改善腦血流動力學水平，減輕神經(jīng)炎性損傷。

Objective To explore the clinical efficacy of Ciwujia Injection combined with Urinary kallindinogenase for injection in treatment of acute cerebral infarction.Methods A total of 79 patients with acute cerebral infarction who visited the Second Affiliated Hospital of Guizhou University of Traditional Chinese Medicine from April 2020 to February 2025 were included and randomly divided into control group (39 cases) and treatment group (40 cases) using a random number table method. The control group of patients received intravenous infusion of Urinary kallindinogenase for injection, once daily, with 100 mL of physiological saline added to one bottle each time for thorough dilution. The treatment group received were iv administered with Ciwujia Injection on the basis of the control group, once daily, at a dose of 7 mg/kg, diluted thoroughly with physiological saline. Two groups completed two weeks of treatment. The therapeutic effects, National Institutes of Health Stroke Scale (NIHSS) scores, Berg Balance Scale (BBS) scores, Modified Barthel Index (MBI) scores, cerebral hemodynamics, and serum indicators were compared between two groups of patients.Results The total effective rate of the treatment group was significantly higher than that of the control group, and the difference was statistically significant (95.00% and 79.49%, P < 0.05). After treatment, the NIHSS scores of the two groups were significantly reduced, while the BBS and MBI score was significantly increased (P < 0.05). The NIHSS scores of the treatment group were lower than those of the control group, while the BBS and MBI score was higher than that of the control group (P < 0.05). After treatment, the peripheral resistance (Rv) of two groups were significantly decreased, while cerebrovascular reserve capacity (CVR) and mean blood flow velocity (MFV) were significantly increased (P < 0.05). And the Rv of the treatment group were lower than those of the control group, but CVR and MFV of the treatment group were higher than those of the control group (P < 0.05). After treatment, the serum levels of preprotein converting enzyme subtilisin 9 (PCSK9), homocysteine (Hcy), pentameric protein 3 (PTX3), and neuron specific enolase (NSE) were significantly reduced in two groups (P < 0.05), and the serum levels of PCSK9, Hcy, PTX3, and NSE in the treatment group were lower than those in the control group (P < 0.05).Conclusion Ciwujia Injection combined with Urinary kallindinogenase for injection can improve clinical efficacy of acute cerebral infarction, reduce nerve damage, enhance balance ability and daily living ability, alleviate cerebral hemodynamics, and reduce neuritic damage.

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