目的 探討苦蝶子注射液聯(lián)合氯吡格雷治療急性腦梗死的臨床療效。方法 選取2017年4月—2018年4月在鄭州市第六人民醫(yī)院治療的急性腦梗死患者190例，根據(jù)用藥的不同分為對(duì)照組（95例）和治療組（95例）。對(duì)照組口服硫酸氫氯吡格雷片，50 mg/次，1次/d；治療組在對(duì)照組基礎(chǔ)上靜脈滴注苦蝶子注射液，40 mL加入5%葡萄糖注射液250 mL，1次/d。兩組患者均治療2周。觀察兩組患者臨床療效，同時(shí)比較治療前后兩組患者NIHSS、mRS和SF-36評(píng)分及血清學(xué)指標(biāo)和腦血流動(dòng)力學(xué)。結(jié)果 治療后，對(duì)照組和治療組臨床有效率分別為82.11%和97.89%，兩組比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，兩組NIHSS評(píng)分和mRS評(píng)分顯著降低（P<0.05），SF-36評(píng)分升高（P<0.05），且治療組NIHSS、mRS和SF-36評(píng)分明顯好于對(duì)照組（P<0.05）。治療后，兩組血清可溶性腫瘤壞死因子相關(guān)凋亡誘導(dǎo)配體（sTRAIL）、嗜環(huán)蛋白/親環(huán)素A（CyPA）、基質(zhì)金屬蛋白酶-9（MMP-9）、血小板激活因子（PAF）、血紅素氧合酶1（HO1）水平均顯著降低（P<0.05），且治療組上述血清學(xué)指標(biāo)明顯低于對(duì)照組（P<0.05）。治療后，兩組相對(duì)平均血流量（Q_mean）和平均血流速度（V_mean）水平明顯升高（P<0.05），動(dòng)態(tài)阻力（DR）、特性阻抗（ZCV）和腦血管周圍阻力（R）明顯降低（P<0.05），且治療組上述腦血流動(dòng)力學(xué)指標(biāo)明顯優(yōu)于對(duì)照組（P<0.05）。結(jié)論 苦蝶子注射液聯(lián)合硫酸氫氯吡格雷片治療急性腦梗死可有效促進(jìn)神經(jīng)功能恢復(fù)，及改善日?；顒?dòng)能力，具有一定的臨床推廣應(yīng)用價(jià)值。

Objective To investigate the clinical effect of Kudiezi Injection combined with clopidogrel in treatment of acute cerebral infarction. Methods Patients (190 cases) with acute cerebral infarction in the Sixth People's Hospital of Zhengzhou from April 2017 to April 2018 were divided into control (95 cases) and treatment (95 cases) groups bases on different treatments. Patients in the control group were po administered with Clopidogrel Bisulfate Tablets, 50 mg/time, once daily. Patients in the treatment group were iv administered with Kudiezi Injection on the basis of the control group, 40 mL added into 5% Glucose Injection 250 mL, once daily. Patients in two groups were treated for 2 weeks. After treatment, the clinical efficacy was evaluated, and NIHSS, mRS and SF-36 scores, serological indexes, and cerebral hemodynamics in two groups before and after treatment were compared. Results After treatment, the clinical efficacy in the control and treatment groups was 82.11% and 97.89%, respectively, and there were differences between two groups (P<0.05). After treatment, the NIHSS and mRS scores in two groups were significantly decreased (P<0.05), but SF-36 scores were significantly increased (P<0.05), and the NIHSS, mRS and SF-36 scores in the treatment group were significantly better than those in the control group (P<0.05). After treatment, the PAF, sTRAIL, MMP-9, CyPA and HO1 levels in two groups were significantly decreased (P<0.05), and serological indexes levels in the treatment group were significantly lower than that in the control group (P<0.05). After treatment, the Q_mean and V_mean levels in two groups were significantly increased (P<0.05), but DR, ZCV and R levels were significantly decreased (P<0.05), and the cerebral hemodynamics indexes in the treatment group were significantly better than those in the control group (P<0.05). Conclusion Kudiezi Injection combined with clopidogrel in treatment of acute cerebral infarction can effectively promote the recovery of nerve function and improve the daily activity, which has a certain clinical application value.