目的 探讨脑络通胶囊联合丁苯酞氯化钠注射液治疗急性脑梗死的临床疗效。方法 选取2018年2月-2019年2月在朝阳市第二医院治疗的急性脑梗死患者94例，根据住院号分为对照组（47例）和治疗组（47例）。对照组患者静脉滴注丁苯酞氯化钠注射液，100 mL/次，2次/d；治疗组在对照组基础上给予脑络通胶囊，1.0 g/次，3次/d。两组患者均治疗2周。观察两组患者临床疗效，同时比较治疗前后两组患者NIHSS、MoCA、mRS和SF-36评分，血清血红素氧合酶1（HO1）、新蝶呤（Npt）、肽素（CP）、血小板激活因子（PAF）、亲环素A（CyPA）和可溶性肿瘤坏死因子相关凋亡诱导配体（sTRAIL）水平，亦及红细胞压积（HCT）、血浆黏度（PV）、全血黏度（WBV）、纤维蛋白原（FIB）、动态阻力（DR）、相对平均血流量（Q_mean）、脑血管周围阻力（R）、平均血流速度（V_mean）和特性阻抗（ZCV）改变。结果 治疗后，对照组临床有效率为80.85%，显著低于治疗组的97.87%，两组比较差异有统计学意义（P<0.05）。治疗后，两组患者NIHSS评分和mRS评分均显著降低（P<0.05），而MoCA评分和SF-36评分均明显升高（P<0.05），且治疗组患者这些评分明显好于对照组（P<0.05）。治疗后，两组患者血清HO1、Npt、CPP、PAF、CyPA、sTRAIL水平均明显降低（P<0.05），且治疗组患者这些血清学指标明显低于对照组（P<0.05）。治疗后，两组患者HCT、PV、WBV、FIB、ZCV和R水平均明显下降，而Q_mean、DR和V_mean均显著升高（P<0.05），且治疗组患者这些指标水平明显好于对照组（P<0.05）。结论 脑络通胶囊联合丁苯酞治疗急性脑梗死可促进神经功能恢复、血液流变学改善，以及提高生活质量。

Objective To explore the clinical effect of Naoluotong Capsules combined with butylphthalide in treatment of acute cerebral infarction. Methods Patients (94 cases) with acute cerebral infarction in the Second Hospital of Chaoyang from February 2018 to February 2019 were divided into control (47 cases) and treatment (47 cases) groups according to hospitalization number. Patients in the control group were iv administered with Butylphthalide and Sodium Chloride Injection, 100 mg/time, twice daily. Patients in the treatment group were po administered with Naoluotong Capsules on the basis of the control group, 1 g/time, three times daily. Patients in two groups were treated for 2 weeks. After treatment, the clinical efficacy was evaluated, and the NIHSS, MoCA, mRS and SF-36 scores, the serum levels of HO1, Npt, CPP, PAF, CyPA and sTRAIL, and the change of HCT, PV, WBV, FIB, Q_mean, DR, V_mean, ZCV and R in two groups before and after treatment were compared. Results After treatment, the clinical efficacy in the control group was 80.85%, which was significantly lower than 97.87% in the treatment group, 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 MoCA and SF-36 scores were 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 serum levels of HO1, Npt, CPP, PAF, CyPA, and sTRAIL in two groups were significantly reduced (P<0.05), and these serological indexes in the treatment group were significantly lower than that in the control group (P<0.05). After treatment, the HCT, PV, WBV, FIB, ZCV and R levels in two groups were significantly decreased (P<0.05), but Q_mean, DR, and V_mean levels were significantly increased (P<0.05), and these indicators in the treatment group were significantly better than those in the control group (P<0.05). Conclusion Naoluotong Capsules combined with butylphthalide in treatment of acute cerebral infarction can promote the recovery of brain nerve function, improve hemorheology indicators and the quality of life.