目的 探究通络化痰胶囊联合胞二磷胆碱注射液治疗急性脑梗死的临床疗效。方法 选取2017年11月-2018年11月大连大学附属新华医院收治的124例急性脑梗死患者为研究对象，将所有患者随机分为对照组和治疗组，每组各62例。对照组静脉滴注胞二磷胆碱注射液，0.75 g加入到生理盐水100 mL中，1次/d。治疗组在对照组治疗的基础上餐后口服通络化痰胶囊，3粒/次，3次/d。根据患者情况治疗5~10 d。观察两组的临床疗效，比较两组的美国国立卫生研究院卒中量表（NIHSS）评分、改良Rankin评分量表（mRS）评分、脑血流动力学参数、血清神经元特异性烯醇化酶（NSE）、同型半胱氨酸（Hcy）、脂蛋白（a）[Lp（a）]、扣针蛋白-5（Fibulin-5）、高迁移率族蛋白-1（HMGB1）水平。结果 治疗后，对照组和治疗组的总有效率分别为83.87%、95.16%，两组比较差异有统计学意义（P<0.05）。治疗后，两组NIHSS评分和MRS评分均显著降低，同组治疗前后比较差异有统计学意义（P<0.05）；且治疗组的NIHSS评分和MRS评分均明显低于对照组，两组比较差异有统计学意义（P<0.05）。治疗后，两组平均血流速度（V_mean）和血流量（Q_mean）水平均显著升高，外周阻力（R_v）水平显著降低，同组治疗前后比较差异有统计学意义（P<0.05）；且治疗组的V_mean和Q_mean水平高于对照组，R_v水平低于对照组，两组比较差异有统计学意义（P<0.05）。治疗后，两组血清NSE、Hcy和Lp（a）水平均显著降低，同组治疗前后比较差异有统计学意义（P<0.05）；且治疗组的血清NSE、Hcy和Lp（a）水平明显低于对照组，两组比较差异有统计学意义（P<0.05）。治疗后，两组血清中Fibulin-5、HMGB1水平均显著降低，同组治疗前后比较差异有统计学意义（P<0.05）；且治疗组的血清中Fibulin-5、HMGB1水平明显低于对照组，两组比较差异有统计学意义（P<0.05）。结论 通络化痰胶囊联合胞二磷胆碱注射液治疗急性脑梗死具有较好的临床疗效，能改善脑组织缺血缺氧状态，降低脑损伤，提高患者生活能力，具有一定的临床推广应用价值。

Objective To investigate the clinical effect of Tongluo Huatan Capsules combined with Citicoline Injection in treatment of acute cerebral infarction. Methods Patients (124 cases) with acute cerebral infarction in Dalian University Affiliated Xinhua Hospital from November 2017 to November 2018 were randomly divided into control and treatment groups, and each group had 62 cases. Patients in the control group were iv administered with Citicoline Injection, 0.75 g added into normal saline 100 mL, once daily. Patients in the treatment group were po administered with Tongluo Huatan Capsules on the basis of the control group, 3 grains/time, three times daily. Patients in two groups were treated for 5-10 d. After treatment, the clinical efficacies were evaluated, and NIHSS scores, mRS scores, cerebral hemodynamic parameters, the serum levels of NSE, Hcy, Lp(a), Fibulin-5 and HMGB1 in two groups were compared. Results After treatment, the clinical efficacies in the control and treatment groups were 83.87% and 95.16%, respectively, and there was difference between two groups (P<0.05). After treatment, NIHSS scores and MRS scores in two groups were significantly decreased, and the difference was statistically significant in the same group (P<0.05). And the scores in the treatment group were significantly lower than those in the control group, with significant difference between two groups (P<0.05). After treatment, the levels of V_mean and Q_mean in two groups were significantly increased, but the levels of R_v in two groups were significantly decreased, and the difference was statistically significant in the same group (P<0.05). And the observational indexes in the treatment group were significantly better than those in the control group, with significant difference between two groups (P<0.05). After treatment, the levels of NSE, Hcy, and Lp(a) in two groups were significantly decreased, and the difference was statistically significant in the same group (P<0.05). And the observational indexes in the treatment group were significantly lower than those in the control group, with significant difference between two groups (P<0.05). After treatment, the levels of Fibulin-5 and HMGB1 in two groups were significantly decreased, and the difference was statistically significant in the same group (P<0.05). And the observational indexes in the treatment group were significantly lower than those in the control group, with significant difference between two groups (P<0.05). Conclusion Tongluo Huatan Capsules combined with Citicoline Injection has clinical curative effect in treatment of acute cerebral infarction, can improve the state of cerebral ischemia and hypoxia, reduce brain injury, and improve the living ability of patients, which has a certain clinical application value.