目的 探讨培元通脑胶囊联合丁苯酞治疗急性脑梗死的临床疗效。方法 选取2016年6月-2017年6月在开封市中心医院治疗的急性脑梗死患者102例，随机分为对照组（51例）和治疗组（51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；治疗组在对照组的基础上口服培元通脑胶囊，1.8 g/次，3次/d。两组均经过2周治疗。评价两组患者临床疗效，同时比较治疗前后两组患者NIHSS、mRS和MBI评分以及血清学指标和脑血流动力学指标。结果 治疗后，对照组临床总有效率为80.39%，显著低于治疗组的94.12%，两组比较差异具有统计学意义（P<0.05）。治疗后，两组患者NIHSS和mRS评分明显降低，MBI评分明显升高，同组比较差异具有统计学意义（P<0.05）；且治疗组NIHSS、mRS和MBI评分改善水平显著优于对照组（P<0.05）。治疗后，两组血清可溶性相关凋亡诱导配体（sTRAIL）、人高迁移率族蛋白B1（HMGB1）、单核细胞趋化蛋白-1（MCP-1）和可溶性细胞间黏附分子-1（sICAM-1）水平均显著降低，脑源性神经营养因子（BDNF）水平显著升高，同组比较差异具有统计学意义（P<0.05）；且治疗组患者上述血清学指标改善程度明显好于比对照组（P<0.05）。治疗后，两组双侧大脑中动脉V_p和V_m均显著增高，DVp和DVm均显著降低，同组比较差异具有统计学意义（P<0.05）；且治疗组患者上述脑血流动力学指标改善水平比对照组更显著（P<0.05）。结论 培元通脑胶囊联合丁苯酞治疗急性脑梗死可有效改善机体细胞因子水平和脑血流动力学指标，有利于神经功能恢复，提高日常生活能力。

Objective To investigate the clinical effect of Peiyuan Tongnao Capsules combined butylphthalide in treatment of acute cerebral infarction. Methods Patients (102 cases) with acute cerebral infarction in Kaifeng Central Hospital from June 2016 to June 2017 were randomly divided into control (51 cases) and treatment (51 cases) groups. Patients in the control group were iv administered with Butylphthalide and Sodium Chloride Injection, 100 mL/time, twice daily. Patients in the treatment group were po administered with Peiyuan Tongnao Capsules on the basis of the control group, 1.8 g/time, three times daily. Patients in two groups were treated for 2 weeks. After treatment, the clinical efficacy was evaluated, and the NIHSS, mRS and MBI scores, serological indexes, and cerebral hemodynamic indexes in two groups before and after treatment were compared. Results After treatment, the clinical efficacy in the control group was 80.39%, which was significantly lower than 94.12% in the treatment groups, and there were differences between two groups (P<0.05). After treatment, the NIHSS and mRS scores in two groups was significantly decreased, but MBI score was significantly increased, and the difference was statistically significant in the same group (P<0.05). And the improvement of NIHSS, mRS and MBI scores in the treatment group was obviously better than those in the control group (P<0.05). After treatment, the sTRAIL, HMGB1, MCP-1, and sICAM-1 levels in two groups were significantly decreased, but BDNF levels were significantly increased, and the difference was statistically significant in the same group (P<0.05). And the serological indexes levels in the treatment group were obviously better than those in the control group (P<0.05). After treatment, the V_p and V_m in two groups were significantly increased, DVp and DVm were significantly increased, and the difference was statistically significant in the same group (P<0.05). And the improvement of the cerebral hemodynamic indexes in the treatment group was obviously better than those in the control group (P<0.05). Conclusion Peiyuan Tongnao Capsules combined butylphthalide can effectively improve the level of cytokines and cerebral hemodynamic indexes in treatment of acute cerebral infarction, which is beneficial to the recovery of neurological function and improve the ability of daily living.