目的 探讨益气通络颗粒联合硫酸氢氯吡格雷片治疗急性脑梗死恢复期的临床疗效。方法 选取2019年1月—2020年1月在河南省直第三人民医院治疗的84例急性脑梗死恢复期患者，随机分为对照组（42例）和治疗组（42例）。对照组患者口服硫酸氢氯吡格雷片，2片/次，1次/d。治疗组在对照组的基础上口服益气通络颗粒，1袋/次，3次/d。两组患者治疗1个月。观察两组患者临床疗效，比较治疗前后两组患者美国国立卫生研究院卒中量表（NIHSS）和应用日常生活能力量表（ADL）评分，白细胞介素-18（IL-18）、高迁移率族蛋白B1（HMGB1）、可溶性血管黏附分子1（sVCAM-1）、肿瘤坏死因子-α（TNF-α）、血浆黏度、血小板聚集率、全血高切黏度和全血低切黏度，及血栓弹力图参数R值、K值、Angle角和MA值。结果 治疗后，对照组总有效率为78.57%，显著低于治疗组的97.62%（P<0.05）。治疗后，两组患者NIHSS评分明显降低，而ADL评分明显升高（P<0.05），且治疗组明显好于对照组（P<0.05）。治疗后，两组患者IL-18、HMGB1、sVCAM-1、TNF-α水平明显下降（P<0.05），且治疗组均显著低于对照组患者（P<0.05）；治疗后，两组患者血浆黏度、血小板聚集率、全血高切黏度、全血低切黏度指标均显著降低（P<0.05），且治疗组明显低于对照组患者（P<0.05）；治疗后，两组患者血栓弹力图中R值、K值指标均低于治疗前，而Angle角、MA值指标均高于治疗前（P<0.05），且治疗组明显好于对照组（P<0.05）。结论 益气通络颗粒联合硫酸氢氯吡格雷片治疗急性脑梗死恢复期，可有效改善神经功能缺损状态和日常生活活动的能力，降低炎性因子水平，改善血液流变学情况。

Objective To explore the effect of Yiqi Tongluo Granules combined with clopidogrel in treatment of acute cerebral infarction.Methods Patients (84 cases) with acute cerebral infarction in the Third People's Hospital of Henan Province from January 2019 to January 2020 were randomly divided into control (42 cases) and treatment (42 cases) groups. Patients in the control group were po administered with Clopidogrel Bisulfate Tablets, 2 tablets/time, once daily. Patients in the treatment group were po administered with Yiqi Tongluo Granules on the basis of the control group, 1 bag/time, three times daily. Patients in two groups were treated for 1 month. After treatment, the clinical efficacy was evaluated, and the scores of NIHSS and ADL, the levels of IL-18, HMGB1, sVCAM-1, TNF-α, plasma viscosity, platelet aggregation rate, whole blood high shear viscosity and whole blood low shear viscosity, and thromboelastogram parameters of R value, K value, Angle and MA value in two groups before and after treatment were compared.Results After treatment, the clinical effective rate of the control group was 78.57%, which was significantly lower than 97.62% of the treatment group (P<0.05). After treatment, the NIHSS score in two groups was significantly decreased, while the ADL score was significantly increased (P<0.05). After treatment, the NIHSS score and ADL score in treatment group were significantly decreased, better than those in the control group (P<0.05). After treatment, the levels of IL-18, HMGB1, sVCAM-1 and TNF-α in two groups were significantly decreased (P<0.05), and the levels in the treatment group were significantly lower than those in the control group (P<0.05). After treatment, the plasma viscosity, platelet aggregation rate, whole blood high shear viscosity and whole blood low shear viscosity in two groups were significantly decreased (P<0.05), and which in the treatment group were significantly lower than those in the control group (P<0.05). After treatment, the R value and K value of thromboelastogram parameters in the two groups were lower than those before treatment, while the Angle angle and MA value were higher than those before treatment (P<0.05), and the treatment group was significantly better than the control group (P<0.05).Conclusion Yiqi Tongluo Granules combined with clopidogrel in treatment of acute cerebral infarction can effectively improve the state of neurological impairment and activities of daily living, reduce the level of inflammatory factors and improve hemorheology.

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