目的 观察苏合香丸联合氯吡格雷治疗急性脑梗死的临床疗效。方法 选取2020年12月—2022年1月保定市第二医院收治的98例急性脑梗死患者，随机数字表法将所有患者分为对照组和治疗组，每组各49例。对照组口服硫酸氢氯吡格雷片，75 mg/次，1次/d。治疗组在对照组基础上口服苏合香丸，1丸/次，2次/d。两组疗程均为2周。观察两组的临床疗效，比较两组卒中相关量表评分，血小板相关参数[血小板最大聚集率（MAR）、血浆血小板α颗粒膜糖蛋白（CD62p）、溶酶体膜糖蛋白（CD63）、血栓素B₂（TXB₂）水平]及血浆纤维蛋白原（FIB）、D-二聚体（D-D）、S100β蛋白和脑源性神经营养因子（BDNF）水平。结果 治疗后，治疗组总有效率是95.9%，显著高于对照组的83.7%（P＜0.05）。治疗后两组欧洲卒中量表（ESS）评分均显著增加，美国国立卫生研究院卒中量表（NIHSS）评分均显著减少（P＜0.05）；且均以治疗组改善更显著（P＜0.05）。治疗后，两组MAR和血浆CD62p、CD63、TXB₂水平比治疗前均显著降低（P＜0.05）；且治疗后，治疗组MAR及血浆CD62p、CD63、TXB₂水平均显著低于对照组（P＜0.05）。治疗后两组血浆FIB、D-D和S100β蛋白水平均显著下降，血浆BDNF水平均显著上升（P＜0.05）；且均以治疗组的改善更显著（P＜0.05）。结论 苏合香丸联合氯吡格雷治疗急性脑梗死的整体效果确切，能有效抑制血小板过度激活，纠正患者血栓前状态，促进神经功能恢复，且安全性较好，值得临床推广应用。

Objective To observe the clinical efficacy of Suhexiang Pills combined with clopidogrel in treatment of acute cerebral infarction.Methods A total of 98 patients with acute cerebral infarction admitted to The NO.2 Hospital of Baoding from December 2020 to January 2022 were selected. All patients were divided into control group and treatment group by random number table method, with 49 cases in each group. Patients in the control group were po administered with Clopidogrel Hydrogen Sulphate Tablets, 75 mg/time, once daily. Patients in the treatment group were po administered with Suhexiang Pills on the basis of the control group, 1 pill/time, twice daily. The treatment course of both groups was 2 weeks. The clinical efficacy of the two groups was observed, and the scores of stroke related scales between the two groups, platelet related parameters[platelet maximum aggregation rate (MAR), plasma platelet α granulosa membrane glycoprotein (CD62p), lysosomal membrane glycoprotein (CD63), thromboxane B₂ (TXB₂) levels] and plasma fibrinogen (FIB), D-dimer (D-D), S100β protein and brain-derived neurotrophic factor (BDNF) levels were compared. Results After treatment, the total effective rate of treatment group was 95.9%, significantly higher than that of control group 83.7% (P < 0.05). After treatment, the European Stroke Scale (ESS) score was significantly increased, and the National Institutes of Health Stroke Scale (NIHSS) score was significantly decreased in both groups (P < 0.05). The improvement was more significant in the treatment group (P < 0.05). After treatment, MAR and plasma LEVELS of CD62p, CD63 and TXB₂ in two groups were significantly lower than those before treatment (P < 0.05). After treatment, MAR and plasma levels of CD62p, CD63 and TXB₂ in the treatment group were significantly lower than those in the control group (P < 0.05). After treatment, the plasma FIB, D-D and S100β protein levels in both groups were significantly decreased, and the plasma BDNF level was significantly increased (P < 0.05). The improvement was more significant in the treatment group (P < 0.05). Conclusion Suhexiang Pills combined with clopidogrel has a definite overall effect in treatment of acute cerebral infarction, and can effectively inhibit platelet hyperactivation, correct patients' pre-thrombotic state, and promote the recovery of neurological function, which is safe and worthy of clinical application.

R971

保定市科技计划项目(1951ZF019)