目的 探讨乐脉颗粒联合吲哚布芬片治疗急性脑梗死的临床疗效。方法 选取2019年1月—2021年12月在中国人民解放军联勤保障部队第九八八医院就诊的96例急性脑梗死患者，根据随机数字表法将96例患者分为对照组和治疗组，每组各48例。对照组口服吲哚布芬片，100 mg/次，1次/d。治疗组在对照组基础上温水冲服乐脉颗粒，6 g/次，3次/d。两组患者连续治疗4周。观察两组的临床疗效，比较两组的神经功能缺损评分、颈总动脉血流动力学指标和血清中基质金属蛋白酶-9（MMP-9）、白细胞介素-17（IL-17）、Toll样受体4（TLR4）水平。结果 治疗后，治疗组的总有效率为95.83%，明显高于对照组总有效率81.25%，组间比较差异有统计学意义（P＜0.05）。治疗后，两组患者的神经功能缺损评分较治疗前降低（P＜0.05），且治疗组神经功能缺损评分小于对照组（P＜0.05）。治疗后，两组颈总动脉平均血流速度（V_m）、平均血流量（Q_m）高于治疗前，动态阻力（DR）低于治疗前（P＜0.05）；治疗组的颈总动脉V_m、Q_m高于对照组，DR低于对照组（P＜0.05）。治疗后，两组的血清MMP-9、IL-17、TLR4水平较治疗前降低（P＜0.05）；治疗组的血清MMP-9、IL-17、TLR4水平低于对照组，差异有统计学意义（P＜0.05）。结论 乐脉颗粒联合吲哚布芬片治疗急性脑梗死的疗效确切，可改善神经功能和颈总动脉血流动力学指标，降低炎症损伤，且安全性良好。

Objective To investigate the effect of Lemai Granules combined with Indobufen Tablets in treatment of acute cerebral infarction.Methods Patients (96 cases) with acute cerebral infarction in PLA Joint Logistic Support Force 988 Hospital from January 2019 to February 2021 were divided into control and treatment groups according to the random number table method,and each group had 48 cases.Patients in the control group were po administered with Indobufen Tablets,100 mg/time,once daily.Patients in the treatment group were po administered with Lemai Granules on the basis of the control group,6 g/time,three times daily.Patients in two groups were treated for 4 weeks.After treatment,the clinical efficacies were evaluated,and neurological deficit score,common carotid artery hemodynamics,and the serum levels of MMP-9,IL-17,and TLR4 in two groups were compared.Results After treatment,the total effective rate of the treatment group was 95.83%,which was significantly higher than that of the control group (81.25%),and there was significant difference between two groups (P<0.05).After treatment,the neurological deficit score of two groups was lower than that before treatment (P<0.05),and the neurological deficit score of the treatment group was lower than that of the control group (P<0.05).After treatment,V_m and Q_m of common carotid artery in two groups were higher than before treatment,but DR in two groups was lower than before treatment (P<0.05).V_m and Q_m of common carotid artery in the treatment group were higher than those in the control group,but DR in the treatment group was lower than that in the control group (P<0.05).After treatment,the serum levels of MMP-9,IL-17,and TLR4 in two groups were significantly lower than those before treatment (P<0.05),and the serum levels of MMP-9,IL-17,and TLR4 in the treatment group were significantly lower than those in the control group (P<0.05).Conclusion Lemai Granules combined with Indobufen Tablets has definite curative effect in treatment of acute cerebral infarction,can improve neurological function and common carotid hemodynamic indexes,reduce inflammatory injury,with good safety.

R971

河南省医学科技攻关计划项目(2018020855)