目的 探讨脑得生丸联合依达拉奉注射液治疗急性脑梗死的临床疗效。方法 选取2020年6月—2022年5月安阳市人民医院收治的150例急性脑梗死患者，采用随机数字表法将所有患者分为对照组和治疗组，每组各75例。对照组静脉滴注依达拉奉注射液，30mg溶于0.9%氯化钠注射液100mL，每次30min滴注完毕，2次/d。治疗组在对照组的基础上口服脑得生丸，1袋/次，3次/d。两组均治疗14d。观察两组临床疗效，比较两组美国国立卫生研究院卒中量表（NIHSS）评分、Barthel指数评分、血液流变学指标、脑神经损伤标志物、脑血流动力学指标。结果 治疗后，治疗组的总有效率为94.67%，明显高于对照组的总有效率84.00%，组间比较差异具有显著性（P＜0.05）。治疗后，两组的Barthel指数显著升高，NIHSS评分显著下降（P＜0.05），且治疗组Barthel指数显著高于对照组，NIHSS评分显著低于对照组（P＜0.05）。治疗后，两组的收缩期峰值血流速度（V_s）、平均血流速度（V_m）、舒张期血流速度（V_d）均显著升高，阻力指数（RI）显著下降（P＜0.05），且治疗组V_s、V_m、V_d均显著高于对照组，RI显著低于对照组（P＜0.05）。治疗后，两组血小板压积、纤维蛋白原、全血低切黏度、红细胞沉降率、全血高切黏度均显著下降（P＜0.05），且治疗组血小板压积、纤维蛋白原、全血低切黏度、红细胞沉降率、全血高切黏度均显著低于对照组（P＜0.05）。治疗后，两组的血清S100β蛋白（S100β）、神经元特异性烯醇化酶（NSE）水平均显著下降（P＜0.05），且治疗组血清S100β、NSE水平明显低于对照组（P＜0.05）。结论 脑得生丸联合依达拉奉注射液治疗急性脑梗死具有较好的临床疗效，可减轻神经功能损伤，促进患者生活自理能力的恢复，改善血液流变学、脑血流动力学和降低血清S100β、NSE水平。

Objective To explore the clinical efficacy of Naodesheng Pills combined with Edaravone Injection in treatment of acute cerebral infarction. Methods Patients (150 cases) with acute cerebral infarction in the People's Hospital of Anyang City from June 2020 to May 2022 were divided into control and treatment groups according to random number table method, and each group had 75 cases. Patients in the control group were iv administered with Edaravone Injection, 30 mg added into 0.9% sodium chloride injection 100 mL, 30 min infusion completed, twice daily. Patients in the treatment group were po administered with Naodesheng Pills on the basis of the control group, 1 bag/time, three times daily. Patients in two groups were treated for 14 d. After treatment, the clinical efficacies were evaluated, and NIHSS scores, Barthel index scores, hemorheology indexes, brain nerve injury markers, and cerebral hemodynamics indexes in two groups were compared. Results After treatment, the total effective rate of the treatment group was 94.67%, which was significantly higher than that of the control group (84.00%), and there was a significant difference between two groups (P<0.05). After treatment, Barthel indexes of two groups were significantly increased, but the NIHSS scores of two groups were significantly decreased (P<0.05), and Barthel index of the treatment group was significantly higher than that of the control group, but NIHSS score of the treatment group was significantly lower than that of the control group (P<0.05). After treatment, the V_s, V_m, and V_d of two groups were significantly increased, but the RI of two groups was significantly decreased (P<0.05). The V_s, V_m, and V_d of the treatment group were significantly higher than those of the control group, but the RI of the treatment group was significantly lower than that of the control group (P<0.05). After treatment, the platelet hematocrit, fibrinogen, whole blood low shear viscosity, erythrocyte sedimentation rate, and whole blood high shear viscosity in two groups were significantly decreased (P<0.05), and the platelet hematocrit, fibrinogen, whole blood low shear viscosity, erythrocyte sedimentation rate, and whole blood high shear viscosity in the treatment group were significantly lower than those in the control group (P<0.05). After treatment, the serum levels of S100β and NSE in two groups were significantly decreased (P<0.05), and the serum levels of S100β and NSE in the treatment group were significantly lower than those in the control group (P<0.05). Conclusion Naodesheng Pills combined with Edaravone Injection has clinical curative effect in treatment of acute cerebral infarction, can reduce the neurological damage, promote the recovery of the patient's self-care ability, improve hemorheology, cerebral hemodynamics, and reduce the serum levels of S100β and NSE.

R971

河南省医学科技攻关计划联合共建项目（LHG20191270）