目的 探讨通塞脉片联合依达拉奉右莰醇治疗急性脑梗死的临床疗效。方法 选取2020年10月—2022年6月郑州市第三人民医院神经内科诊治的96例急性脑梗死患者，按照随机数字表法分为对照组和治疗组，每组各48例。对照组患者静脉滴注依达拉奉右莰醇注射用浓溶液，30 mg/次，2次/d，加入100 mL生理盐水中稀释后，30 min内滴完。治疗组在对照组的基础上口服通塞脉片，5片/次，3次/d。两组均用药14 d。观察两组的治疗效果，比较两组症状改善时间、美国国立卫生研究院卒中量表（NIHSS）评分、日常生活能力量表评分（Barthel指数）和血清炎性因子水平。结果 治疗后，治疗组总有效率97.92%，显著高于对照组的83.33%（P<0.05）。经治疗，治疗组出现头晕、失语、肢体偏瘫、神志不清改善时间均显著短于对照组（P<0.05）。治疗后，两组NHISS评分显著降低，而Barthel评分显著升高（P<0.05）；治疗后，治疗组NHISS评分低于对照组，而Barthel评分高于对照组（P<0.05）。治疗后，两组血清五聚素3（PTX3）、白细胞介素-6（IL-6）、脂蛋白相关磷脂酶A2（Lp-PLA2）、白细胞介素-1β（IL-1β）水平均较治疗前显著降低（P<0.05）；治疗后，治疗组血清PTX3、IL-6、Lp-PLA2、IL-1β水平均低于对照组（P<0.05）。治疗后，治疗组不良反应发生率6.28%，显著低于对照组的12.47%（P<0.05）。结论 通塞脉片联合依达拉奉右莰醇治疗急性脑梗死具有较好的临床疗效，可显著改善患者临床症状，降低脑神经受损程度，提高患者日常生活能力，同时还可有效降低炎性反应，值得临床借鉴。

Objective To investigate the clinical study of Tongsaimai Tablets combined with edaravone and dexborneol in treatment of acute cerebral infarction. Methods A total of 96 patients with acute cerebral infarction diagnosed and treated in the Department of Neurology of the Third People's Hospital of Zhengzhou from October 2020 to June 2022 were selected and divided into control group and treatment group according to random number table method, with 48 cases in each group. Patients in the control group were iv administered with Edaravone and Dexborneol Concentrated Solution for injection, 30 mg/time, twice daily, added 150 mL normal saline for dilution and finished the drip within 30 min. Patients in the treatment group were po administered with Tongsaimai Tablets on the basis of the control group, 5 tablets/time, there times daily. Both groups were treated for 14 d. The therapeutic effects of the two groups were observed, and the symptom improvement time, National Institutes of Health Stroke Scale score (NIHSS), Daily Living Ability Scale score (Barthel index) and serum inflammatory factors levels were compared between the two groups. Results After treatment, the total effective rate of the treatment group was 97.92%, which was significantly higher than that of the control group (83.33%, P < 0.05). After treatment, the improvement times of dizziness, aphasia, hemiplegia, and confusion in the treatment group were significantly shorter than those in the control group (P < 0.05). After treatment, NHISS score was significantly decreased, while Barthel score was significantly increased in both groups (P < 0.05). After treatment, NHISS score in the treatment group was lower than that in the control group, while Barthel score was higher than that in the control group (P< 0.05). After treatment, serum pentamylin 3 (PTX3), interleukin-6 (IL-6), lipoprotein-associated phospholipase A2 (Lp-PLA2) and interleukin-1β (IL-1β) levels in two groups were significantly decreased compared with before treatment (P < 0.05). After treatment, the levels of PTX3, IL-6, Lp-PLA2, and IL-1β in treatment group were lower than those in control group (P < 0.05). After treatment, the incidence of adverse reactions in the treatment group was 6.28%, significantly lower than that in the control group (12.47%) (P < 0.05). Conclusion Tongsaimai Tablets combined with edaravone and dexborneol has good clinical effect in treatment of acute cerebral infarction, and can significantly improve the clinical symptoms of patients, reduce the degree of neurological damage, improve patients' daily life ability, and also effectively reduce inflammatory response, which is worth clinical reference.

R971