目的 探讨华佗再造丸联合硫酸氢氯吡格雷片治疗急性脑梗死的临床疗效。方法 选取2020年11月—2022年12月三亚中心医院收治的100例急性脑梗死患者，按照随机数字表法将患者分为对照组（50例）和治疗组（50例）。对照组口服硫酸氢氯吡格雷片，1片/次，1次/d。在对照组的基础上，治疗组口服华佗再造丸，4 g/次，2次/d。两组均用药14 d。观察两组患者临床疗效，比较治疗前后两组患者症状改善时间，神经损伤脑卒中（NIHSS）评分，血清炎性因子白细胞介素-6（IL-6）、血管内皮生长因子-A（VEGF-A）、肿瘤坏死因子-α（TNF-α）和同型半胱氨酸（Hcy）水平。结果 治疗后，治疗组总有效率为94.00%，明显高于对照组（86.00%，P＜0.05）。治疗组头痛、眩晕、肢体麻木、耳鸣改善时间均明显短于对照组（P＜0.05）。治疗后，两组神经功能损伤程度NIHSS评分明显下降（P＜0.05），且治疗组NIHSS评分明显低于对照组（P＜0.05）。治疗后，两组血清炎性因子VEGF-A明显升高，而IL-6、TNF-α和Hcy水平明显降低（P＜0.05），且治疗组上述血清炎性因子水平均明显好于对照组（P＜0.05）。结论 华佗再造丸联合硫酸氢氯吡格雷片治疗急性脑梗死效果确切，能有效恢复神经功能损伤，明显改善症状，有效降低炎性反应，对预后改善有利。

Objective To explore the clinical effect of Huatuo Zaizao Pills combined with Clopidogrel Hydrogen Sulfate Tablets in treatment of acute cerebral infarction. Methods Patients (100 cases) with acute cerebral infarction in Sanya Central Hospital from November 2020 to December 2022 were were divided into control group (50 cases) and treatment group (50 cases) according to random number table method. Patients in the control group were po administered with Clopidogrel Hydrogen Sulphate Tablets, 1 tablet/time, once daily. Patients in the treatment group were po administered with Huatuo Zaizai Pills on the basis of the control group, 4 g/time, twice daily. Patients in two groups were treated for 14 d. After treatment, the clinical evaluation was evaluated, and the relief time of symptom, NIHSS scores, and the levels of serum inflammatory factors VEGF-A, IL-6, TNF-α, and Hcy in two groups before and after treatment were compared. Results After treatment, the clinical effective rate of the treatment group was 94.00%, which was significantly higher than that of the control group (86.00%, P < 0.05). The improvement time of headache, dizziness, numbness, tinnitus in the treatment group was significantly lower than that in the control group (P < 0.05). After treatment, the NIHSS score of neurological injury in two groups was significantly decreased (P < 0.05), and the NIHSS score in the treatment group was significantly lower than that in the control group (P < 0.05). After treatment, the levels of serum inflammatory factors VEGF-A were significantly increased, while the levels of IL-6, TNF-α, and Hcy were significantly decreased in two groups (P < 0.05), and the levels of serum inflammatory factors in the treatment group were significantly better than those in the control group (P < 0.05). Conclusion Huatuo Zaizao Pills combined with Clopidogrel Hydrogen Sulfate Tablets in treatment of acute cerebral infarction has a definite therapeutic effect, which can effectively recover the injury of nerve function, significantly improve the symptoms, effectively reduce the inflammatory reaction, and is beneficial to the prognosis.

R971

海南省卫生健康行业科研项目（21A200152）