目的 探讨苦碟子注射液与阿司匹林肠溶片、硫酸氢氯吡格雷片对急性脑梗死患者的协同治疗效果。方法 选择研究对象为南通市第三人民医院 2022年8月—2024年2月收治的急性脑梗死患者92例，将入选的92例患者随机分为对照组（46例）与治疗组（46例）。对照组口服硫酸氢氯吡格雷片75 mg/次、阿司匹林肠溶片100 mg/次，1次/d。于对照组基础上，治疗组加用静脉滴注苦碟子注射液（0.9%氯化钠注射液500mL＋苦碟子注射液40 mL），1次/d。两组均治疗14 d。比较两组的临床疗效、神经功能、脑血流动力学指标和血清炎症因子变化情况。结果 治疗后，相较于对照组的总有效率85.61%，治疗组总有效率95.65%明显更高（P＜0.05）。相较于治疗前，两组治疗后的NIHSS评分明显减少（P＜0.05），治疗组NIHSS评分明显低于对照组（P＜0.05）。相较于治疗前，两组治疗后的平均血流速度明显加快，外周阻力明显减小（P＜0.05），其中治疗组的平均血流速度更快，外周阻力更小（P＜0.05）。与治疗前相比，两组的血清肿瘤坏死因子-α（TNF-α）、白细胞介素-6（IL-6）水平均降低（P＜0.05），且治疗组血清TNF-α、IL-6水平更低（P＜0.05）。结论 硫酸氢氯吡格雷片、阿司匹林肠溶片与苦碟子注射液协同作用可提升急性脑梗死患者的临床疗效，可改善神经功能、优化脑血流动力学，并降低炎症因子水平。

Objective To investigate the synergistic clinical therapeutic efficacy in acute cerebral infarction with Kudiezi Injection combined with Aspirin Enteric-coated Tablets and Clopidogrel Bisulfate Tablets. Methods 92 Patients with acute cerebral infarction in Nantong Third People's Hospital from August 2022 to February 2024 were included and were randomly divided into control group and treatment group, with 46 cases in each group. The control group was given Clopidogrel Bisulfate Tablets 75 mg/ time and Aspirin Enteric-coated Tablets 100 mg/time, both once daily. On the basis of the control group, the treatment group was given iv Kudiezi Injection (0.9% sodium chloride injection 500 mL + Kudiezi Injection 40 mL), once daily. After 14 days of treatment, the clinical efficacy, the changes of neurological function, cerebral hemodynamics and serum inflammatory factors were compared between two groups. Results The total effective rate of 95.65% in the treatment group was significantly higher than total effective rate of 85.61% in the control group after treatment (P < 0.05). The NIHSS scores of both groups were significantly decreased compared with before treatment (P < 0.05), and compared with control group, the NIHSS scores in the treatment group were significantly lower (P < 0.05). The average blood flow velocity of both groups was increased compared with before treatment, but the peripheral resistance was decreased (P < 0.05), and compared with control group, the average blood flow velocity of the treatment group was faster, but the peripheral resistance of the treatment group was shorter (P < 0.05). After treatment, the levels of IL-6 and TNF-α were decreased in both groups compared with before treatment (P < 0.05), and compared with control group, the serum levels of IL-6 and TNF-α in the treatment group were lower (P < 0.05). Conclusion The synergistic effect of Clopidogrel Bisulfate Tablets, Aspirin Enteric-coated Tablets, and Kudiezi Injection can enhance therapeutic efficacy in acute cerebral infarction, improve nerve function, optimize cerebral hemodynamics and reduce the level of inflammatory factors.

R971