目的 探讨银丹心脑通软胶囊联合瑞舒伐他汀钙和硫酸氢氯吡格雷对伴有2型糖尿病急性脑梗死患者血脂、颈动脉粥样硬化（CAS）斑块及神经功能恢复的影响。方法 选择2013年5月-2015年1月于天津医院收治的伴有2型糖尿病脑梗死患者150例，经颈动脉彩色超声证实有颈动脉斑块。所选病例随机分为两组，每组75例。两组在基础病治疗基础上，对照组给予瑞舒伐他汀钙片10 mg/d（每日1次）及硫酸氢氯吡格雷75 mg/d（每日1次），口服；治疗组在对照组基础上给予银丹心脑通软胶囊每次3粒（0.4 g/粒），每日3次。两组均进行饮食控制，根据病情给予控制血压、血糖及其他基础疾病药物治疗。检测两组治疗前及治疗12个月后血脂水平；统计两组颈动脉斑块总数、测量斑块内膜-中层厚度（IMT）及判定斑块性质；于治疗前后对两组患者进行神经功能评分及疗效判定；统计两组终点事件发生情况。结果 疗程结束后，两组血清总胆固醇（TC）、低密度脂蛋白胆固醇（LDL-C）、三酰甘油（TG）降低，高密度脂蛋白胆固醇（HDL-C）升高，但治疗组LDL-C较对照组明显降低（P<0.05）；两组颈部IMT较治疗前明显降低，但治疗组斑块面积较对照组明显缩小（P<0.05）；治疗组的神经功能评分较对照组明显减低（P<0.05）；治疗组疗效显著优于对照组（P<0.01），治疗组药物不良反应发生率低于对照组（P<0.05）。结论 银丹心脑通软胶囊联合瑞舒伐他汀钙和硫酸氢氯吡格雷治疗伴有2型糖尿病急性脑梗死患者的高脂血症及CAS斑块疗效显著。

Objective To investigate the effect of the combination of Yindan Xinnao Tong Soft Capsule (YXTSC) and atorvastatin, Clopidogre Tablets on blood lipid, carotid atherosclerosis (CAS) plaque, and the neurological function recovery in the patients of acute cerebral infarction with type 2 diabetes. Methods One hundred and fifty patients (CAS plaque in them was confirmed by carotid artery color Doppler ultrasound) with acute cerebral infarction and diabetes in Tianjin Hospital during May form 2013 to 2015 were seleted and randomly divided into two groups, 75 cases in each group. On the basis of basic disease treatment for the patients in the two groups, the patients in the control group were given Atorvastatin Tablet of 10 mg/d and Clopidogre Tablets of 75 mg/d, orally once daily. On the basis of the control group treatment, the patients in the treatment group were given YXTSC (0.4 g/capsulae) three capsules once and three times daily. The patients in both groups were given diet control and their blood pressure, blood sugar, and other drug treatments were controlled according to the disease. The blood lipid level was observed before and after the treatment for 12 months in the two groups, the total number of CAS plaque was calculated, the plaque intima media thickness (IMT) was measured, and the nature of the change was determined. The neurological function score, curative effect judgment, and the statistics of the end events between the two groups were carried at the end of the treatment. Results After the treatment, the serum TC, LDL-C, and TG were reduced, HDL-C of the patients in the two groups increased, while the LDL-C of the patients in the treatment group was lower than that of the patients in the control group significantly (P<0.05); The IMT of the patients in the two groups was significantly lower than that of patients before the treatment, but the plaque area of the patients in the treatment group was smaller than that of the patients in the control group significantly (P<0.05); The scores of nervous function of the patients in treatment group were significantly lower than those of the patients in the control group; The curative effect of the treatment group was better than that of the control group (P<0.01). The incidence of adverse drug reactions in treatment group was lower than that in the control group (P<0.05). Conclusion The combination of YXTSC and atorvastatin could effectively treat hyperlipidemia and CAS plaque in cerebral infarction patients associated with type 2 diabetes.