目的 探讨脑血康胶囊联合注射用阿替普酶治疗急性脑梗死的临床疗效。方法 选取2017年3月-2019年2月南京医科大学附属明基医院神经内科就诊的82例急性脑梗死患者作为研究对象，按照随机数字表法将所有患者分为对照组和治疗组，每组各41例。对照组给予注射用阿替普酶0.9 mg/kg，其中10%的总剂量注射用阿替普酶加入10 mL生理盐水充分混合后在10 s内静脉推注；然后将剩余90%的阿替普酶加入100 mL生理盐水稀释后静脉滴注，滴注时间不低于60 min。治疗组在对照组治疗的基础上口服脑血康胶囊，3粒/次，3次/d。两组均连续治疗14 d。观察两组患者的临床疗效，同时比较两组治疗前后的大脑平均血流速度、血清细胞因子水平和美国国立卫生院卒中量表（NIHSS）评分。结果 治疗后，对照组和治疗组的总有效率分别为78.05%、92.68%，两组比较差异具有统计学意义（P<0.05）。治疗后，两组的大脑前动脉、大脑中动脉、大脑后动脉的平均血流速度均显著升高，同组治疗前后比较差异具有统计学意义（P<0.05）；治疗后，治疗组大脑动脉平均血流速度显著高于对照组，两组比较差异具有统计学意义（P<0.05）。治疗后，两组神经元特异性烯醇化酶（NSE）、髓鞘碱性蛋白（MBP）、超敏C反应蛋白（hs-CRP）、同型半胱氨酸（Hcy）水平均明显降低，同组治疗前后比较差异具有统计学意义（P<0.05）；治疗后，治疗组细胞因子水平显著低于对照组，两组比较差异具有统计学意义（P<0.05）。治疗后，两组NIHSS评分均显著降低，同组治疗前后比较差异具有统计学意义（P<0.05）；治疗后，治疗组NIHSS评分显著低于对照组，两组比较差异具有统计学意义（P<0.05）。结论 脑血康胶囊联合注射用阿替普酶治疗急性脑梗死具有较好的临床疗效，可有效提高脑组织的血流速度，促进神经功能的恢复，改善血液因子水平，具有一定的临床推广应用价值。

Objective To investigate the clinical efficacy of Naoxuekang Capsules combined with Alteplase for injection in treatment of acute cerebral infarction. Methods Patients (82 cases) with acute cerebral infarction in Mingji Hospital Affiliated to Nanjing Medical University from March 2017 to February 2019 were randomly divided into control and treatment groups, and each group had 41 cases. Patients in the control group were given Alteplase for injection 0.9 mg/kg, 10% of the total dose of Alteplase for injection was mixed with 10 mL saline and then injected intravenously within 10 s, and the remaining 90% of Alteplase for Injection was diluted with 100 mL saline and dripped intravenously for no less than 60 min. Patients in the treatment group were po administered with Naoxuekang Capsules on the basis of control group, 3 grains/time, three times daily. Patients in two groups were treated for 14 d. After treatment, the clinical efficacy was evaluated, and the average cerebral blood flow velocity, serum cytokine levels, and NIHSS score in two groups before and after treatment were compared. Results After treatment, the clinical efficacy in the control and treatment groups were 78.05% and 92.68%, respectively, and there were differences between two groups (P<0.05). After treatment, the average blood flow velocity of anterior cerebral artery, middle cerebral artery, and posterior cerebral artery in the two groups were significantly increased, and the difference was statistically significant in the same group (P<0.05). After treatment, the average blood flow velocity of cerebral artery in the treatment group was significantly higher than that in the control group, with significant difference between two groups (P<0.05). After treatment, the serum levels of NSE, MBP, hs-CRP, and Hcy in two groups were significantly decreased, and the difference was statistically significant in the same group (P<0.05). After treatment, the serum cytokine levels in the treatment group were lower than those in the control group, with significant difference between two groups (P<0.05). After treatment, the NIHSS score in two groups were significantly decreased, and the difference was statistically significant in the same group (P<0.05). After treatment, the NIHSS score in the treatment group were lower than those in the control group, with significant difference between two groups (P<0.05). Conclusion Naoxuekang Capsules combined with Alteplase for injection has good clinical efficacy in treatment of acute cerebral infarction, can effectively improve the blood flow velocity of brain tissue, promote the recovery of nerve function, and improve the cytokine levels, which has a certain clinical application value.