目的 探讨脑络通胶囊联合依达拉奉治疗急性脑梗死的临床效果。方法 选取2016年7月-2019年7月巴彦淖尔市医院收治的86例急性脑梗死患者，随机分为对照组（n=43）和治疗组（n=43）。对照组静脉滴注依达拉奉注射液，30 mg加入100 mL生理盐水中充分稀释后给药，0.5 h内滴完，2次/d。治疗组患者在对照组基础上口服脑络通胶囊治疗，2粒/次，3次/d。两组均连续治疗2周。观察两组的临床疗效，比较两组治疗前后美国国立卫生研究院卒中量表（NIHSS）评分、单胺类神经递质[5-羟色胺（5-HT）、去甲肾上腺素（NE）]、C反应蛋白（CRP）、血清氧化应激指标、血清颅脑损伤标志物的变化情况。结果 治疗组总有效率95.3%较对照组81.4%显著增高（P<0.05）。与治疗前比较，两组治疗后NIHSS评分、5-HT、NE、CRP均显著降低（P<0.05）；但治疗组下降更显著（P<0.05）。两组治疗后血清丙二醛（MDA）、8-羟基脱氧鸟苷（8-OHdG）水平均显著低于治疗前（P<0.05），而超氧化物歧化酶（SOD）水平均显著增高（P<0.05）；且治疗后，治疗组这些血清氧化应激相关指标水平均显著优于对照组同期（P<0.05）。两组治疗后血清中枢神经特异性蛋白（S100β）、基质金属蛋白酶（MMP）-9及神经元特异性烯醇化酶（NSE）水平均较治疗前显著下降（P<0.05）；并均以治疗组颅脑损伤各项标志物的改善效果更为显著（P<0.05）。结论 脑络通胶囊联合依达拉奉治疗急性脑梗死具有较好的临床疗效，可明显减轻患者颅脑损伤，抑制体内氧化应激，纠正相关单胺类神经递质的代谢紊乱，降低机体炎症反应，促进神经功能恢复，具有一定的临床推广应用价值。

Objective To investigate the clinical effect of Capsules combined with edaravone in treatment of acute cerebral infarction. Methods 86 Patients with acute cerebral infarction admitted to Bayannur City Hospital from July 2016 to July 2019 were randomly divided into control group (n=43) and treatment group (n=43). The control group was iv administered with Edaravone Injection, 30 mg added into normal saline 100 mL and diluted it thoroughly before giving the drug, and drop it within 0.5 h, twice daily. The treatment group was po administered with Naoluotong Capsules, 2 grains/time, three times daily. All patients were treated for 2 weeks. The clinical efficacy of two groups was observed, and the changes of NIHSS score, 5-HT, NE, CRP, serum oxidative stress indicators, and serum markers of craniocerebral injury before and after treatment were compared. Results The total effective rate of the treatment group 95.3% was significantly higher than that of the control group 81.4% (P<0.05). Compared with before treatment, NIHSS score, 5-HT, NE and CRP in both groups were significantly decreased after treatment (P<0.05). However, the reduction was more significant in the treatment group (P<0.05). The serum levels of MDA and 8-OHdG in both groups were significantly lower than those before treatment (P<0.05), but the levels of SOD were significantly higher in both groups (P<0.05). After treatment, these serum oxidative stress related indicators in the treatment group were significantly better than those in the control group (P<0.05). Serum levels of S100, MMP-9 and NSE in both groups decreased significantly after treatment (P<0.05). The improvement effect of various markers of craniocerebral injury in the treatment group was more significant (P<0.05). Conclusion Naoluotong Capsules combined with edaravone has good clinical efficacy in treatment of acute cerebral infarction, and can significantly reduce the brain injury of patients, and can inhibit the oxidative stress, correct the metabolic disorder of related monoamine neurotransmitters, and also can reduce the body's inflammatory response, and promote the recovery of nerve function, which has a certain clinical application value.

R971