目的 探讨芪龙胶囊联合奥扎格雷钠治疗急性脑梗死的临床研究。方法 选取2018年6月-2019年7月在安阳市人民医院住院治疗的急性脑梗死患者127例为研究对象，所有患者随机分成对照组（63例）和治疗组（64例）。对照组患者iv奥扎格雷钠注射液，80 mg/次，溶于5%葡萄糖溶液250 mL中，1次/d。治疗组患者在对照组的基础上口服芪龙胶囊，2粒/次，3次/d，饭前0.5 h服用。两组均连续治疗2周。观察两组的临床疗效，比较两组治疗前后改良爱丁堡-斯堪的纳维亚卒中量表（MESSS）评分、血液流变学指标、血清炎性因子水平的变化情况。结果 治疗后，对照组总有效率85.71%，治疗组总有效率96.88%，治疗组总有效率显著高于对照组（P<0.05）。治疗后，两组患者治疗7、14 d的MESSS评分均显著低于同组治疗前水平（P<0.05）；治疗7、14 d后，治疗组的MESSS评分显著低于对照组（P<0.05）。治疗后，两组患者血细胞比容、血小板聚集率、全血高切黏度、全血低切黏度均较治疗前显著降低（P<0.05）；治疗后，治疗组患者血液流变学指标优于对照组（P<0.05）。治疗后，两组患者白细胞介素6（IL-6）、肿瘤坏死因子α（TNF-α）、C反应蛋白（CRP）水平均显著降低（P<0.05）；治疗后，治疗组患者IL-6、TNF-α、CRP水平均低于对照组（P<0.05）。结论 芪龙胶囊联合奥扎格雷钠治疗急性脑梗死具有较好的临床疗效，利于患者神经功能的恢复，可有效改善血流变学及炎症反应情况，具有一定的临床价值。

Objective To explore the clinical study of Qilong Capsules combined with ozagrel sodium in treatment of acute cerebral infarction. Methods A total of 127 patients with acute cerebral infarction who were hospitalized in Anyang People's Hospital from June 2018 to July 2019 were selected as the research subjects, and all patients were randomly divided into control group (63 cases) and treatment group (64 cases). Patients in the control group were iv administered with Sodium Ozagrel Injection, 80 mg/time, dissolved in 250 mL 5% glucose solution, once daily. Patients in the treatment group were po administered with Qilong Capsules half an hour before meals on the basis of the control group, 2 grains/time, 3 times daily. Both groups were treated continuously for 2 weeks. The clinical efficacy of the two groups was observed, and the changes of modified Edinburgh-Scandinavian Stroke Scale (MESSS) scores, hemorheology indexes and serum inflammatory factors were compared before and after treatment. Results After treatment, the total effective rate of the control group was 85.71%, the total effective rate of the treatment group was 96.88%, and the total effective rate of the treatment group was significantly higher than the control group (P<0.05). After treatment, the MESSS scores of 7 and 14 d of treatment in two groups were significantly lower than the level before treatment (P<0.05). After treatment, the MESSS scores of the treatment group were significantly lower than those of the control group on 7 and 14 d (P<0.05). After treatment, blood cell specific volume, platelet aggregation rate, whole blood high shear viscosity and whole blood low shear viscosity in two groups were significantly decreased compared with before treatment (P<0.05). After treatment, the hemorheological indexes in the treatment group were better than those in the control group (P<0.05). After treatment, the levels of IL-6, TNF-α, and CRP in two groups were significantly decreased (P<0.05). After treatment, the levels of IL-6, TNF-α, and CRP in treatment group were lower than those in control group (P<0.05). Conclusion Qilong Capsules combined with ozagrel sodium has good clinical effect in treatment of acute cerebral infarction, is beneficial to the recovery of patients' neurological function, and can effectively improve hemorheology and inflammatory response, which has certain clinical value.

R971

河南省医学科学技术进步奖（2017-YJ-025-R01/15）