目的 观察化瘀丸联合阿加曲班注射液治疗急性脑梗死的临床疗效。方法 选取2015年1月—2020年10月安阳市人民医院收治的138例急性脑梗死患者，根据信封抽签法将患者分为对照组和治疗组，每组各69例。对照组静脉泵注阿加曲班注射液，10 mg阿加曲班溶入100 mL生理盐水中，持续泵注3 h，2次/d。治疗组在对照组治疗的基础上口服化瘀丸，5 g/次，2次/d。两组均治疗4周。观察两组的临床疗效，比较两组治疗前后的美国国立卫生研究院卒中量表（NIHSS）评分、Barthel指数（BI）评分、血液流变学指标、炎症因子水平。结果 治疗后，治疗组的总有效率（92.75%）高于对照组（76.81%），两组比较差异有统计学意义（P<0.05）。治疗后，两组BI评分升高，NIHSS评分降低（P<0.05），且治疗组BI评分高于对照组，NIHSS评分低于对照组（P<0.05）。治疗后，两组患者全血高切黏度、全血低切黏度、纤维蛋白原、血浆黏度均降低（P<0.05），且治疗组全血高切黏度、全血低切黏度、纤维蛋白原、血浆黏度均低于对照组（P<0.05）。治疗后，两组血清肿瘤坏死因子-α（TNF-α）、超敏C反应蛋白（hs-CRP）、白细胞介素-8（IL-8）水平均降低（P<0.05），且治疗组血清TNF-α、hs-CRP、IL-8水平低于对照组（P<0.05）。结论 化瘀丸联合阿加曲班注射液治疗急性脑梗死患者可减轻患者神经功能缺损程度，提高患者日常生活自理能力，改善机体血液流变学状态，降低炎性因子水平，疗效较好且安全有效。

Objective To observe the clinical effect of Huayu Pills combined with Argatroban Injection in treatment of acute cerebral infarction. Methods Patients (138 cases) with acute cerebral infarction in the People’s Hospital of Anyang City from January 2015 to October 2020 were randomly divided into control and treatment groups, and each group had 69 cases. Patients in the control group were iv pumping administered with Argatroban Injection, 10 mg added into normal saline 100 mL, pumped continuously for 3 h, twice daily. Patients in the treatment group were po administered with Huayu Pills on the basis of the control group, 5 g/time, twice daily. Patients in two groups were treated for 4 weeks. After treatment, the clinical efficacies were evaluated, and NIHSS scores, BI scores, hemorheological indexes, and inflammatory factors in two groups were compared. Results After treatment, the total effective rate of the treatment group (92.75%) was higher than that of the control group (76.81%), and the difference was statistically significant (P<0.05). After treatment, the BI scores in two groups were increased, but the NIHSS scores in two groups were decreased (P<0.05). And the BI score in the treatment group was higher than that in the control group, while the NIHSS score in the treatment group was lower than that in the control group (P<0.05). After treatment, the whole blood high shear viscosity, whole blood low shear viscosity, fibrinogen, and plasma viscosity of two groups were decreased (P<0.05), and the whole blood high shear viscosity, whole blood low shear viscosity, fibrinogen, and plasma viscosity of the treatment group were lower than those of the control group (P<0.05). After treatment, the serum levels of TNF-α, hs-CRP, and IL-8 in two groups were decreased (P<0.05), and the serum levels of TNF-α, hs-CRP, and IL-8 in the treatment group were lower than those in the control group (P<0.05). Conclusion Huayu pills combined with Argatroban Injection in the treatment of acute cerebral infarction can reduce the degree of neurological deficit, improve the ability of daily living, improve the state of hemorheology, and reduce the level of inflammatory factors, which is safe and effective.

R971

河南省科技发展计划项目（18210211512）