目的 探讨银杏二萜内酯葡胺联合曲克芦丁治疗急性脑梗死患者的临床疗效。方法 选取2020年1月—2020年10月于河南省人民医院治疗的182例急性脑梗死患者，随机分为对照组和治疗组，每组各91例。对照组静脉滴注注射用曲克芦丁，0.48 g加入5%葡萄糖注射液250 mL，1次/d；治疗组患者在对照组基础上静脉滴注银杏二萜内酯葡胺注射液，25 mg加入生理盐水250 mL，1次/d。两组患者均连续治疗2周。观察两组患者临床疗效，比较治疗前后两组患者美国国立卫生研究院卒中量表（NIHSS）、改良Barthel指数（MBI），脑血流速度，血清氧化应激和神经损伤指标水平。结果 治疗后，对照组临床有效率为82.42%，显著低于治疗组的92.31%（P<0.05）。治疗后，两组患者NIHSS评分较治疗前显著下降，而MBI评分显著提高（P<0.05），且治疗组患者改善更显著（P<0.05）。治疗后，两组大脑前动脉（ACA）、中动脉（MCA）、后动脉（PCA）、基底动脉（BA）、椎动脉（VA）血流速度较治疗前均显著提高（P<0.05），且治疗组升高更明显（P<0.05）。治疗后，两组超氧化物歧化酶（SOD）和谷胱甘肽过氧化物酶（GSH-Px）水平较治疗前均显著升高，而丙二醛（MDA）水平显著下降（P<0.05），且治疗组患者上述血清氧化应激指标水平改善更明显（P<0.05）。治疗后，两组神经肽Y（NPY）、神经元特异性烯醇化酶（NSE）水平较治疗前均显著下降（P<0.05），且治疗组患者下降更明显（P<0.05）。结论 银杏二萜内酯葡胺注射液联合曲克芦丁可显著改善急性脑梗死患者临床症状，改善脑血流速度，有效抑制氧化应激反应，减轻脑损伤，临床疗效佳，且安全性高。

Objective To investigate the clinical efficacy of Yinxing Ertie Neizhi Puan combined with troxerutin in treatment of acute cerebral infarction. Methods Patients (182 cases) with acute cerebral infarction in Henan Provincial People's Hospital from January 2020 to October 2020 were randomly divided into control and treatment groups, and each group had 91 cases. Patients in the control group were iv administered with Troxerutin for injection, 0.48 g added into 5% glucose injection 250 mL, once daily. Patients in the treatment group were iv administered with Yinxing Ertie Neizhi Puan Injection on the basis of the control group, 25 mg added into normal saline 250 mL, once daily. Patients in two groups were treated for 2 weeks. After treatment, the clinical efficacy was evaluated, and the NIHSS score, the MBI score, the cerebral blood flow velocity, the serum oxidative stress indexes, and the levels of nerve injury markers in two groups before and after treatment were compared. Results After treatment, the clinical effective rate in the control group was 82.42%, which was significantly lower than 92.31% in the treatment group (P < 0.05). After treatment, the NIHSS score in two groups was significantly lower than that before treatment, while the MBI score was significantly higher than that before treatment (P < 0.05), and the improvement was more significant in the treatment group (P < 0.05). After treatment, the levels of ACA, MCA, PCA, BA and VA in two groups were significantly higher than those before treatment (P < 0.05), especially in the treatment group (P < 0.05). After treatment, the levels of SOD and GSH-Px in two groups were significantly higher than those before treatment, while the level of MDA were significantly decreased (P < 0.05), and the above-mentioned serum oxidative stress indexes were improved more significantly in the treatment group (P < 0.05). After treatment, the levels of NPY and NSE in two groups were significantly lower than those before treatment (P < 0.05), especially in the treatment group (P < 0.05). Conclusion Yinxing Ertie Neizhi Puan combined with troxerutin can significantly improve the clinical symptoms of patients with acute cerebral infarction, can improve cerebral blood flow velocity, effectively inhibit oxidative stress reaction, reduce brain injury, and has good clinical effect and high safety.

R971