目的 探讨脑安滴丸联合硫酸氢氯吡格雷片治疗急性脑梗死的临床疗效。方法 选择2020年4月—2021年12月天津中医药大学附属北辰区中医医院（天津市北辰区中医医院）收治的86例急性脑梗死患者，所有患者按随机数字表法分为对照组和治疗组，每组各43例。对照组患者口服氯吡格雷片，1片/次，1次/d。治疗组在对照组治疗的基础上口服脑安滴丸，20粒/次，2次/d。两组患者连续治疗4周。观察两组的临床疗效，比较两组的美国国立卫生研究院卒中量表（NIHSS）评分、斑块面积、血流动力学、血清指标。结果 治疗后，治疗组的总有效率为95.35%，明显高于对照组的总有效率81.40%，组间比较差异具有显著性（P<0.05）。治疗后，两组的NIHSS评分、斑块面积均显著降低（P<0.05）；治疗组的NIHSS评分、斑块面积均低于对照组，差异有统计学意义（P<0.05）。治疗后，两组的搏动指数、阻力指数低于治疗前，平均血流速度高于治疗前（P<0.05），且治疗组搏动指数、阻力指数低于对照组，平均血流速度高于对照组，组间比较差异有统计学意义（P<0.05）。治疗后，两组的血清白细胞介素-6（IL-6）、内皮素-1（ET-1）、血管紧张素Ⅱ（ANG Ⅱ）水平明显低于治疗前（P<0.05），且治疗组的血清IL-6、ET-1、Ang Ⅱ水平明显低于对照组（P<0.05）。结论 脑安滴丸联合硫酸氢氯吡格雷片治疗急性脑梗死的疗效确切，可降低斑块面积，减轻神经功能缺损，改善血流动力学和血管内皮功能，且安全性良好。

Objective To investigate the clinical efficacy of Naoan Dropping Pills combined with Clopidogrel Hydrogen Sulphate Tablets in treatment of acute cerebral infarction. Methods Patients (86 cases) with acute cerebral infarction in Tianjin Beichen Traditional Chinese Medicine Hospital from April 2020 to December 2021 were divided into control and treatment groups according to the random number table method, and each group had 43 cases. Patients in the control group were po administered with Clopidogrel Hydrogen Sulphate Tablets, 1 tablet/time, once daily. Patients in the treatment group were po administered with Naoan Dripping Pills on the basis of the control group, 20 grains/time, twice daily. Patients in two groups were treated for 4 weeks. After treatment, the clinical efficacies were evaluated, and the NIHSS scores, plaque area, hemodynamics indexes, and serum indexes in two groups were compared. Results After treatment, the total effective rate of the treatment group was 95.35%, which was significantly higher than that of the control group 81.40% (P < 0.05). After treatment, the NIHSS scores and plaque area were significantly decreased in two groups (P < 0.05), and the NIHSS scores and plaque area in the treatment group were lower than those in the control group (P < 0.05). After treatment, the pulsatility index and resistance index of two groups were lower than those before treatment, but the average blood flow velocity was higher than that before treatment (P < 0.05). The pulsatility index and resistance index of the treatment group were lower than those of the control group, but the average blood flow velocity was higher than that of the control group, and the difference between two groups was statistically significant (P < 0.05). After treatment, the serum levels of IL-6, ET-1, and Ang Ⅱ in two groups were significantly lower than those before treatment (P < 0.05), and the serum levels of IL-6, ET-1, and Ang Ⅱ in the treatment group were significantly lower than those in the control group (P < 0.05). Conclusion Naoan Dripping Pills combined with Clopidogrel Hydrogen Sulphate Tablets has clinical efficacy in treatment of acute cerebral infarction, can reduce plaque area, alleviate nerve function defect, and improve vascular endothelial function and hemodynamics with good safety.

R971

天津市北辰区科技发展计划项目（2015-SHGY-23）