目的 探讨通塞脉片联合硫酸氢氯吡格雷片治疗急性脑梗死的临床疗效。方法 选取2020年1月—2023年3月阜阳市中医医院收治的108例急性脑梗死患者，按随机数字法将患者分对照组（54例）和治疗组（54例）。对照组患者口服硫酸氢氯吡格雷片，75 mg/次，1次/d。在对照组的基础上，治疗组口服通塞脉片，5片/次，3次/d。两组患者均治疗14 d。观察两组患者临床疗效，比较治疗前后两组患者症状好转时间，美国国立卫生研究院卒中量表（NIHSS）和Fugl-Meyer运动功能表（FMA）评分，血清炎性因子白细胞介素-6（IL-6）和同型半胱氨酸（Hcy）水平及不良反应。结果 治疗后；治疗组患者总有效率（98.15%）明显高于对照组（83.33%，P＜0.05）。治疗后，治疗组症状好转时间均早于对照组（P＜0.05）。治疗后，两组NIHSS评分明显降低，而FMA评分明显升高（P＜0.05），且治疗组评分明显好于对照组（P＜0.05）。治疗后，两组患者血清炎性因子IL-6、Hcy水平明显降低（P＜0.05），且治疗组明显低于对照组（P＜0.05）。治疗后，治疗组不良反应总发生率（5.56%）明显低于对照组（12.96%，P＜0.05）。结论 通塞脉片联合硫酸氢氯吡格雷片治疗急性脑梗死疗效确切，可有效改善临床症状，纠正脑神经损伤状态，并减弱机体炎性反应，增强患者运动功能。

Objective To explore the therapeutic effect of Tongsaimai Tablets combined with clopidogrel bisulfate in treatment of acute cerebral infarction. Methods Patients (108 cases) with acute cerebral infarction from January 2020 to March 2023 were randomly divided into control (54 cases) and treatment (54 cases) group. Patients in the control group were po administered with Clopidogrel Bisulfate Tablets, 75 mg/time, once daily. Patients in the treatment group were po administered with Tongsaimai Tablets on the basis of the control group, 5 tablets/time, three times daily. Patients in two groups were treated for 14 d. After treatment, the clinical evaluation was evaluated, and the symptom relief times, the scores of FMA and NIHSS, the levels of IL-6 and Hcy, and adverse reaction in two groups before and after treatment were compared. Results After treatment, the clinical effective rate of patients in the treatment group (98.15%) was significantly higher than that in the control group (83.33%, P < 0.05). After treatment, the time of symptom improvement in the treatment group was significantly earlier than that in the control group (P < 0.05). After treatment, the NIHSS score in two groups was significantly decreased, while the FMA score was significantly increased (P < 0.05), and these scores in the treatment group were significantly better than those in the control group (P < 0.05). After treatment, the levels of serum inflammatory factors IL-6 and Hcy in the treatment group were significantly lower than those in the control group (P < 0.05), which in the treatment group was significantly lower than that in the control group (P < 0.05). After treatment, the incidence of adverse reactions in the treatment group (5.56%) was significantly lower than that in the control group (12.96%, P < 0.05). Conclusion The curative effect of clopidogrel bisulfate combined with Tongsaimai Tablets in treatment of acute cerebral infarction is definite, which can effectively improve the clinical symptoms, correct the state of cerebral nerve injury, weaken the inflammatory response and enhance the motor function of patients.

R971

安徽省中医药科技项目（2021M081）