目的 探讨清开灵注射液联合丁苯酞治疗急性脑梗死的临床疗效。方法 选取2022年12月—2023年12月秦皇岛市工人医院收治的88例急性脑梗死患者，按随机数字表法将患者分为对照组和治疗组，每组各44例。对照组静脉滴注丁苯酞氯化钠注射液，100 mL/次，滴注时间≥50 min/次，2次/d。治疗组在对照组治疗基础上静脉滴注清开灵注射液，40 mL加入生理盐水250 mL中充分稀释，1次/d。两组疗程14 d。观察两组临床疗效，比较两组治疗前后情绪和社会功能障碍量表（ESDQ）评分、美国国立卫生研究院卒中量表（NIHSS）评分、凝血酶–抗凝血酶复合物（TAT）、血小板参数[血小板平均体积（MPV）、血小板聚集率（PAgT）]及血清同型半胱氨酸（Hcy）、C反应蛋白（CRP）、超氧化物歧化酶（SOD）、神经元特异性烯醇化酶（NSE）水平。结果 治疗后，治疗组总有效率是95.45%，显著高于对照组的81.82%（P＜0.05）。治疗后，两组ESDQ评分、NIHSS评分均显著降低（P＜0.05）；治疗后，治疗组ESDQ评分、NIHSS评分低于对照组（P＜0.05）。治疗后，两组TAT和血小板参数MPV、PagT均较同组治疗前显著降低（P＜0.05）；治疗后，治疗组TAT、MPV、PagT低于对照组（P＜0.05）。治疗后，两组血清Hcy、CRP、NSE水平均显著降低，而血清SOD水平均显著上升（P＜0.05）；治疗后，治疗组血清Hcy、CRP、SOD、NSE水平改善优于对照组（P＜0.05）。结论 清开灵注射液联合丁苯酞治疗急性脑梗死具有较好的临床疗效，能有效抗血栓形成、缓解炎症和氧化应激损害，保护神经元，促进患者神经功能、情绪和社会功能障碍恢复。

Objective To investigate the clinical effect of Qingkailing Injection combined with butylphthalein in treatment of acute cerebral infarction. Methods A total of 88 patients with acute cerebral infarction admitted to Qinhuangdao Workers’ Hospital from December 2022 to December 2023 were divided into control group and treatment group according to random number table method, with 44 cases in each group. Patients in the control group were iv administered with Butylphthalide and Sodium Chloride Injection, 100 mL/time, infusion time ≥ 50 min/time, twice daily. Patients in the treatment group were iv administered with Qingkailing Injection on the basis of the control group, 40 mL was added to normal saline 250 mL and dilute fully, once daily. Both groups were treated for 14 d. The clinical effect of the two groups was observed, and the changes of Mood and Social Dysfunction Scale (ESDQ) score, National Institutes of Health Stroke Scale (NIHSS) score, thrombin-antithrombase complex (TAT), platelet parameters [mean platelet volume (MPV), platelet aggregation rate (PAgT)], serum homocysteine (Hcy), C-reactive egg before and after treatment White (CRP), superoxide dismutase (SOD), neuron-specific enolase (NSE) in two groups before and after treatment were compared.Results After treatment, the total effective rate of the treatment group was 95.45%, which was significantly higher than that of the control group (81.82%, P < 0.05). After treatment, ESDQ score and NIHSS score were significantly decreased in both groups (P < 0.05). After treatment, ESDQ scores and NIHSS scores in the treatment group were lower than those in the control group (P < 0.05). After treatment, TAT and platelet parameters MPV and PagT in two groups were significantly decreased compared with before treatment (P < 0.05). After treatment, TAT, MPV and PagT in the treatment group were lower than those in the control group (P < 0.05). After treatment, the levels of serum Hcy, CRP and NSE were significantly decreased, but the levels of serum SOD were significantly increased in both groups (P < 0.05). After treatment, the levels of Hcy, CRP, SOD and NSE in the treatment group were better than those in the control group (P < 0.05). Conclusion Qingkailing Injection combined with butylphthalein has good clinical efficacy in treatment of acute cerebral infarction, and can effectively anti-thrombosis, relieve inflammation and oxidative stress damage, protect neurons, and promote the recovery of neurological, emotional and social dysfunction in patients.

R971