目的 探究通塞脉片联合阿托伐他汀治疗气虚血瘀型急性脑梗死的临床疗效。方法 选取新疆维吾尔自治区人民医院2021年1月—2023年10月收治的气虚血瘀型急性脑梗死患者120例，随机分为对照组和治疗组，每组各60例。对照组患者口服阿托伐他汀钙片，20 mg/次，1次/d。治疗组患者在对照组基础上口服通塞脉片，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神经功能缺损、认知功能评分和中医证候积分，血液流变学指标全血比黏度、血浆比黏度、纤维蛋白原、红细胞体积分数，血清炎性因子超敏C反应蛋白（hs-CRP）、白细胞介素-6（IL-6）和肿瘤坏死因子-α（TNF-α）水平，神经功能指标神经元特异性烯醇化酶（NSE）和脑源性神经营养因子（BDNF）水平，及血管内皮功能血管内皮生长因子（VEGF）和内皮素-1（ET-1）水平。结果 治疗后，治疗组临床总有效率（98.33%）显著高于对照组（86.67%，P＜0.05）。治疗后，与治疗前相比，两组NIHSS评分、中医证候积分、全血比黏度、血浆比黏度、纤维蛋白原水平、红细胞体积分数、血清hs-CRP、IL-6、TNF-α、NSE、ET-1水平均显著降低，而MMSE评分、BDNF水平、VEGF水平显著升高（P＜0.05）。治疗后，治疗组患者评分、血液流变学指标、血清炎性因子、神经功能指标和血管内皮功能水平均显著优于对照组（P＜0.05）。结论 通塞脉片联合阿托伐他汀治疗气虚血瘀型急性脑梗死临床疗效显著，其机制与改变血液流变学，抑制炎症反应，保护神经功能和血管内皮功能相关。

Objective To explore the clinical efficacy of Tongsaimai Tablets combined with atorvastatin in treatment of acute cerebral infarction with qi deficiency and blood stasis type. Methods Patients (120 cases) with acute cerebral infarction with qi deficiency and blood stasis type in Xinjiang Uygur Autonomous Region People′s Hospital from January 2021 to October 2023 were randomly divided into control and treatment group, and each group had 60 cases. Patients in the control group were po administered with Atorvastatin Calcium Tablets, 20 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 evaluations were evaluated, and the neurological deficits scores, cognitive function scores, and traditional Chinese medicine syndrome scores, hemorheological indicators whole blood specific viscosity, plasma specific viscosity, fibrinogen, erythrocyte volume fraction, serum inflammatory factor hs-CRP, IL-6 and TNF-α levels, neurological function indicators NSE and BDNF levels, and endothelial function indicators VEGF and ET-1 levels in two groups before and after treatment were compared. Results After treatment, the total clinical effective rate in the treatment group (98.33%) was significantly higher than that in the control group (86.67%, P < 0.05). After treatment, compared with before treatment, the NIHSS score, TCM syndrome score, whole blood specific viscosity, whole blood specific viscosity, fibrinogen level, red blood cell volume fraction, serum hs-CRP, IL-6, TNF-α, NSE, ET-1 levels were significantly decreased in two groups, while the MMSE score, BDNF level, and VEGF level were significantly increased (P < 0.05). After treatment, the scores, the hemorheological indicators, serum inflammatory factor, neurological function indicators, and endothelial function indicators in the treatment group were significantly better than those in the control group (P < 0.05). Conclusion The clinical efficacy of Tongsaimai Tablets combined with atorvastatin in treating acute cerebral infarction of qi deficiency and blood stasis type is significant, and the mechanism is related to changing blood rheology, inhibiting inflammatory response, protecting nerve function and vascular endothelial function.

R971

新疆维吾尔自治区卫生健康科研资助项目（2022D01C111）