目的 探讨血栓通注射液联合艾地苯醌治疗急性脑梗死的临床疗效。方法 选取2022年3月—2025年1月北京中医药大学东方医院收治的82例急性脑梗死患者的病例资料，进行回顾性分析，按治疗方法分成对照组和治疗组（各41例）。对照组给予艾地苯醌片治疗，30 mg/次，3次/d，餐后温水送服。治疗组在此基础上联合血栓通注射液静脉滴注治疗，将5 mL加入0.9%氯化钠注射液250 mL稀释后使用，2次/d。两组疗程14 d。观察两组临床疗效，比较治疗前后中文版脑卒中上肢能力量表（SULCS）、美国国立卫生研究院卒中量表（NIHSS）、36项健康调查简表（SF-36）评分、凝血功能指标[血浆纤维蛋白（原）降解产物（FDP）、纤溶酶–抗纤溶酶复合物（PAP）、血小板聚集率（PAgT）]和血清8-异前列腺素F2α（8-iso-PGF2α）、丙二醛（MDA）、内皮素-1（ET-1）、内皮型一氧化氮合成酶（eNOS）、基质金属蛋白酶-9（MMP-9）、基质细胞衍生因子1（SDF-1）水平。结果 治疗组总有效率是95.12%，显著高于对照组的80.49%（P＜0.05）。治疗后，两组SULCS、SF-36评分都高于组内治疗前，NIHSS评分都低于组内治疗前（P＜0.05）；治疗后相关评分均以治疗组改善更明显（P＜0.05）。治疗后，两组FDP、PAP、PAgT水平都低于组内治疗前（P＜0.05）；治疗后，凝血功能指标均以治疗组更低（P＜0.05）。治疗后，两组8-iso-PGF2α、MDA、ET-1、MMP-9水平都低于组内治疗前，eNOS、SDF-1水平都高于组内治疗前（P＜0.05）；治疗后，均以治疗组改善更显著（P＜0.05）。结论 急性脑梗死应用血栓通注射液联合艾地苯醌治疗，能有效改善患者的凝血功能和血管内皮功能，抑制氧化应激及炎症损害，进一步保护神经功能，促进上肢功能状态恢复和生活质量好转。

Objective To investigate the clinical efficacy of Xueshuantong Injection combined with idebenone in treatment of acute cerebral infarction. Methods The case data of 82 patients with acute cerebral infarction admitted to Dongfang Hospital of Beijing University of Chinese Medicine from March 2022 to January 2025 were selected for retrospective analysis and divided into control group and treatment group (41 cases in each group) according to treatment methods. Patients in control group were treated with Idebenone Tablets, 30 mg each time, 3 times daily, taken with warm water after meals. Patients in treatment group were combined with intravenous drip treatment of Xueshuantong Injection on the basis of control group, 5 mL was added to 250 mL of 0.9% sodium chloride injection for dilution and used twice daily. The treatment courses of two groups were 14 d. The clinical efficacy of two groups was observe. The changes of SULCS score, NIHSS score, SF-36 score, and coagulation function indicators (FDP, PAP, and PAgT), 8-iso-PGF2α, MDA, ET-1, eNOS, MMP-9, and SDF-1 in two groups before and after treatment were compared. Results After treatment, the total effective rate of treatment group was 95.12%, significantly higher than that of control group (80.49%) (P < 0.05). After treatment, the SULCS and SF-36 scores of both groups were higher than those before treatment within the same groups, and the NIHSS scores were lower than those before treatment within the same groups (P < 0.05). After treatment, the relevant scores improved more significantly in treatment group (P < 0.05). After treatment, the levels of FDP, PAP and PAgT in both groups were lower than those before treatment within the same groups (P < 0.05). After treatment, the coagulation function indicators were all lower in treatment group (P < 0.05). After treatment, the levels of 8-iso-PGF2α, MDA, ET-1, and MMP-9 in both groups were lower than those before treatment within the same groups, and the levels of eNOS and SDF-1 were higher than those before treatment within the same groups (P < 0.05). After the treatment, the improvement was more significant in treatment group (P < 0.05). Conclusion The application of Xueshuantong Injection combined with idebenone in treatment of acute cerebral infarction can effectively improve the coagulation function and vascular endothelial function, inhibit oxidative stress and inflammatory damage, further protect nerve function, and promote the recovery of upper limb function and life quality.

R971

国家中医药管理局十一五重点专项专病（040104001003）