目的 探讨刺五加注射液联合注射用尤瑞克林治疗急性脑梗死的临床疗效。方法 将2020年4月—2025年2月在贵州中医药大学第二附属医院就诊的79例急性脑梗死患者纳入，按随机数字表法将患者分为对照组（39例）和治疗组（40例）。对照组患者静脉滴注注射用尤瑞克林，1次/d，每次1瓶加入100 mL生理盐水充分稀释。治疗组在对照组基础上静脉注射刺五加注射液，1次/d，7 mg/kg加入生理盐水充分稀释。两组在完成2周治疗统计疗效。比较两组患者的治疗效果、美国国立卫生研究院卒中量表（NIHSS）评分、Berg平衡量表（BBS）评分、改良Barthel指数（MBI）评分、脑血流动力学和血清指标。结果 治疗组的总有效率明显比对照组高，差异有统计学意义（95.00% vs 79.49%，P＜0.05）。两组治疗后的NIHSS评分显著降低，BBS、MBI评分显著升高（P＜0.05）；治疗组的BBS评分低于对照组，BBS、MBI评分高于对照组（P＜0.05）。两组治疗后的外周阻力（Rv）降低，脑血管储备能力（CVR）、平均血流速度（MFV）均明显升高（P＜0.05），治疗组的Rv低于对照组，CVR、MFV高于对照组（P＜0.05）。两组治疗后的血清前蛋白转化酶枯草溶菌素9（PCSK9）、同型半胱氨酸（Hcy）、正五聚蛋白3（PTX3）、神经元特异性烯醇化酶（NSE）水平均明显降低（P＜0.05），治疗组的血清PCSK9、Hcy、PTX3、NSE水平均低于对照组（P＜0.05）。结论 刺五加注射液联合注射用尤瑞克林可提高急性脑梗死的临床疗效，减轻神经损伤，提高平衡能力和日常生活能力，改善脑血流动力学水平，减轻神经炎性损伤。

Objective To explore the clinical efficacy of Ciwujia Injection combined with Urinary kallindinogenase for injection in treatment of acute cerebral infarction.Methods A total of 79 patients with acute cerebral infarction who visited the Second Affiliated Hospital of Guizhou University of Traditional Chinese Medicine from April 2020 to February 2025 were included and randomly divided into control group (39 cases) and treatment group (40 cases) using a random number table method. The control group of patients received intravenous infusion of Urinary kallindinogenase for injection, once daily, with 100 mL of physiological saline added to one bottle each time for thorough dilution. The treatment group received were iv administered with Ciwujia Injection on the basis of the control group, once daily, at a dose of 7 mg/kg, diluted thoroughly with physiological saline. Two groups completed two weeks of treatment. The therapeutic effects, National Institutes of Health Stroke Scale (NIHSS) scores, Berg Balance Scale (BBS) scores, Modified Barthel Index (MBI) scores, cerebral hemodynamics, and serum indicators were compared between two groups of patients.Results The total effective rate of the treatment group was significantly higher than that of the control group, and the difference was statistically significant (95.00% and 79.49%, P < 0.05). After treatment, the NIHSS scores of the two groups were significantly reduced, while the BBS and MBI score was significantly increased (P < 0.05). The NIHSS scores of the treatment group were lower than those of the control group, while the BBS and MBI score was higher than that of the control group (P < 0.05). After treatment, the peripheral resistance (Rv) of two groups were significantly decreased, while cerebrovascular reserve capacity (CVR) and mean blood flow velocity (MFV) were significantly increased (P < 0.05). And the Rv of the treatment group were lower than those of the control group, but CVR and MFV of the treatment group were higher than those of the control group (P < 0.05). After treatment, the serum levels of preprotein converting enzyme subtilisin 9 (PCSK9), homocysteine (Hcy), pentameric protein 3 (PTX3), and neuron specific enolase (NSE) were significantly reduced in two groups (P < 0.05), and the serum levels of PCSK9, Hcy, PTX3, and NSE in the treatment group were lower than those in the control group (P < 0.05).Conclusion Ciwujia Injection combined with Urinary kallindinogenase for injection can improve clinical efficacy of acute cerebral infarction, reduce nerve damage, enhance balance ability and daily living ability, alleviate cerebral hemodynamics, and reduce neuritic damage.

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