目的 探讨苏合香丸联合奥扎格雷氨丁三醇注射用浓溶液治疗急性脑梗死的临床效果。方法 选取2024年10月—2025年10月南阳市中心医院收治的106例急性脑梗死患者为研究对象，采用随机数字表法将患者分为对照组和治疗组，每组53例。对照组静脉滴注奥扎格雷氨丁三醇注射用浓溶液，112 mg加入0.9%氯化钠注射液250 mL中，1次/d。治疗组在对照组治疗基础上温水化服苏合香丸，1丸/次，2次/d。两组连续治疗14 d。比较两组的临床疗效、神经功能、日常生活能力、大脑中动脉血流动力学指标、凝血功能指标、血清炎症因子指标。结果 治疗组的总有效率为94.34%，高于对照组的总有效率83.02%（P＜0.05）。治疗后，两组美国国立卫生研究院卒中量表（NIHSS）评分均降低，改良Barthel指数（MBI）评分升高（P＜0.05），且治疗组NIHSS评分低于对照组，MBI评分高于对照组（P＜0.05）。治疗后，两组平均血流速度（MFV）、收缩期峰值流速（PSV）、舒张期末流速（EDV）均升高，搏动指数（PI）、阻力指数（RI）均降低（P＜0.05），且治疗组MFV、PSV、EDV均高于对照组，PI、RI低于对照组（P＜0.05）。治疗后，两组D-二聚体（D-D）水平均降低，凝血酶原时间（PT）、凝血酶时间（TT）、活化部分凝血活酶时间（APTT）均延长（P＜0.05），且治疗组D-D水平低于对照组，PT、TT、APTT长于对照组（P＜0.05）。治疗后，两组血清超敏C反应蛋白（hs-CRP）、肿瘤坏死因子-α（TNF-α）、白细胞介素-1β（IL-1β）、脂蛋白相关磷脂酶A2（Lp-PLA2）水平均降低（P＜0.05），且治疗组患者血清hs-CRP、TNF-α、IL-1β、Lp-PLA2水平低于对照组（P＜0.05）。结论 苏合香丸联合奥扎格雷氨丁三醇注射用浓溶液治疗急性脑梗死患者可显著提高临床疗效，改善神经功能缺损和日常生活能力，提升脑血流灌注，优化凝血功能，减轻炎性反应。

Objective To investigate the clinical efficacy of Suhexiang Pills combined with Ozagrel Trometamol Concentrated Solution for injection in treatment of acute ischemic stroke. Methods A total of 106 patients with acute cerebral infarction admitted to Nanyang Central Hospital from October 2024 to October 2025 were selected as the research subjects. The patients were divided into control group and treatment group using a random number table method, with 53 patients in each group. The control group received intravenous infusion of Ozagrel Trometamol Concentrated Solution for injection, 112 mg added to 250 mL 0.9% sodium chloride injection, once daily. The treatment group received warm water treatment of Suhexiang Pill on the basis of the control group’s treatment, 1 pill/time, twice daily. The two groups were treated continuously for 14 days. The clinical efficacy, neurological function, daily living ability, middle cerebral artery hemodynamics, coagulation function, and serum inflammatory factor indicators were compared between two groups. Results The total effective rate of the treatment group was 94.34%, which was higher than the total effective rate (83.02%) in the control group (P < 0.05). After treatment, National Institutes of Health Stroke Scale (NIHSS) scores in two groups decreased, but Modified Barthel Index (MBI) scores were increased (P < 0.05). After treatment, the NIHSS score in the treatment group was lower than that in the control group, but the MBI score was higher than that in the control group (P < 0.05). After treatment, the average blood flow velocity (MFV), peak systolic velocity (PSV), and end diastolic velocity (EDV) of two groups increased, while the pulsatility index (PI) and resistance index (RI) decreased (P < 0.05). After treatment, MFV, PSV, and EDV of the treatment group were higher than those of the control group, while PI and RI were lower than those of the control group (P < 0.05). After treatment, the levels of D-dimer (D-D) decreased in two groups, while prothrombin time (PT), thrombin time (TT), and activated partial thromboplastin time (APTT) were prolonged (P < 0.05). The D-D levels in the treatment group were lower than those in the control group, while PT, TT, and APTT were longer than those in the control group (P < 0.05). After treatment, the serum levels of high-sensitivity C-reactive protein (hs-CRP), tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β), and lipoprotein associated phospholipase A2 (Lp-PLA2) decreased in two groups (P < 0.05), and the serum levels of hs-CRP, TNF-α, IL-1β, and Lp-PLA2 in the treatment group were lower than those in the control group (P < 0.05). Conclusion The combination of Suhexiang Pills with Ozagrel Trometamol Concentrated Solution for injection in treatment of acute cerebral infarction can significantly improve clinical efficacy, enhance neurological deficits and daily living abilities, increase cerebral blood flow perfusion, optimize coagulation function, and reduce inflammatory responses.

R971

河南省医学科技攻关计划联合共建项目（LHGJ20191467）