目的 探讨大活络胶囊联合曲克芦丁治疗急性脑梗死的临床疗效。方法 回顾性选取厦门大学附属东南医院神经内科2023年5月—2025年5月收治的122例急性脑梗死患者，按照随机数字表法分为对照组和治疗组，每组61例。对照组静滴曲克芦丁注射液，0.24 g/次，1次/d。在对照组的基础上，治疗组患者口服大活络胶囊，4粒/次，3次/d。两组连续治疗14 d。观察两组的临床疗效，比较两组治疗前后中医症状积分、美国国立卫生研究院卒中（NIHSS）评分、改良Barthel指数量表（MBI）、血清细胞因子水平。结果 治疗后，治疗组总有效率是96.72%，显著高于对照组的85.25%（P＜0.05）。治疗后，两组患者肢体偏瘫积分、视力障碍积分、说话不清积分、口角歪斜积分与治疗前比较均明显降低（P＜0.05），且与对照组对比，治疗组肢体偏瘫积分、视力障碍积分、说话不清积分、口角歪斜积分均更低（P＜0.05）。治疗后，两组患者与治疗前比较NIHSS评分下降，而MBI评分提高（P＜0.05）；且与对照组对比，治疗组NIHSS评分更低，MBI评分更高（P＜0.05）。治疗后，两组脑源性神经营养因子（BDNF）、人神经生长因子（NGF）、碱性成纤维细胞生长因子（bFGF）、血管内皮生长因子（VEGF）水平均高于治疗前（P＜0.05），且治疗后，与对照组对比，治疗组BDNF、NGF、bFGF、VEGF水平更高（P＜0.05）。结论 大活络胶囊联合曲克芦丁治疗急性脑梗死有显著的临床疗效，尤其是在改善神经功能和日常生活能力方面效果更佳，可提高BDNF、NGF、bFGF和VEGF等神经保护因子水平，为急性脑梗死的治疗提供了新的思路。

Objective To investigate the therapeutic effect of Dahuoluo Capsules combined with troxerutin in treatment of acute cerebral infarction. Methods A total of 122 patients with acute cerebral infarction admitted to the Department of Neurology of Southeast Hospital Affiliated to Xiamen University from May 2023 to May 2025 were retrospectively selected and divided into control group and treatment group according to random number table method, with 61 cases in each group. Patients in control group were iv administered with Troxerutin Injection, 0.24 g each time, once daily. Patients in the treatment group were po administered with Dahuoluo Capsules on the basis of control group, 4 capsules each time, 3 times daily. Both groups were treated continuously for 14 d. The clinical efficacy of the two groups was observed, and the TCM symptom scores, NIHSS scores, MBI, and serum cytokine levels of the two groups before and after treatment were compared. Results After treatment, the total effective rate of the treatment group was 96.72%, significantly higher than 85.25% of control group (P < 0.05). After treatment, the scores of hemiplegia, visual impairment, unclear speech and crooked mouth corners in both groups were significantly lower than those before treatment (P < 0.05), and compared with the control group, the scores of hemiplegia, visual impairment, unclear speech and crooked mouth corners in the treatment group were all lower (P < 0.05). After treatment, the NIHSS scores of two groups of patients decreased compared with those before treatment, but MBI scores increased (P < 0.05). Moreover, compared with control group, the NIHSS score of patients in treatment group was lower and the MBI score was higher (P < 0.05). After treatment, the levels of BDNF, NGF, bFGF, and VEGF in both groups were higher than those before treatment (P < 0.05), and after treatment, compared with control group, the levels of BDNF, NGF, bFGF, and VEGF in treatment group were higher (P < 0.05). Conclusion Dahuoluo Capsules combined with troxerutin in treatment of acute cerebral infarction has a significant clinical effect in treatment of acute cerebral infarction, especially in improving neurological function and daily living ability. It can increase the levels of neuroprotective factors such as BDNF, NGF, bFGF and VEGF, providing a new idea for the treatment of acute cerebral infarction.

R971

国家科技重大专项课题（2024ZD0527905）