目的 探讨强力天麻杜仲胶囊联合硫酸氢氯吡格雷片治疗急性脑梗死恢复期（气虚血瘀型）的临床疗效。方法 纳入焦作煤业（集团）有限责任公司中央医院神经内二科在2022年6月—2024年10月确诊的160例急性脑梗死恢复期（气虚血瘀型）患者作为研究对象，所有患者根据随机数字表法随机分为对照组和治疗组，每组各80例。对照组口服硫酸氢氯吡格雷片，1片/次，1次/d；治疗组在对照组的基础上口服强力天麻杜仲胶囊，2粒/次，2次/d。两组均治疗6周。比较两组临床疗效、NIHSS评分、MMSE-R评分、ADL-R评分、炎症因子、氧化应激因子和血管内皮细胞功能因子。结果 治疗后，治疗组的总有效率93.75%显著高于对照组的总有效率82.50%，差异有统计学意义（P＜0.05）。治疗后两组MMSE-R评分显著升高，NIHSS评分、ADL-R评分显著降低（P＜0.05）；治疗后治疗组MMSE-R评分显著高于对照组，NIHSS评分和ADL-R评分显著低于对照组（P＜0.05）。治疗后两组血清肿瘤坏死因子-α（TNF-α）、白细胞介素-6（IL-6）和超敏C反应蛋白（hs-CRP）水平均显著降低（P＜0.05）；治疗后，治疗组TNF-α、IL-6和hs-CRP水平均显著低于对照组（P＜0.05）。治疗后两组超氧化物歧化酶（SOD）水平显著升高，丙二醛（MDA）水平显著降低（P＜0.05）；治疗后治疗组SOD水平显著高于对照组，MDA水平显著低于对照组（P＜0.05）。治疗后两组内皮素-1（ET-1）、基质金属蛋白酶-9（MMP-9）和可溶性细胞间黏附分子-1（sICAM-1）水平均显著降低（P＜0.05）；治疗后治疗组ET-1、MMP-9和sICAM-1水平均显著低于对照组（P＜0.05）。结论 强力天麻杜仲胶囊联合硫酸氢氯吡格雷片治疗急性脑梗死恢复期（气虚血瘀型）的临床疗效显著，与降低机体炎症水平以及改善氧化应激、血管内皮细胞功能水平有关。

Objective To investigate the clinical efficacy of Qiangli Tianma Duzhong Capsules combined with Clopidogrel Bisulfate Tablets in treatment of acute cerebral infarction during convalescence period (qi deficiency and blood stasis type). Methods A total of 160 patients with acute cerebral infarction during convalescence period (qi deficiency and blood stasis type) in the Department of Neurology, Jiaozuo Coal Industry (Group) Co., Ltd. Central Hospital from June 2022 to October 2024 were included as the research subjects. All patients were randomly divided into control group and treatment group using a random number table method, with 80 patients in each group. The control group were po administered with Clopidogrel Bisulfate Tablets, 1 tablets/time, once daily. The treatment group po administered with Qiangli Tianma Duzhong Capsules on the basis of the control group, 2 capsules/time, twice daily. Both groups were treated for 6 weeks. The clinical efficacy, NIHSS score, MMSE-R score, ADL-R score, inflammatory factors, oxidative stress factors, and endothelial cell function factors were compared between two groups. Results After treatment, the total effective rate of the treatment group was 93.75%, and was significantly higher than the total effective rate (82.50%) of the control group, and the difference was statistically significant (P < 0.05). After treatment, the MMSE-R scores of two groups significantly increased, while the NIHSS and ADL-R scores significantly decreased (P < 0.05). After treatment, the MMSE-R score in the treatment group was significantly higher than that in the control group, while the NIHSS score and ADL-R score were significantly lower than those in the control group (P < 0.05). After treatment, the serum levels of TNF-α, IL-6, and hs-CRP in two groups were significantly reduced (P < 0.05), and the levels of TNF-α, IL-6, and hs-CRP in the treatment group were significantly lower than those in the control group after treatment (P < 0.05). After treatment, the levels of SOD significantly increased in two groups, while the levels of MDA significantly decreased (P < 0.05). After treatment, the SOD level in the treatment group was significantly higher than that in the control group, but the MDA level was significantly lower than that in the control group (P < 0.05). After treatment, the levels of ET-1, MMP-9, and sICAM-1 were significantly reduced in two groups (P < 0.05). After treatment, the levels of ET-1, MMP-9, and sICAM-1 in the treatment group were significantly lower than those in the control group (P < 0.05). Conclusion Qiangli Tianma Duzhong Capsules combined with Clopidogrel Bisulfate Tablets has significant clinical efficacy in treatment of acute cerebral infarction during convalescence period (qi deficiency and blood stasis type), which is related to reducing the level of inflammation in the body and improving oxidative stress and endothelial cell function.

R971

河南省医学科技攻关计划项目（LHGJ20200488）