目的 探讨脑心通胶囊联合盐酸替罗非班氯化钠注射液治疗急性进展性脑梗死的临床疗效。方法 选取2024年10月—2025年10月兵器工业总医院收治的急性进展性脑梗死患者104例为研究对象，采用简单随机数字表法分为对照组和治疗组，每组52例。对照组静脉泵入盐酸替罗非班氯化钠注射液，起始负荷剂量0.4μg/(kg·min)泵入30 min，随后以0.1 μg/(kg·min)维持剂量持续静脉泵入48 h，泵入结束后进行常规治疗；治疗组在对照组相同治疗方案基础上口服脑心通胶囊，3粒/次、3次/d。两组疗程均为14 d。比较两组临床疗效、神经功能、生活自理能力、凝血功能指标、炎症指标。结果 治疗组的总有效率高于对照组（94.23% vs 80.77%，P＜0.05）。治疗后，两组美国国立卫生研究院卒中量表（NIHSS）、改良Rankin量表（MRS）评分均显著降低（P＜0.05），且治疗组NIHSS、MRS评分低于对照组（P＜0.05）。治疗后两组Barthel指数（BI）、日常生活能力量表（ADL）评分均显著升高（P＜0.05），且治疗组BI、ADL评分高于对照组（P＜0.05）。治疗后两组凝血酶时间（TT）、凝血酶原时间（PT）、活化部分凝血活酶时间（APTT）水平显著升高，纤维蛋白原（FIB）水平显著降低（P＜0.05），且治疗组的凝血功能指标改善优于对照组（P＜0.05）。治疗后两组血清白细胞介素-6（IL-6）、肿瘤坏死因子-α（TNF-α）、超敏C反应蛋白（hs-CRP）、高迁移率族蛋白B1（HMGB1）水平均显著下降（P＜0.05），且治疗组血清IL-6、TNF-α、hs-CRP、HMGB1水平低于对照组（P＜0.05）。结论 脑心通胶囊联合盐酸替罗非班氯化钠注射液治疗急性进展性脑梗死的临床疗效确切，有效改善患者神经功能缺损症状，减轻机体炎症应激反应，优化凝血功能状态，同时显著提升患者日常生活自理能力。

Objective To investigate the clinical efficacy of Naoxintong Capsules combined with Tirofiban Hydrochloride and Sodium Chloride Injection in treatment of acute progressive cerebral infarction. Methods Patients (104 cases) with acute progressive cerebral infarction admitted to Norinco General Hospital from October 2024 to October 2025 were selected as the research subjects. They were divided into control group and treatment group using a simple random number table method, with 52 patients in each group. The control group received intravenous infusion of Tirofiban Hydrochloride and Sodium Chloride Injection at an initial loading dose of 0.4 μg/(kg·min) for 30 min, followed by continuous intravenous infusion at a maintenance dose of 0.1 μg/(kg·min) for 48 h. After infusion, routine treatment was administered. On the basis of the same treatment plan as the control group, the treatment group took Naoxintong Capsules orally, 3 capsules/time, 3 times daily. The treatment course for two groups was 14 d. The clinical efficacy, neurological function, self-care ability, coagulation function indicators, and inflammation indicators were compared between two groups. Results The total effective rate of the treatment group was higher than that of the control group (94.23% vs 80.77%, P < 0.05). After treatment, the National Institutes of Health Stroke Scale (NIHSS) and Modified Rankin Scale (MRS) scores in two groups significantly decreased (P < 0.05), and the NIHSS and MRS scores in the treatment group were lower than those in the control group (P < 0.05). After treatment, the Barthel Index (BI) and Activities of Daily Living (ADL) scores in two groups significantly increased (P < 0.05), and the BI and ADL scores in the treatment group were higher than those in the control group (P < 0.05). After treatment, the levels of thrombin time (TT), prothrombin time (PT), and activated partial thromboplastin time (APTT) significantly increased in two groups, while fibrinogen (FIB) levels significantly decreased (P < 0.05), and the improvement in coagulation function indicators in the treatment group was better than that in the control group (P < 0.05). After treatment, the serum levels of interleukin-6 (IL-6), tumor necrosis factor alpha (TNF-α), high-sensitivity C-reactive protein (hs-CRP), and high mobility group protein B1 (HMGB1) in two groups significantly decreased (P < 0.05), and the serum levels of IL-6, TNF-α, hs-CRP, and HMGB1 in the treatment group were lower than those in the control group (P < 0.05). Conclusion The clinical efficacy of Naoxintong Capsulse combined with Tirofiban Hydrochloride and Sodium Chloride Injection in treatment of acute progressive cerebral infarction is definite, effectively improving the symptoms of neurological deficit in patients, reducing the inflammatory stress response of the body, optimizing the coagulation function status, and significantly improving the patient’s daily life self-management ability.

R971

陕西省重点研发计划项目(2024SF-YBXM-096)