目的 探讨葛酮通络胶囊联合丁苯酞氯化钠注射液治疗急性脑梗死的临床疗效。方法 选取2017年5月—2018年5月在淮南市第一人民医院进行治疗的86例急性脑梗死患者作为研究对象，根据用药不同将患者分为对照组（43例）和治疗组（43例）。对照组静脉滴注丁苯酞氯化钠注射液，100 mL/次，2次/d；治疗组在对照组治疗的基础上口服葛酮通络胶囊，0.5 g/次，2次/d。两组患者均连续治疗2周。观察两组患者的临床疗效，比较两组治疗前后的美国国立卫生研究卒中量表（NIHSS）评分、改良Rankin评分（mRS）、蒙特利尔认知评估量表法（MoCA）评分、血清学指标和脑血流动力学指标。结果 治疗后，对照组和治疗组有效率分别为81.40%和97.67%，两组比较差异具有统计学意义（P<0.05）。治疗后，两组患者NIHSS评分、mRS评分显著降低，MoCA评分显著升高，同组治疗前后比较差异具有统计学意义（P<0.05）；治疗后治疗组评分显著优于对照组，两组比较差异具有统计学意义（P<0.05）。治疗后，两组血清超敏C反应蛋白（hs-CRP）、可溶性肿瘤坏死因子相关凋亡诱导配体（sTRAIL）、单核细胞趋化蛋白-1（MCP-1）、新喋呤（Npt）水平均明显降低，同组治疗前后比较差异具有统计学意义（P<0.05）；治疗后治疗组血清学指标水平明显低于对照组，两组比较差异具有统计学意义（P<0.05）。治疗后，两组平均血流量（Q_mean）、平均血流速度（V_mean）均显著升高，动态阻抗（DR）、脑血管特性阻抗（ZCV）和脑血管外周阻力（R）均显著降低，同组治疗前后比较差异具有统计学意义（P<0.05）；治疗后治疗组脑血流动力学指标明显优于对照组，两组比较差异具有统计学意义（P<0.05）。结论 葛酮通络胶囊联合丁苯酞氯化钠注射液治疗急性脑梗死可有效改善细胞因子水平，促进神经功能恢复，改善脑血流动力学指标、日常活动能力和认知能力，具有一定的临床推广应用价值。

Objective To investigate the clinical efficacy of Getong Tongluo Capsules combined with Butylphthalide and Sodium Chloride Injection in treatment of acute cerebral infarction. Methods Patients (86 cases) with acute cerebral infarction in Huainan First People's Hospital from May 2017 to May 2018 were randomly divided into control (43 cases) and treatment (43 cases) groups according to different drugs. Patients in the control group were iv administered with Butylphthalide and Sodium Chloride Injection, 100 mL/time, twice daily. Patients in the treatment group were po administered with Getong Tongluo Capsules, 0.5 g/time, twice daily. Patients in two groups were treated for 2 weeks. After treatment, the clinical efficacy was evaluated, and the NIHSS scores, mRS scores, MoCA scores, serological indexes, and cerebral hemodynamic indexes in two groups before and after treatment were compared. Results After treatment, the clinical efficacy in the control and treatment groups were 81.40% and 97.67%, respectively, and there was difference between two groups (P<0.05). After treatment, the NIHSS and mRS scores in two groups were significantly decreased, but MoCA scores were significantly increased, and the difference was statistically significant in the same group (P<0.05). And those scores in the treatment group after treatment were significantly better those in the control group, with significant difference between two groups (P<0.05). After treatment, the serum levels of hs-CRP, sTRAIL, MCP-1, and Npt in two groups were significantly decreased, and the difference was statistically significant in the same group (P<0.05). And the serological indexes in the treatment group after treatment were significantly lower than those in the control group, with significant difference between two groups (P<0.05). After treatment, Q_mean and V_mean in two groups were significantly increased, but DR, ZCV, and R were significantly decreased, and the difference was statistically significant in the same group (P<0.05). And the cerebral hemodynamic indexes in the treatment group after treatment were significantly better those in the control group, with significant difference between two groups (P<0.05). Conclusion Getong Tongluo Capsules combined with Butylphthalide and Sodium Chloride Injection in treatment of acute cerebral infarction can effectively improve the cytokines level, promote the recovery of nerve function, and improve cerebral hemodynamics indicators, daily activity and cognitive ability, which has a certain clinical application value.