目的 探討參麥注射液聯(lián)合丁苯酞氯化鈉注射液治療急性腦梗死的臨床療效。方法 選取2016年1月-2018年1月解放軍第二五五醫(yī)院收治的急性腦梗死患者140例為研究對(duì)象，根據(jù)隨機(jī)區(qū)組設(shè)計(jì)法將患者分為對(duì)照組和治療組，每組各70例。對(duì)照組靜脈滴注丁苯酞氯化鈉注射液，25 mg/次，2次/d。治療組在對(duì)照組治療基礎(chǔ)上靜脈滴注參麥注射液，50 mL加入到5%葡萄糖溶液250 mL中，1次/d。兩組患者均連續(xù)治療14 d。觀察兩組的臨床療效，比較兩組的神經(jīng)功能、生活能力、凝血功能指標(biāo)、血清炎性指標(biāo)。結(jié)果 治療后，對(duì)照組和治療組的總有效率分別為71.4%、90.0%，兩組比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，兩組美國(guó)國(guó)立衛(wèi)生研究院卒中量表（NIHSS）評(píng)分、改良Rankin評(píng)分（mRS）均顯著降低，Barthel指數(shù)顯著升高，同組治療前后比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）；且治療組神經(jīng)功能和生活能力指標(biāo)明顯優(yōu)于對(duì)照組，兩組比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，兩組活化部分凝血酶時(shí)間（APTT）、凝血酶原時(shí)間（PT）均顯著升高，纖維蛋白原（FIB）、血小板計(jì)數(shù)（PLT）均顯著降低，同組治療前后比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）；且治療組FIB、PLT明顯高于對(duì)照組，兩組比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，兩組血清腫瘤壞死因子-α（TNF-α）、白細(xì)胞介素-18（IL-18）、S100β蛋白（S100β）水平均顯著降低，同組治療前后比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）；且治療組血清炎性指標(biāo)水平明顯低于對(duì)照組，兩組比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。結(jié)論 參麥注射液聯(lián)合丁苯酞氯化鈉注射液治療急性腦梗死具有較好的臨床療效，可改善患者神經(jīng)功能和血清炎性指標(biāo)，提高生活能力，具有一定的臨床推廣應(yīng)用價(jià)值。

Objective To investigate the clinical effect of Shenmai Injection combined with Butylphthalide and Sodium Chloride Injection in treatment of acute cerebral infarction. Methods Patients (140 cases) with acute cerebral infarction in the No. 255 Hospital of Chinese People's Liberation Army from January 2016 to January 2018 were randomly divided into control and treatment groups, and each group had 70 cases. Patients in the control group were iv administered with Butylphthalide and Sodium Chloride Injection, 25 mg/time, twice daily. Patients in the treatment group were iv administered with Shenmai Injection on the basis of the control group, 50 mL added into 5% glucose solution 250 mL, once daily. Patients in two groups were treated for 14 d. After treatment, the clinical efficacies were evaluated, and neurological function, life ability, coagulation function indexes, and serum inflammatory indexes in two groups were compared. Results After treatment, the clinical efficacies in the control and treatment groups were 71.4% and 90.0%, respectively, and there was difference between two groups (P<0.05). After treatment, NIHSS scores and MRS in two groups were significantly decreased, but Barthel indexes in two groups were significantly increased, and the difference was statistically significant in the same group (P<0.05). And the observational indexes in the treatment group were significantly better than those in the control group, with significant difference between two groups (P<0.05). After treatment, APTT and PT in two groups were significantly decreased, but FIB and PLT in two groups were significantly increased, and the difference was statistically significant in the same group (P<0.05). And FIB and PLT in the treatment group were significantly higher than those in the control group, with significant difference between two groups (P<0.05). After treatment, the levels of TNF-α, IL-18, and S100β in two groups were significantly decreased, and the difference was statistically significant in the same group (P<0.05). And the serum inflammatory indexes in the treatment group were significantly lower than those in the control group, with significant difference between two groups (P<0.05). Conclusion Shenmai Injection combined with Butylphthalide and Sodium Chloride Injection has clinical curative effect in treatment of acute cerebral infarction, can improve the neurological function and serum inflammatory indexes, and improve the living ability of patients, which has a certain clinical application value.