目的 探討苦碟子注射液與阿司匹林腸溶片、硫酸氫氯吡格雷片對急性腦梗死患者的協(xié)同治療效果。方法 選擇研究對象為南通市第三人民醫(yī)院 2022年8月—2024年2月收治的急性腦梗死患者92例，將入選的92例患者隨機分為對照組（46例）與治療組（46例）。對照組口服硫酸氫氯吡格雷片75 mg/次、阿司匹林腸溶片100 mg/次，1次/d。于對照組基礎上，治療組加用靜脈滴注苦碟子注射液（0.9%氯化鈉注射液500mL＋苦碟子注射液40 mL），1次/d。兩組均治療14 d。比較兩組的臨床療效、神經(jīng)功能、腦血流動力學指標和血清炎癥因子變化情況。結果 治療后，相較于對照組的總有效率85.61%，治療組總有效率95.65%明顯更高（P＜0.05）。相較于治療前，兩組治療后的NIHSS評分明顯減少（P＜0.05），治療組NIHSS評分明顯低于對照組（P＜0.05）。相較于治療前，兩組治療后的平均血流速度明顯加快，外周阻力明顯減小（P＜0.05），其中治療組的平均血流速度更快，外周阻力更?。?i>P＜0.05）。與治療前相比，兩組的血清腫瘤壞死因子-α（TNF-α）、白細胞介素-6（IL-6）水平均降低（P＜0.05），且治療組血清TNF-α、IL-6水平更低（P＜0.05）。結論 硫酸氫氯吡格雷片、阿司匹林腸溶片與苦碟子注射液協(xié)同作用可提升急性腦梗死患者的臨床療效，可改善神經(jīng)功能、優(yōu)化腦血流動力學，并降低炎癥因子水平。

Objective To investigate the synergistic clinical therapeutic efficacy in acute cerebral infarction with Kudiezi Injection combined with Aspirin Enteric-coated Tablets and Clopidogrel Bisulfate Tablets. Methods 92 Patients with acute cerebral infarction in Nantong Third People's Hospital from August 2022 to February 2024 were included and were randomly divided into control group and treatment group, with 46 cases in each group. The control group was given Clopidogrel Bisulfate Tablets 75 mg/ time and Aspirin Enteric-coated Tablets 100 mg/time, both once daily. On the basis of the control group, the treatment group was given iv Kudiezi Injection (0.9% sodium chloride injection 500 mL + Kudiezi Injection 40 mL), once daily. After 14 days of treatment, the clinical efficacy, the changes of neurological function, cerebral hemodynamics and serum inflammatory factors were compared between two groups. Results The total effective rate of 95.65% in the treatment group was significantly higher than total effective rate of 85.61% in the control group after treatment (P < 0.05). The NIHSS scores of both groups were significantly decreased compared with before treatment (P < 0.05), and compared with control group, the NIHSS scores in the treatment group were significantly lower (P < 0.05). The average blood flow velocity of both groups was increased compared with before treatment, but the peripheral resistance was decreased (P < 0.05), and compared with control group, the average blood flow velocity of the treatment group was faster, but the peripheral resistance of the treatment group was shorter (P < 0.05). After treatment, the levels of IL-6 and TNF-α were decreased in both groups compared with before treatment (P < 0.05), and compared with control group, the serum levels of IL-6 and TNF-α in the treatment group were lower (P < 0.05). Conclusion The synergistic effect of Clopidogrel Bisulfate Tablets, Aspirin Enteric-coated Tablets, and Kudiezi Injection can enhance therapeutic efficacy in acute cerebral infarction, improve nerve function, optimize cerebral hemodynamics and reduce the level of inflammatory factors.

R971