目的 探究通塞脈片聯(lián)合阿托伐他汀治療氣虛血瘀型急性腦梗死的臨床療效。方法 選取新疆維吾爾自治區(qū)人民醫(yī)院2021年1月—2023年10月收治的氣虛血瘀型急性腦梗死患者120例，隨機(jī)分為對(duì)照組和治療組，每組各60例。對(duì)照組患者口服阿托伐他汀鈣片，20 mg/次，1次/d。治療組患者在對(duì)照組基礎(chǔ)上口服通塞脈片，5片/次，3次/d。兩組患者均治療14 d。觀察兩組患者臨床療效，比較治療前后兩組患者神經(jīng)功能缺損、認(rèn)知功能評(píng)分和中醫(yī)證候積分，血液流變學(xué)指標(biāo)全血比黏度、血漿比黏度、纖維蛋白原、紅細(xì)胞體積分?jǐn)?shù)，血清炎性因子超敏C反應(yīng)蛋白（hs-CRP）、白細(xì)胞介素-6（IL-6）和腫瘤壞死因子-α（TNF-α）水平，神經(jīng)功能指標(biāo)神經(jīng)元特異性烯醇化酶（NSE）和腦源性神經(jīng)營養(yǎng)因子（BDNF）水平，及血管內(nèi)皮功能血管內(nèi)皮生長因子（VEGF）和內(nèi)皮素-1（ET-1）水平。結(jié)果 治療后，治療組臨床總有效率（98.33%）顯著高于對(duì)照組（86.67%，P＜0.05）。治療后，與治療前相比，兩組NIHSS評(píng)分、中醫(yī)證候積分、全血比黏度、血漿比黏度、纖維蛋白原水平、紅細(xì)胞體積分?jǐn)?shù)、血清hs-CRP、IL-6、TNF-α、NSE、ET-1水平均顯著降低，而MMSE評(píng)分、BDNF水平、VEGF水平顯著升高（P＜0.05）。治療后，治療組患者評(píng)分、血液流變學(xué)指標(biāo)、血清炎性因子、神經(jīng)功能指標(biāo)和血管內(nèi)皮功能水平均顯著優(yōu)于對(duì)照組（P＜0.05）。結(jié)論 通塞脈片聯(lián)合阿托伐他汀治療氣虛血瘀型急性腦梗死臨床療效顯著，其機(jī)制與改變血液流變學(xué)，抑制炎癥反應(yīng)，保護(hù)神經(jīng)功能和血管內(nèi)皮功能相關(guān)。

Objective To explore the clinical efficacy of Tongsaimai Tablets combined with atorvastatin in treatment of acute cerebral infarction with qi deficiency and blood stasis type. Methods Patients (120 cases) with acute cerebral infarction with qi deficiency and blood stasis type in Xinjiang Uygur Autonomous Region People′s Hospital from January 2021 to October 2023 were randomly divided into control and treatment group, and each group had 60 cases. Patients in the control group were po administered with Atorvastatin Calcium Tablets, 20 mg/time, once daily. Patients in the treatment group were po administered with Tongsaimai Tablets on the basis of the control group, 5 tablets/time, three times daily. Patients in two groups were treated for 14 d. After treatment, the clinical evaluations were evaluated, and the neurological deficits scores, cognitive function scores, and traditional Chinese medicine syndrome scores, hemorheological indicators whole blood specific viscosity, plasma specific viscosity, fibrinogen, erythrocyte volume fraction, serum inflammatory factor hs-CRP, IL-6 and TNF-α levels, neurological function indicators NSE and BDNF levels, and endothelial function indicators VEGF and ET-1 levels in two groups before and after treatment were compared. Results After treatment, the total clinical effective rate in the treatment group (98.33%) was significantly higher than that in the control group (86.67%, P < 0.05). After treatment, compared with before treatment, the NIHSS score, TCM syndrome score, whole blood specific viscosity, whole blood specific viscosity, fibrinogen level, red blood cell volume fraction, serum hs-CRP, IL-6, TNF-α, NSE, ET-1 levels were significantly decreased in two groups, while the MMSE score, BDNF level, and VEGF level were significantly increased (P < 0.05). After treatment, the scores, the hemorheological indicators, serum inflammatory factor, neurological function indicators, and endothelial function indicators in the treatment group were significantly better than those in the control group (P < 0.05). Conclusion The clinical efficacy of Tongsaimai Tablets combined with atorvastatin in treating acute cerebral infarction of qi deficiency and blood stasis type is significant, and the mechanism is related to changing blood rheology, inhibiting inflammatory response, protecting nerve function and vascular endothelial function.

R971

新疆維吾爾自治區(qū)衛(wèi)生健康科研資助項(xiàng)目（2022D01C111）