Objective To explore the effect of Tianma Gouteng Yin combined with butylphthalein(NBP)on symptom improvement and vascular elasticity in patients with acute cerebral infarction(ACI).Methods Eighty-two ACI patients admitted to Lu'an Hospital of Traditional Chinese Medicine were included in this study,and they were randomly separated into the single group and the combination group,with 41 cases in each group.The single group was given intravenous infusion of NBP sodium chloride injection,and the combination group was given treatment with Tianma Gouteng Yin on the basis of the single group.Cerebrovascular reserve function,endothelial function,neurological function,independent living ability,hemodynamic indicators,vascular elasticity,clinical efficacy and incidence of adverse reactions were compared between the two groups of patients at 1 day after admission(T0)and 14 days after treatment(T1).Results There were no significant differences in cerebrovascular reserve function,endothelial function,National Institutes of Health Stroke Scale(NIHSS)scores,independent living ability scores,hemodynamic indicators and vascular elasticity indicators at T0 between the two groups(P＞0.05).At T1,levels of cerebrovascular reactivity(CVR),nitric oxide(NO),nitric oxide synthase(NOS),large artery elasticity index(C1)and small artery elasticity index(C2)were significantly increased in both groups,and levels were higher in the combined group than those of the single group(P＜0.05).At T1 moment,levels of ET-1,vascular endothelial growth factor(VEGF),NIHSS score,MRS score,red blood cell count,whole blood viscosity,platelet adhesion rate and arterial pressure were reduced in both groups,and levels were lower in the combined group than those of the single group(P＜0.05).The total effective rate was higher in the combination group(80.5%)than that of the single group(46.3%).The overall incidence of adverse reactions was lower in the combined group than that in the single group(P＜0.05).Conclusion Tianma Gouteng Yin combined with NBP can effectively improve the cerebral vascular reserve function,endothelial function and neurological damage in ACI patients,increase vascular elasticity and improve hemodynamic levels.