To analyze the effects of folic acid and vitamin B12 combined with Huangqi Shengmai Decoction（黄芪生脉饮）on homocysteine（Hcy），C-reactive protein（CRP），nerve function and vascular endothelial function in patients with acute cerebral infarction（ACI）.

A total of 113 ACI patients admitted to the hospital from January 2018 to January 2022 were selected and divided into two groups using a random number table method. The control group（48 cases）were treated with conventional therapy plus folic acid combined with vitamin B12，and the observation group（65 cases）were treated with Huangqi Shengmai Decoction on the basis of the control group. The levels of Hcy and CRP，National Institutes of Health Stroke Scale（NIHSS）score，the activity of daily living Barthel index score，the levels of vascular endothelial function indicators［nitric oxide（NO），endothelin-1（ET-1），vascular endothelial growth factor（VEGF）］，the cerebral blood perfusion level and the vascular endothelium before and after treatment were statistically analyzed in the two groups.

After treatment，the serum levels of Hcy and CRP in the two groups were significantly decreased（P<0.001）. The serum Hcy and CRP levels in the observation group after treatment were significantly lower than those in the control group，and the difference was statistically significant（P<0.01）. After treatment，NIHSS score decreased significantly（P<0.001）and Barthel index score increased significantly（P<0.001）. There was a statistically significant difference between the observation group and the control group in NIHSS score and Barthel index score after treatment（P<0.01）. After treatment，the levels of NO in the two groups were significantly increased（P<0.001）while the levels of ET-1 and VEGF were significantly decreased（P<0.001）. There were statistically significant differences in the levels of NO，ET-1 and VEGF between the observation group and the control group after treatment（P<0.01）. After treatment，the levels of CRP，interleukin-6（IL-6）and tumor necrosis factor-α（TNF-α）in the observation group were significantly lower than those in the control group（P<0.05）. The activated partial thromboplastin time（aPTT），prothrombin time（PT）and D-dimer（D-D）in the observation group after treatment were higher than those before treatment and the control group at the same period（P<0.05），and the FIB was lower than that in the control group before treatment and the control group at the same period（P<0.05）. The values of cerebral blood volume（CBV）and cerebral blood flow（CBF）in the observation group were significantly higher than those in the control group after treatment，and the difference was statistically significant（P<0.05）. After treatment，the levels of NO，ET-1 and VEGF in the observation group were significantly better than those in the control group，and the differences were statistically significant（P<0.05）.

Folic acid and vitamin B12 combined with Huangqi Shengmai Decoction can effectively improve the nerve function，vascular endothelial function，immune function and coagulation function of ACI patients，reduce the risk of cerebral infarction recurrence，and improve the quality of life of patients，which is worthy of clinical application.