[1]金硕果,尹海燕,孙鸿辉△,等.三七对轻型缺血性脑卒中患者“双抗”治疗后出血事件影响的研究*[J].陕西中医,2019,(3):287-289.
　JIN Shuoguo,YIN Haiyan,SUN Honghui,et al.Impact study of Panax notoginseng on hemorrhagic event after treatment of dual antiplatelet therapy in patients with acute minor stroke[J].,2019,(3):287-289.
点击复制

三七对轻型缺血性脑卒中患者“双抗”治疗后出血事件影响的研究*
分享到：

《陕西中医》[ISSN:1000-7369/CN:61-1281/TN]

卷:
期数:
2019年3
页码:
287-289
栏目:
临床研究
出版日期:
2019-03-05

文章信息/Info

Title:
Impact study of Panax notoginseng on hemorrhagic event after treatment of dual antiplatelet therapy in patients with acute minor stroke
文章编号:
DOI: 10.3969/j.issn.10007369.2019.03.004
作者:
金硕果1; 尹海燕2; 孙鸿辉1△; 刘美君1; 杨 芳1; 方 妤1
1.成都中医药大学附属医院（成都 610072）;2.成都中医药大学针灸推拿学院（成都610072）
Author(s):
JIN Shuoguo; YIN Haiyan; SUN Honghui; et al.
Hospital of Chengdu University of Traditional Chinese Medicine(Chengdu 610072)
关键词:
脑卒中; 缺血性; 轻型; 三七; 双联抗血小板聚集; 出血事件
Keywords:
Key words Stroke; Ischemic; Light; Sanqi; Dual antiplatelet aggregation; Hemorrhage
分类号:
R255.2
文献标志码:
A
摘要:
摘 要 目的：观察三七对轻型缺血性脑卒中患者“双抗”治疗后神经功能恢复及出血事件的影响。方法:60例脑梗死患者，以数字法随机分成三七组(30例)和对照组(30例)。对照组患者给予氯吡格雷联合阿司匹林治疗，三七组在对照组的基础上加三七粉口服，上述治疗持续 21 d，之后仅口服氯吡格雷。观察并比较两组患者的NIHSS 评分、mRS评分及PLT、APTT、PT、INR、FIB变化，21 d内进展型卒中发生率、出血事件发生率，90 d内卒中复发率。结果:对照组、三七组治疗后NIHSS 评分、mRS评分均较治疗前减少，差异有统计学意义(P<0.05)。两组均有发生进展型卒中及卒中复发病例，两组比较无统计学差异(P>0.05)。三七组在出血事件发生率（皮肤黏膜出血）上对照组少，差异有统计学意义(P<0.05)。两组间治疗前后PLT、PT、INR、FIB变化无统计学意义(P>0.05)，三七组治疗后APTT较治疗前延迟，有统计学差异(P<0.05)。结论：三七加“双抗”治疗可减少轻型缺血性脑卒中患者神经功能损伤程度，并降低患者皮肤黏膜出血率，这可能与影响内源性凝血有关。
Abstract:
Abstract Objective: To observe the clinical effect of Panax notoginseng on the nerve function deficient recovery and the rate of skin mucous membrane hemorrhage after combination therapy with clopidogrel and aspirin in patients with minor stroke. Methods：60 patients with minor stroke were randomly divided into the Sanqi group (30 cases) and control group (30 cases) by digital method. Patients in the control group were treated with clopidogrel combined with aspirin.The Sanqi group was given Sanqi powder on the basis of the control group. The variation of NIHSS scores, mRS, PLT,APTT,PT,INR and FIB, the incidence of progressive stroke and the rate of skin mucous membrane hemorrhage within 21 days, and the incidence of recurrent stroke within 90 days were compared. Results：After treatment, the NIHSS score and mRS score of the control group and the Sanqi group were all decreased compared with those before treatment, and the difference was statistically significant (P<0.05).There were both cases of progressive stroke and recurrent stroke in both groups, and there was no statistical difference between the two groups (P<0.05).The incidence rate of bleeding events (cutaneous mucosal bleeding) in the panax notoginseng group was lower than that in the control group, with statistically significant differences (P<0.05).There were no statistically significant variations in PLT, PT, INR and FIB before and after treatment between the two groups (P>0.05).There were statistically significant differences in APTT after treatment in the Sanqi group (P<0.05). Conclusion：The combination of Panax notoginseng and clopidogrel with aspirin treatment can reduce the degree of neurological damage in patients with minor stroke and the rate of skin mucosa bleeding in patients, which may be related to the influence of endogenous coagulation

参考文献/References:

[1] 付梦璐,董若兰,凃 玲,等.氯吡格雷抵抗研究进展[J] .医药导报,2018,37(2):139145.
[2] 中华医学会神经病学分会脑血管病学组.中国缺血性脑卒中和短暂性脑缺血发作二级预防指南2014[J] .中华神经科杂志, 2015,48(4): 258273.
[3] 周 琰,李 静.PCI术后双联抗血小板治疗致皮肤瘀斑患者的药学监护[J] .上海医药,2018,39(1):6770.
[4] 杨德彦,方 全.房颤合并冠状动脉粥样硬化性心脏病的抗栓治疗策略[J] .协和医学杂志,2018,9(2):118122.〖ZK)〗
[5] 孙 怡,杨任民,韩景献.实用中西医结神经病学\[M\].2版.北京:人民卫生出版社，2011:376409.
[6] 高 颖.中医临床诊疗指南释义·脑病分册\[M\].北京:中国中医药出版社，2015:18.
[7] Wang Y , Wang Y ，Zhao X，et al. Clopidogrel with Aspirin in Minor Stroke or Transient Ischemic Attack [J] .N Engl J Med,2013,369（1）:1119.
[8] 王婷婷,陈玮琪,王伊龙.缺血性脑卒中的精准抗血小板治疗[J] .精准医学杂志,2018,33(1):8691.
[9] 袁 蓉,郭丽丽．三七在血栓性疾病中的应用概述[J] .时珍国医国药，2015,26（6）：14571459.〖ZK)〗
[10] 杨 娟,袁一怔,尉广飞,等.三七植物化学成分及药理作用研究进展[J] .世界科学技术中医药现代化,2017,19(10):16411647.
[11] 于德伟,陈文学,杨 铭, 等.三七活血片对大鼠急性软组织损伤治疗作用的实验研究[J] .中国中医药科技,2016,23(1):2829.
[12] 张海英,盛树东,薛 洁.三七止血与抗血栓作用的实验研究[J] .新疆医科大学学报,2012,35(4):487490.
[13] 张 运,王莉莉,唐 涛.三七通舒胶囊治疗急性脑梗死合并消化道溃疡的疗效观察[J] .中风与神经疾病杂志,2016,33 (5) :457460.
[14] 李 越,杨丰文,张明妍,等.三七制剂对血小板功能影响的系统评价[J] .中国中药杂志,2017,42(21):42264233.
[15] 邝 晶,张志荣,祝 晨,等.三七对脑出血合并VTE大鼠血小板活化因子的影响[J] .全科医学临床与教育,2018,16(4):372376,356,481.

相似文献/References:

[1]张子英,吴伯涛,翟清华.益气活血法与化痰通络疗法对脑卒中症状治疗的应用价值探讨[J].陕西中医,2019,(2):250.
[2]樊锐敏.肝胃百合汤对脑卒中肠内营养患者胃肠道反应的影响[J].陕西中医,2019,(1):52.
　FAN Ruimin..Effect of Ganwei Baihe decoction on gastrointestinal reaction in patients with cerebral apoplexy enteral nutrition[J].,2019,(3):52.
[3]常雪利.针灸治疗对脑卒中后偏瘫颈肩痛患者疼痛改善及预后的影响*[J].陕西中医,2019,(4):525.
　CHANG Xueli..Analysis of the effect of acupuncture on pain improvement and prognosis in patients with hemiplegia neck shoulder and pain[J].,2019,(3):525.
[4]许文杰,蒋瑞冲,周一心,等.王翘楚教授经验方治疗肝郁瘀阻型脑卒中后失眠临床研究*[J].陕西中医,2019,(7):867.
　XU Wenjie,Jiang Ruichong,Zhou Yixin,et al.Therapeutic observation of experience prescription in party of professor Wang Qiaochu for post-stroke insomnia due to liver depression and blood stasis bolck[J].,2019,(3):867.
[5]罗 玮,李 耘,刘 玲.加味涤痰汤治疗卒中后抑郁疗效及对患者外周血NF-κB、miR-146a表达的影响[J].陕西中医,2019,(8):1029.
　LUO Wei,LI Yun,LIU Ling..Clinical effect of Jiawei Ditan decoction on post-stroke depressionand the expression of NF-κB and miR-146a in peripheral blood[J].,2019,(3):1029.
[6]蒋 岚,田慧军△,黄 伟.针灸联合黛力新治疗脑卒中后抑郁疗效及对患者血清神经递质水平的影响[J].陕西中医,2019,(8):1134.
　JIANG Lan,TIAN Huijun,HUANG Wei..Effects of Acupuncture combined with Deanxit on Post-stroke depression and its influence on serum neurotransmitters level[J].,2019,(3):1134.
[7]萨仁,李长君,蔡海鑫.头穴丛刺对脑卒中后血管性痴呆患者认知功能及血清HIF1α的影响*[J].陕西中医,2019,(11):1622.
　SA Ren,LI Changjun,CAI Haixin..Effect of scalp acupuncture on cognitive function and serum HIF1α in patients with vascular dementia after stroke[J].,2019,(3):1622.
[8]王 佳 ,沈卫东△.头针、舌针联合康复训练治疗脑卒中后吞咽障碍疗效研究*[J].陕西中医,2019,(12):1774.
　WANG Jia,SHEN Weidong..Efficacy of scalp acupuncture and tongue acupuncture combined with rehabilitation training on dysphagia after cerebral stroke[J].,2019,(3):1774.
[9]刘兰兰,耿翊宁.经穴针刺对老年脑卒中患者脑灌注及血小板反应蛋白1水平影响研究[J].陕西中医,2019,(12):1778.
　LIU Lanlan,GENG Yining..Effect of acupoint acupuncture on cerebral perfusion and thrombospondin 1 in senile patients with stroke[J].,2019,(3):1778.
[10]陈 可.针灸联合中药冰刺激治疗脑卒中吞咽障碍疗效及安全性分析[J].陕西中医,2019,(12):1782.
　CHEN Ke..Therapeutic effect of acupuncture and moxibustion combined with occupational therapy on stroke patients with hemiplegia[J].,2019,(3):1782.

备注/Memo

备注/Memo:
*四川省医学科研青年创新项目（Q16021）
更新日期/Last Update: 2019-03-13