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

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。

Impact study of Panax notoginseng on hemorrhagic event after treatment of dual antiplatelet therapy in patients with acute minor stroke

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.