天红口服液治疗急性脑梗死风痰瘀阻证临床研究

目的研究天红口服液治疗急性脑梗死风痰瘀阻证的临床疗效并探讨其可能的作用机制.方法对入选病例60例急性脑梗死风痰瘀阻证病人进行随机对照研究,治疗组用天红口服液结合西药治疗,对照组采用单纯西药治疗,治疗前及疗程结束后均进行神经功能缺损评分及中医证候评分,疗程结束后进行脑血流量(CBF)测定.结果治疗组与对照组相比,神经功能缺损评分和中医证候评分明显改善(P＜0.01),CBF增加(P＜0.01).结论天红口服液能改善急性脑梗死风痰瘀阻证病人神经功能缺损,改善其中医临床证候,可作为治疗急性脑梗死风痰瘀阻证的有效药物.     

化痰通络颗粒治疗风痰瘀阻证脑梗死临床研究

目的观察化痰通络颗粒治疗脑梗死临床疗效并探讨其作用机制.方法选择符合中西医诊断标准及辨证属风痰瘀阻证脑梗死病人90例,随机分为治疗组46例和对照组44例.治疗组应用化痰通络颗粒配合复方丹参注射液静脉输注,对照组单用复方丹参注射液静脉输注,治疗3周后评定疗效,比较两组治疗前后中医证候积分、血液流变学指标及血脂.结果治疗组在临床疗效、改善血液流变性及调节血脂代谢等方面明显优于对照组(P＜0.01).结论化痰通络颗粒能提高风痰瘀阻证脑梗死的治疗效果,是治疗风痰瘀阻证脑梗死安全有效的药物.     

急性脑梗死风痰瘀阻证患者证候与凝血象的相关性研究

目的 探讨脑梗死急性期风痰瘀阻证患者中医证候要素与神经功能缺损程度评分(NDS)及凝血象的相关性.方法 选择123例脑梗死急性期,中医证名诊断属风痰瘀阻证患者.按<中风病辨证诊断标准>进行证候评分,参照美国国立卫生研究院卒中量表(NIHSS)进行神经功能缺损评分,同时检测凝血因子凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、纤维蛋白原(FIB)含量.研究中医证候与NDS及凝血因子的相关性.结果 123例急性脑梗死风痰瘀阻证患者风证、痰证与NDS评分均呈正相关(r分别为0.202、0.285,P分别为0.002、0.000);痰证、血瘀证与APTT均呈负相关(r分别为-0.212、-0.184,P分别为0.004、0.031);余证候与NDS及凝血象均无明显相关性.结论 脑梗死急性期风痰瘀阻证患者以风证、痰证对患者神经功能缺损影响较大.痰证、瘀证与患者凝血功能密切相关,其分值可反映患者的凝血功能状态.     

针药配合治疗中风病风痰瘀阻证临床研究

目的观察针刺疗法配合中药治疗中风病的临床疗效.方法选择符合中风病中西医诊断标准及中医辨证属风痰瘀阻证病人80例,随机分为治疗组和对照组各40例.治疗组运用针刺疗法配合熄风化痰通络中药,对照组单用熄风化痰通络中药,治疗3周后采用中风病疗效评定标准评价临床疗效.结果治疗组疗效明显优于对照组,两组疗效经处理有统计学意义(P＜0.05).结论针药配合能明显提高中风病风痰瘀阻证的治疗效果,是治疗中风病风痰瘀阻证安全有效的治疗方法.     

通天口服液治疗脑梗死恢复期瘀血阻络挟风证的安全性与有效性

目的:观察通天口服液治疗脑梗死恢复期瘀血阻络挟风证的安全性与有效性。方法:选取2020年1月—2022年1月上海市第六人民医院治疗的脑梗死恢复期瘀血阻络挟风证病人185例,采用随机数字表法将病人分为观察组和对照组。对照组予以常规治疗,观察组在常规治疗基础上予以通天口服液治疗,两组疗程均为8周。记录两组研究期间不良反应发生情况。疗程结束后,比较两组临床疗效、安全性及治疗前后两组血清神经营养因子(NTF)、神经元特异性烯醇化酶(NSE)、髓鞘碱性蛋白(MBP)、神经生长因子(NGF)、脑源性神经营养因子(BDNF)及超敏C反应蛋白(hs-CRP)、白细胞介素-1β(IL-1β)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)炎性因子水平。结果:治疗后,观察组总有效率为92.86%,对照组为74.23%,两组比较差异有统计学意义(P<0.05)。治疗后,观察组血清NTF、BDNF及NGF水平较治疗前升高,血清NSE、MBP水平较治疗前下降,且观察组治疗后血清NTF、BDNF及NGF水平高于对照组,血清NSE、MBP水平低于对照组,差异均有统计学意义(P<0.05或P&...     

氯吡格雷对不稳定型心绞痛患者血小板功能的影响

目的 :观察氯吡格雷对不稳定型心绞痛 （UAP）患者血小板功能的影响 ,探讨其临床应用价值。方法 :UAP患者 85例 ,随机分为氯吡格雷负荷剂量组 （n=30 ） ,氯吡格雷常规剂量组 （n=30 ）及噻氯匹定治疗组 （n=2 5 ）。所有患者在给予阿司匹林 30 0 mg/ d的基础上 ,氯吡格雷负荷剂量组 1次性给予氯吡格雷 （波立维 ） 30 0 mg,氯吡格雷常规剂量组给予波立维 75 mg/ d,噻氯匹定组给予噻氯匹定 （抵克力得 ） 2 5 0 mg/ d,观察 3组患者治疗前 ,氯吡格雷负荷剂量组给药 2 h后 ,氯吡格雷常规剂量组及噻氯匹定组给药 3d后患者血浆 GMP- 14 0含量及血小板最大聚集率（MPAR）的变化。结果 :各组患者治疗后血浆 GMP- 14 0含量及 MPAR较治疗前显著降低 （P<0 .0 1） ,组间血浆GMP- 14 0含量及 MPAR无显著性差异 （P>0 .0 5 ）。结论 :氯吡格雷起效迅速 ,首剂负荷剂量 30 0 mg服药后 2 h即可有效抑制血小板激活 ,可达到服用常规剂量氯吡格雷或噻氯匹定连续 3d抑制血小板激活的效果     

中医治疗胸痹心痛痰瘀痹阻证的临床体会

目的在胸痹心痛痰瘀痹阻证中采用中医治疗的临床效果。方法将我院2017年10月-2019年9月收治的60例胸痹心痛伴有痰瘀痹阻证的患者,根据治疗用药情况,将其分为基础组和实验组,每组30例。给予基础组患者行西医标准治疗(β受体阻滞剂、氯吡格雷等),实验组患者在基础组基础上联合中药治疗(瓜蒌薤白半夏汤合桃红四物汤加减),对比两种治疗方式在胸痹心痛痰瘀痹阻证治疗中的临床疗效。结果采用西医标准联合瓜蒌薤白半夏汤合桃红四物汤加减进行治疗的实验组,患者的临床治疗疗效高于基础组(P<0.05)。结论采用西医标准联合中药瓜蒌薤白半夏汤合桃红四物汤加减对胸痹心痛患者进行治疗,患者的不适症状得到了有效消除或缓解,提高了综合治疗疗效。     

银杏叶提取物对急性脑梗死患者血小板聚集率的影响

目的探讨银杏叶提取物(EGB)对急性脑梗死患者血小板聚集率的影响,并观察其临床疗效。方法将105例急性脑梗死患者随机分为两组。对照组接受常规治疗,试验组在常规治疗基础上加用EGB治疗,于用药前及用药后第14天分别测定两组患者血小板聚集率水平,并进行神经功能缺损评分。结果试验组血小板聚集率较对照组下降明显,神经功能缺损改善显著,差异有统计学意义(P<0.05)。结论急性脑梗死患者使用EGB后可使血小板聚集得到显著抑制,同时使患者神经功能得到明显改善。     

痰瘀阻络型脑梗死急性期的中医研究进展

脑血管病(CVD)是全球人口死亡和致残的首要原因.我国脑血管病(其中约75%为脑梗死)每年新发病例150万,患病人数高达500万～600万,每年死亡者近100万,存活者之中约75%致残,其中40%重残[1].     

尿激酶对急性脑梗死患者血小板α颗粒膜蛋白水平的影响

近年来，国内外多数学者认为溶栓是治疗急性脑梗死最有前途的方法，尿激酶是一种比较经济、有效的溶栓药物。作者观察了经尿激酶静脉溶栓治疗的急性脑梗死患者血浆血小板α颗粒膜蛋白(GMP-140)动态水平，旨在探讨溶栓期间，血小板的变化及GMP-140的临床意义。     

熄风复遂汤联合钙通道抑制剂治疗急性脑梗死近期疗效研究

目的 :观察熄风复遂汤联合钙通道抑制剂治疗急性脑梗死(ACI)的疗效并探讨其作用机制。方法 :选择 75例符合诊断标准的病例 ,7d内起病的ACI病人 ,随机分为治疗组、对照 1组和对照 2组 ,每组 2 5例。治疗组以尼莫地平 10mg( 5 0ml)静脉输注 ,每日 1次 ,同时每日服 1剂熄风复遂汤 ,1个疗程后停用 5d ,继续第 2个疗程。对照 1组 :单用尼莫地平 ,剂量同治疗组。对照 2组 :单服中药。 3组均以 15d为一疗程。结果 :第 1个疗程、第 2个疗程后 ,治疗组与自身治疗前比较 ,NFD有统计学意义 (P <0 .0 5 ,P <0 .0 0 1) ;第 2疗程后 ,治疗组与对照 1组、对照 2组比较 ,NFD均有统计学意义 ;治疗组与对照 1组、对照 2组比较 ,有效率、显效率均有统计学意义 (P <0 .0 5 ,P <0 .0 0 1)。结论 :中药方剂熄风复遂汤联合钙通道抑制剂尼莫地平治疗ACI ,取得比单一用药更好的近期治疗效果 ,且副作用少。     

The Influence of Age,Sex, and the Use of Oral Contraceptives on the Inhibitory Effects of Endothelial Cells and PGI2 (Prostacyclin) on Platelet Function

The inhibitory effects of human endothelial cells (ECM) and PGI₂ (prostacyclin) on platelet function have been examined in 60 healthy subjects. 5 groups were studied. I. 10 women (19–33 yrs.); II. 10 women (21–31 yrs.) using combined oral contraceptives; III. 10 postmenopausal women (45–66 yrs.); IV. 20 men (24–48 yrs.) and V. 10 men (48–71 yrs.). Spontaneous platelet aggregation in platelet-rich plasma (PRP) was commonly observed in groups II, III, and V. This was prevented when PRP was incubated with ECM, aspirin (ASA), or PGI2. ADP-induced platelet aggregation (PA) was always reduced by ECM, but significantly less in groups II and III. Collagen-induced PA was inhibited by ECM, but less in groups I, II, III and V than in young men (IV). ECM significantly reduced collagen-induced prostaglandin (MDA) production in platelets. Again, the inhibitory effect was significantly reduced in groups II and III. Platelet factor 3 activity, measured after exposure of PRP to ADP, was significantly reduced by ECM, but was significantly less in groups II, III, and V than in group I. Less of an inhibitory effect of PGI₂ upon ADP-induced PA was shown by all groups of females than by the two groups of males.     

海鱼鱼油和胆固醇对卒中型自发性高血压大鼠血压和脑卒中作用的比较

予高盐下卒中型自发性高血压大鼠 (SHRsp)饲料中分别补充海鱼鱼油 [含二十碳五烯酸 (EPA)和二十碳六烯酸 (DHA) ]和胆固醇 ,发现两种饲料能不同程度地降低血压和脑卒中发生率 ,延长寿命     

Outcomes of Transradial PCI compared to Transfemoral PCI in veterans with anemia: Insight from the VA Clinical Assessment,Reporting and Tracking (CART) program

BackgroundPre-procedural anemia is associated with increased bleeding and mortality post-percutaneous coronary intervention (PCI). The effect of trans-radial PCI (TR-PCI) in improving outcomes compared to trans-femoral PCI (TF-PCI) in anemic patients is not known.ObjectiveThe aim of this study was to evaluate the association between arterial access site (radial versus femoral) and outcomes in anemic Veterans undergoing PCI.MethodsPatients with baseline anemia, undergoing PCI at Veterans Affairs (VA) facilities between 2009 and 2015, were divided into two groups based on primary radial or femoral access. The association between anemia and access site with in-hospital and one-year adverse outcomes was evaluated using multivariable analysis.Results7330 veterans were included in the analysis, with 1712 (23%) treated via radial access. Baseline anemia was independently associated with in-hospital major bleeding (OR 3.8, 95% CI 2.5–5.6 for moderate anemia, OR 18.6, 95% CI 11.6–29.7 for severe anemia), and in-hospital mortality (OR 3.2, 95% CI 1.8–5.8 for moderate anemia, OR 7.9, 95% CI 3.7–16.8 for severe anemia). Anemia was also associated with increased one-year MACE and mortality. PCI performed via radial access was not associated with different outcomes compared with femoral access in the presence of anemia. Comparable results were noted when analysis was restricted to only patients with acute coronary syndrome (ACS).ConclusionsModerate and severe anemia were strongly associated with increased in-hospital and one-year mortality in a large healthcare system, though there was no interaction between arterial access site for PCI and clinical outcomes among patients with moderate or severe anemia.