冠脉粥样硬化患者AR中医证型分布及活血胶囊对血瘀型AR的干预作用  

Study on TCM Syndrome Distribution Patterns of Aspirin Resistance in Coronary Atherosclerosis and Influence of Huoxue Capsule

作　　者：彭宁[1] 刘勤社[1] 梁磊[1] 李锐[1] 衣蕾[1] 

机构地区：[1]陕西省人民医院陕西省中西医结合研究所

出　　处：《中西医结合心脑血管病杂志》2011年第3期257-259,共3页Chinese Journal of Integrative Medicine on Cardio-Cerebrovascular Disease

基　　金：陕西省"13115"科技创新工程重大科技专项计划基金项目资助(No.2009ZDKG-85)

摘　　要：目的明确阿司匹林抵抗与冠状动脉粥样硬化患者中医证型的关系以及中药活血胶囊对阿司匹林抵抗血瘀型患者的影响,为有效降低阿司匹林抵抗发生率提供预测和治疗新思路。方法对冠状动脉粥样硬化需服用阿司匹林的310例患者通过专家商讨确定其所属中医证型,随访两年;并在临床研究前后测定血小板聚集率。将发生阿司匹林抵抗血瘀型的37例患者随机分成三组,空白对照组(13例)、活血胶囊治疗组(12例)、活血胶囊联合阿司匹林组(12例)。用以研究活血胶囊改善阿司匹林抵抗的作用。结果心血瘀阻型发生阿司匹林抵抗(28.5%)明显高于寒凝心脉型(10.0%)、痰浊内阻型(16.7%)、心气虚弱型(15.9%)、心肾阴虚型(15.0%)和心肾阳虚型(20.0%),经χ2检验差异有统计学意义(P<0.05)。心血瘀阻型患者服用活血胶囊3个月可降低血小板聚集率,但与空白组比较差异无统计学意义;而活血胶囊联合阿司匹林治疗明显降低血小板聚集率,与空白组比较差异有统计学意义(P<0.05)。结论心血瘀阻型患者更易发生阿司匹林抵抗;活血化瘀方药活血胶囊具有降低血小板聚集的作用,联合应用阿司匹林能够明显降低阿司匹林抵抗的发生。Objective To observe the distribution patterns of traditional Chinese medicine（TCM） syndrome of aspirin resistance（AR） in patients with coronary heart disease and the effect of huoxue capsule on AR.Methods Three hundreds and ten pts taking aspirin were divided into blood-stasis syndrome,cold-accumulation syndrome,sputum-turbid syndrome,heart qi-deficiency syndrome,heart and kidney yin-deficiency syndrome and heart and kidney yang-deficiency syndrome,according to TCM syndrome types by three TCM experts.All pts were followed up for 2 years.The platelet aggregation was assayed before and after investigation.Thirty-seven patients with blood-stasis syndrome were divided into 3 groups randomly：Control group（n=13）,Huoxue capsule group（n=12）,and Huoxue capsule with aspirin group（n=12）.Results The incidence of AR in patients with blood-stasis syndrome was 28.5%,which was much higher than that in patients with cold-accumulation syndrome（10.0%）,sputum-turbid syndrome（16.7%）,heart qi-deficiency syndrome（15.9%）,heart and kidney yin-deficiency syndrome（15.0%）,and heart and kidney yang-deficiency syndrome（20.0%,P0.05）.Platelet aggregation in patients with blood-stasis syndrome was partly reduced after treatment of Huoxue capsule for 3 months.Platelet aggregation in patients with blood-stasis syndrome was obviously reduced after treatment of Huoxue capsule with aspirin（P0.05）.Conclusion Blood-stasis syndrome in TCM syndrome of cardiac ischemic had higher AR than that in other syndromes.Huoxue capsule could reduce platelet aggregation of blood deposition type.Huoxue capsule with aspirin could reduce aspirin resistance.

关 键 词：阿司匹林抵抗 血瘀证 活血胶囊 血小板聚集 

分 类 号：R259[医药卫生—中西医结合]