健脾补肾活血方联合阿司匹林+氯吡格雷治疗缺血性脑卒中患者的临床疗效及对ADP、AA抑制率的影响  

Clinical efficacy of Jianpi Bushen Huoxue Formula combined with aspirin and clopidogrel in the treatment of ischemic stroke patients and its effect on the inhibition rate of ADP and AA

作　　者：刘勇 魏俊 冯雪梅 段业芬 LIU Yong;WEI Jun;FENG Xue-mei(Department of Neurosurgery,Yibin Fourth People's Hospital,Yibin Sichuan 644000,China)

机构地区：[1]宜宾市第四人民医院神经外科,四川宜宾644000

出　　处：《临床和实验医学杂志》2023年第17期1800-1805,共6页Journal of Clinical and Experimental Medicine

基　　金：2020宜宾市卫生健康委科研项目(编号:2020YW052)。

摘　　要：目的分析健脾补肾活血方联合阿司匹林+氯吡格雷治疗缺血性脑卒中患者的临床疗效及对腺苷二磷酸(ADP)、花生四烯酸(AA)抑制率的影响。方法前瞻性选取2019年4月至2021年4月宜宾市第四人民医院收治的180例缺血性脑卒中患者作为研究对象。按随机数字表法将其分为3组,每组60例。A组采用健脾补肾活血方联合阿司匹林治疗,B组使用健脾补肾活血方联合氯吡格雷氯治疗,C组采用健脾补肾活血方联合阿司匹林+氯吡格雷治疗。观察并记录3组临床疗效,治疗后ADP及AA抑制率、神经功能[美国国立卫生研究院卒中量表(NIHSS)评分、日常生活活动能力(ADL)评分]、凝血因子[纤维蛋白原(FIB)、活化部分凝血活酶时间(APTT)、凝血酶原时间(PT)和D-二聚体(D-D)]、Lovett评分、Berg平衡量表(BBS)评分、Sheikh控制量表(SCS)评分及不良反应发生情况。结果C组临床总有效率为91.67%,显著高于A组、B组(70.00%、73.33%),差异均有统计意义(P<0.05)。治疗后,C组ADP抑制率为(61.97±22.18)%,高于B组[(52.86±13.77)%],C组AA抑制率为(97.21±18.70)%,高于A组[(81.27±21.77)%],差异均有统计意义(P<0.05)。治疗后,C组NIHSS评分为(6.38±1.87)分,低于A、B两组[(15.99±2.22)、(16.31±2.37)分],C组ADL评分为(53.75±8.11)分,高于A、B两组[(41.27±6.03)、(42.13±6.11)分],差异均有统计意义(P<0.05)。治疗后,C组FIB低于A、B两组,APTT、PT、D-D水平均明显高于A、B两组,差异均有统计意义(P<0.05)。治疗后,C组Lovett评分、BBS评分及SCS评分均明显高于A、B两组,差异均有统计意义(P<0.05)。3组不良反应总发生率比较,差异无统计意义(P>0.05)。结论健脾补肾活血方联合阿司匹林+氯吡格雷可以兼有ADP及AA两种途径抑制缺血性脑卒中患者血小板聚集,增强ADP及AA抑制率,更有助于改善患者神经功能,减少复发,且不良反应无显著增加,安全性及有效性均可得到保障,值得临床予以推广应�Objective To analyze the effect of Jianpi Bushen Huoxue Formula combined with aspirin and clopidogrel in the treatment of ischemic stroke patients and its effect on the inhibition rate of adenosine diphosphate(ADP)and arachidonic acid(AA).Methods A total of 180 patients with ischemic stroke admitted to Yibin Fourth People's Hospital from April 2019 to April 2021 were prospectively selected as the research subjects.According to the random number table method,they were divided into three groups,each 60 patients.Group A was treated with Jianpi Bushen Huoxue Formula combined with aspirin,group B was treated with Jianpi Bushen Huoxue Formula combined with clopidogrel chloride,and group C was treated with Jianpi Bushen Huoxue Formula combined with aspirin and clopidogrel.The clinical efficacy of three groups was observed and recorded,ADP and AA inhibition rates,neurological function[National Institutes of Health Stroke Scale(NIHSS)score,Activity of Daily Living(ADL)score],coagulation factor[Fibrinogen(FIB),activated partial thromboplastin time(APTT),prothrombin time(PT)and D-dimer(D-D)score],Lovett score,Berg Balance Scale(BBS)score Sheikh Control Scale(SCS)score after treatment and incidence of adverse reactions were compared.Results The total clinical effective rate of group C was 91.67%,which was significantly higher than those of groups A and B(70.00%,73.33%),the differences were statistically significant(P<0.05).After treatment,the ADP inhibition rate in group C was(61.97±22.18)%,which was higher than that in group B[(52.86±13.77)%],and the AA inhibition rate in group C was(97.21±18.70)%,which was higher than that in group A[(81.27±21.77)%],the differences were statistically significant(P<0.05).After treatment,the NIHSS score of goup C was(6.38±1.87)points,which was lower than those of groups A and B[(15.99±2.22),(16.31±2.37)points],while the ADL score of group C was(53.75±8.11)points,which was higher than those of groups A and B[(41.27±6.03),(42.13±6.11)points],the differences were statistically signifi

关 键 词：缺血性脑卒中 阿司匹林 氯吡格雷 血小板抑制 神经功能 

分 类 号：R743.3[医药卫生—神经病学与精神病学]