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纸质出版日期:2016
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范小勇, 王成. 不同中药序贯疗法对痰瘀互结证急性冠脉综合征血小板功能的影响[J]. 中国实验方剂学杂志, 2016,22(4):169-173.
FAN Xiao-yong, WANG Cheng. Effect of Different Traditional Chinese Medicine Sequential Therapies on Blood Platelet Function in Patients with Acute Coronary Syndrome (Phlegm and Blood Stasis Type)[J]. Chinese journal of experimental traditional medical formulae, 2016, 22(4): 169-173.
范小勇, 王成. 不同中药序贯疗法对痰瘀互结证急性冠脉综合征血小板功能的影响[J]. 中国实验方剂学杂志, 2016,22(4):169-173. DOI: 10.13422/j.cnki.syfjx.2016040169.
FAN Xiao-yong, WANG Cheng. Effect of Different Traditional Chinese Medicine Sequential Therapies on Blood Platelet Function in Patients with Acute Coronary Syndrome (Phlegm and Blood Stasis Type)[J]. Chinese journal of experimental traditional medical formulae, 2016, 22(4): 169-173. DOI: 10.13422/j.cnki.syfjx.2016040169.
目的: 探讨疏血通注射液和丹蒌片的序贯使用对急性冠脉综合征(ACS)(痰瘀互结证)血小板功能和急性冠脉事件全球注册风险评分(GRACE)的影响。方法: 将符合条件的90例ACS患者随机按数字表法分为对照组和观察组
各45例。两组均行经皮冠状动脉介入治疗术(PCI)
对照组术后参照指南给予抗缺血治疗、降脂治疗和抗血小板与抗凝治疗等
口服阿司匹林肠溶片
首次负荷剂量300 mg
并以100 mg/次
1次/d
维持治疗;和硫酸氢氯吡格雷片
首次负荷剂量300 mg
维持量75 mg/次
1次/d;疗程10周。观察组西医治疗同对照组
并加用①疏血通注射液
6 mL
缓慢静脉滴入
1次/d
疗程2周;和②丹蒌片
5片/次
3次/d。疗程8周。分别于治疗前、治疗后第2周、第10周进行痰瘀互结证评分
GRACE于入院和出院时各评价1次;血小板参数[血小板计数(PLT)
平均血小板体积(MPV)
血小板分布宽度(PDW)
血小板压积(PCT)]和血小板活化指标[包括血小板聚集性(PAR)
血小板P-选择素(P-selectin)
血管假性血友病因子(vWF)
血小板膜表面GMP-140(GMP-140)]
于治疗前、治疗后第2周、第10周各进行1次检测。结果: 治疗后第2周和第10周
两组痰瘀互结证评分均逐渐下降(P<0.01)
观察组在第2周和第10周痰瘀互结证评分均低于对照组(P<0.01);观察组出院时观察GRACE评分均低于对照组(P<0.01);治疗后第2周和第10周两组PLT
MPV
PDW均较治疗前下降(P<0.05
P<0.01)
在第2周观察组MPV和PDW下降更为显著(P<0.05);观察组在治疗后第2周和第10周PAR
P-selectin
vWF和GMP-140水平均低于对照组(P<0.01); 结论: 疏血通注射液和丹蒌片的序贯用于急性冠脉综合征PCI术后患者能抑制血小板活化
降低血栓形成风险
降低痰瘀互结证和GRACE评分
有助于改善患者预后。
Objective: To discuss the effect of sequential therapies of Shuxuetong injection and Danlou pills on the blood platelet function and risk scores of global registration of acute coronary events (GRACE) in treating acute coronary syndrome (phlegm and blood stasis type). Method: Ninety eligible patients with acute coronary syndrome (ACS) were randomly divided into control group (45 cases) and observation group (45 cases) by random number table. Both groups received percutaneous coronary intervention (PCI) operation. After the operation
patients in control group received treatments of anti-ischemia
lipid-lowering
antiplatelet and anticoagulation
orally taking aspirin enteric-coated tablets
300 mg for first load dose
and 100 mg/time
1 time/day for maintenance treatment
clopidogrel bisulfate tablets
300 mg for first load dose
and 75 mg/time
1 time/day for maintenance dose. The treatment course was 10 weeks. Based on the treatment of control group
patients in observation group received additional ①Shuxuetong injection for intravenous drip
6 mL/time
1time/day
with a treatment course of 2 weeks.② Danlou pills
5 pills/time
3 times/day
with a treatment course of 8 weeks. Scores of phlegm and blood stasis were graded before treatment
at Week 2 and week 10 after treatment.GRACE was evaluated at time of admission and discharge. Before treatment and at Week 2 and week 10 after treatment
levels of platelets counts (PLT)
mean platelet volume (MPV)
platelet distribution width (PDW)
plateletcrit (PCT) of platelet parameters and platelet aggregation (PAR)
platelet-selectin (P-selectin)
von willebrand factor (vWF) and GMP-140 platelets surface were detected respectively. Result: At week 2 and week 10 after treatment
scores of phlegm and blood stasis were gradually decreased in both groups (P<0.01)
and the scores in observation group were lower than those in control group (P<0.01). At the time of discharge
GRACE score in observation group was lower than that in control group (P<0.01). And at week 2 and week 10 after treatment
levels of PLT
MPV and PDW were decreased in both groups (P<0.05
P<0.01). At week 2 after treatment
levels of MPV and PDW in observation group were decreased more obviously (P<0.05). Levels of PAR
P-selectin
vWF and GMP-140 in observation group were lower than those in control group at week 2 and week 10 after treatment group (P<0.01). Conclusion: sequential therapies of Shuxuetong injection and Danlou pills can inhibit platelet activation in patients with acute coronary syndrome after PCI
reduce thrombosis risk and scores of phlegm and blood stasis and GRACE
so it is helpful to improve prognosis for the patients.
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