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补阳还五汤联合阿司匹林治疗阿司匹林抵抗的短暂性脑缺血发作患者:一项随机对照观察

[Treatment of aspirin resistance patients at transient ischemic attack by buyang huanwu decoction combination with aspirin: a randomized control observation].

作者信息

Zhang Lei, Liu Tao

机构信息

Traditional Chinese Medicine Hospital of Xinjiang Uyghur Autonomous Region, Urumqi 830000, China.

出版信息

Zhongguo Zhong Xi Yi Jie He Za Zhi. 2013 May;33(5):594-7.

PMID:23905373
Abstract

OBJECTIVE

To investigate the curative effect and safety of buyang huanwu decoction (BHD) combined aspirin (ASP) in treatment of aspirin resistance (AR) patients at transient ischemic attack (TIA).

METHODS

Recruited were 86 AR patients at TIA who took ASP as the secondary prevention. Two cases were rejected due to poor compliance. The rest 84 patients were randomly assigned to the treatment group and the control group. Those in the treatment group were treated with BHD and ASP, while those in the control group took Clopidogrel and ASP. After 30-, 60-, and 90-day of treatment, arachidonic acid (AA) and adenosine diphosphate (ADP) induced platelet aggregation rate (PAG) were detected using turbidimetry. After treatment of 90 days, the case numbers of TIA recurrence or of progressing to cerebral infarction were counted. The incidence of adverse events was also observed.

RESULTS

The ADP-and AA-induced PAG showed similar decreasing tendency in the treatment group and the control group at each time point (P >0.05). There was no statistical difference in the risk control of end point events (including ischemic cerebrovascular diseases, TIA recurrence, cerebral infarction) between the two groups (P >0.05). One patient suffered from bleeding (mild gastrointestinal bleeding) in the treatment group, while 4 patients suffered from bleeding (3 due to skin and mucous membrane bleeding and 1 to stool bleeding). The bleeding risk was lowered by 76.29% in the treatment group when compared with the control group.

CONCLUSIONS

BHD combined ASP showed similar efficacy in treating AR and controlling endpoint events. Besides, they lowered bleeding risk.

摘要

目的

探讨补阳还五汤(BHD)联合阿司匹林(ASP)治疗短暂性脑缺血发作(TIA)患者阿司匹林抵抗(AR)的疗效及安全性。

方法

招募86例服用ASP进行二级预防的TIA合并AR患者。2例因依从性差被剔除。其余84例患者随机分为治疗组和对照组。治疗组给予BHD和ASP治疗,对照组给予氯吡格雷和ASP治疗。治疗30天、60天和90天后,采用比浊法检测花生四烯酸(AA)和二磷酸腺苷(ADP)诱导的血小板聚集率(PAG)。治疗90天后,统计TIA复发或进展为脑梗死的病例数。观察不良事件的发生率。

结果

治疗组和对照组在各时间点ADP和AA诱导的PAG均呈相似的下降趋势(P>0.05)。两组终点事件(包括缺血性脑血管病、TIA复发、脑梗死)的风险控制差异无统计学意义(P>0.05)。治疗组有1例患者发生出血(轻度胃肠道出血),对照组有4例患者发生出血(3例为皮肤黏膜出血,1例为便血)。治疗组出血风险较对照组降低76.29%。

结论

BHD联合ASP治疗AR及控制终点事件的疗效相似,且降低了出血风险。

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