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基于抗血小板作用和胃肠道损伤的血塞通与阿司匹林联合应用:一项随机对照非劣效性试验的研究方案

Combination of Xuesaitong and Aspirin Based on the Antiplatelet Effect and Gastrointestinal Injury: Study Protocol for a Randomized Controlled Noninferiority Trial.

作者信息

Zhu Bao-Chen, Xue Chun-Miao, Lang Rui, Weng Wei-Liang, Wang Xu-Jie, Lei Zhen-Zhen, Zhang Sha-Sha, Yang Wen-Hua, Zhang Wan-Tong, Hua Guo-Dong

机构信息

Department of Pharmacy, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China.

Department of Nephrology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China.

出版信息

Evid Based Complement Alternat Med. 2021 Jul 13;2021:5552506. doi: 10.1155/2021/5552506. eCollection 2021.

Abstract

BACKGROUND

Aspirin is the first-line medication for prevention and treatment of coronary heart disease (CHD). However, long-term use of aspirin resulting in gastrointestinal mucosal injury and bleeding limits the regularity of medication. Xuesaitong is a marketed Chinese medicine contained main active component in Panax notoginseng saponins (PNS), which can significantly inhibit platelet aggregation in patients with CHD. Our previous studies have already showed that PNS could reduce the gastrointestinal mucosal injury caused by aspirin in preclinical study. However, there is a need for further clinical studies to evaluate synergy and attenuation effect of the combination.

METHODS

This trial is a prospectively planned, open-labeled, parallel-grouped, single-centered clinical trial. A total of eligible 480 participants will be randomly allocated into three groups: aspirin group, Xuesaitong group, and drug combination group at a ratio of 1 : 1 : 1. The primary outcome is the change of platelet aggregation rate and calprotectin activity. Secondary outcomes include PAC-1, P-selectin, P2Y12, I-FABP activity, and fecal occult blood. . The results of the study are expected to provide evidence of high methodological and reporting quality on the synergy function of Xuesaitong and aspirin upon the antiplatelet and anti-gastrointestinal injury effect for CHD. It also provides an experimental basis for clinical rational drug combination therapy. . This trial was registered in the Chinese Clinical Trail Registry, ChiCTR2000036311, on 22 August 2020, http://www.chictr.org.cn/edit.aspx?pid=58798&htm=4.

摘要

背景

阿司匹林是预防和治疗冠心病(CHD)的一线药物。然而,长期使用阿司匹林导致胃肠道黏膜损伤和出血,限制了用药的规律性。血塞通是一种已上市的中药,其主要活性成分是三七总皂苷(PNS),可显著抑制冠心病患者的血小板聚集。我们之前的研究已经表明,在临床前研究中PNS可以减轻阿司匹林引起的胃肠道黏膜损伤。然而,需要进一步的临床研究来评估联合用药的协同和减毒效果。

方法

本试验是一项前瞻性规划、开放标签、平行分组、单中心的临床试验。总共480名符合条件的参与者将按1∶1∶1的比例随机分为三组:阿司匹林组、血塞通组和联合用药组。主要结局是血小板聚集率和钙卫蛋白活性的变化。次要结局包括PAC-1、P-选择素、P2Y12、I-FABP活性和粪便潜血。本研究结果有望为血塞通和阿司匹林在冠心病抗血小板和抗胃肠道损伤作用方面的协同功能提供高质量的方法学和报告证据。它也为临床合理药物联合治疗提供实验依据。本试验于2020年8月22日在中国临床试验注册中心注册,注册号为ChiCTR2000036311,网址为http://www.chictr.org.cn/edit.aspx?pid=58798&htm=4。

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