高压氧配合三七总皂甙治疗对缺血性脑血管病患者血液流变学指标的影响

Effects of hyperbaric oxygenation associated with panax notoginseng saponins therapy on hemorrhology indexes in patients with ischemic cerebrovascular disease

目的:观察高压氧与三七总皂甙联合治疗后缺血性脑血管病患者血液流变学指标的变化。方法:选择1996-01／2000-01在解放军第一医院神经内科的血液流变学异常的缺血性脑血管病患者64例。随机分为治疗组34例和对照组30 例。两组均给予三七总皂甙治疗,1次／d,21 d为1个疗程。对照组:单用三七总皂甙。治疗组:在给药的同时,每天进行氧舱治疗,压力为0．22 MPa, 吸纯氧60 min,1次／d,20次为1个疗程。所有患者在用药前及用药后 7 d、21 d均清晨空腹抽血,2 h内测定血液流变学。结果:64例患者均进入结果分析。①全血黏度比较:治疗组治疗21 d、7 d 后明显比治疗前低[(4.20±0．80,4．45±0．12,6．55±1．08),t=5．42-17．22,P<0．01]; 对照组治疗21 d、7 d后明显比治疗前低[(4．84±0．03,5．78±0．18,6．50+1．25), t=2．27-5．68,P<0．01]。②血浆纤维蛋白原比较:治疗组治疗21 d,7 d后明显比治疗前低[(462．50+37．6,497．62±39．2,558．30±1．40)g／L,t=5．42-17．22, P<0．01];对照组治疗21 d、7 d后明显比治疗前低[(483．40+35．6, 550．43±37．20,557．60±141．00)g／L,t=2．27-5．68,P<0．01]。③红细胞压积比较:治疗组治疗21 d,7 d后明显比治疗前低[(39．20±3．98,40．85±4．64, 45．51±4．69)％,t=5．42-17．22,P<0．01];对照组治疗21 d,7 d后明显比治疗前低[(42．25±3．76,43．72±4．64,46．30±5．00)％,t=2．27-5．68,P<0．02]。④血沉方程K值比较:治疗组治疗21 d,7 d后明显比治疗前低[(68．72±35．66, 70．68±38．63,105．67±20．10),t=5．42-17．22,P<0．01];对照组治疗21 d,7 d后明显比治疗前低[(74.58±35．23,92．70±36．43,107．50±19．10),t=2．27-5．68,P<0．01]。结论:高压氧与三七总皂甙配合治疗缺血性脑血管病血液流变学异常比单纯用三七总皂甙起效快、副反应少。

AIM：To observe the changes of index of hemorheology indexes in patients with ischemia cerebral vessel disease after the treatment of hyperbaric oxygenation （HBO） associated with panax notoginseng saponins （PNS）. METHODS： Sixty-four patients with ischemia cerebral vessels disease and abnormal hemorheology,who were treated at the Department of Neurology,First Military Hospital of Lanzhou Military Area Command of Chinese PLA from January 1996 to January 2000,were selected, and were divided randomly into treatment group with 34 patients and control group with 30 patients.They were all treated with PNS, once a day, 21 days as a course. The patients in the control group were only given PNS. Those in the treatment group were also treated in the oxygen chamber when giving administration, at the pressure of 0.22 Mpa, sucking pure oxygen for 60 minutes, once a day, 20 times as a course. Blood in fasting stomach was gained in the morning hefore administration and at 7 clays and 21 clays after administration. Hemorheology was measured within 2 hours. RESULTS：Totally 64 patients were involved in the result analysis. ① Comparison of Blood Specific Viscosity （BSV）： It was lower significantly in the treatment group after treatment for 21 days and 7 days than before treatment [（4.20±0.80,4.45±0.12,6.55±1.08）,t=5.42-17.22,P 〈 0.01]. It was lower significantly in the control group after treatment for 21 days and 7 days than before treatment [（4.84±0.03,5.78±0.18,6.50±1.25 ）,t=2.27-5.68, P 〈 0.01].② Comparison of plasma fibrinogen： It was lower significantly in the treatment group after treatment for 21 days and 7 days than before treatment [（462.50±37.6,497.62±39.2,558.30±1.40）g/h,t =5.42 -17.22,P 〈 0.01].lt was lower significantly in the control group after treatment for 21 days and 7 days than before treatment [（483.40±35.6,550.43±37.20,557.60±141.00）g/L, t=2.27-5.68,P 〈 0.01].③ Comparison of erythrocyte rigidity： It was lower significantly in the treatment group after treatment for 21 days and 7 days than before treatment [（39.20±3.98,40.85±4.64,45.51±4.69）% ,t =5.42- 17.22,P〈 0.01 ].It was lower significantly in the control group after treatment for 21 days and 7 days than before treatment [（42.25±3.76,43.72±4.64, 46.30±5.00）% ,t =2.27-5.68,P〈 0.01]. ④ Comparison of K value of erythrocyte sedimentation rate equation：It was lower significantly in the treatment group after treatment for 21 days and 7 days than before treatment [（68.72±35.66,70.68±38.63,105.67±20.10）,t =5.42 -17.22,P 〈 0.01].lt was lower significantly in the control group after treatment for 21 days and 7 days than hefore treatment ] （ 74.58±35.23.92.70±36.43,107.50±19.10 ）, t=2.27-5.68,P 〈 0.01]. CONCLUSlON：HBO associated with PNS therapy has rapid effects with few adverse reactions in the treatment of abnormal hcmorheology in patients with ischemia cerebral vessel disease as compared with the only using of PNS. With prolongation of treating time, the effects were more obvious.