低分子肝素联合中药治疗阿司匹林预防进展型脑梗死失败48例

Clinical Study on 48 Cases of Progressive Cerebral Infarction Controlled by Aspirin Failure to be Treated with Low Molecular Weight Heparin plus Traditional Chinese Medicine

目的观察低分子肝素联合中药治疗阿司匹林预防失败的进展型脑梗死的临床效果和安全性。方法随机分为治疗组和对照组，均行头部CT证实无出血，符合进展型脑梗死。治疗组中48例用低分子肝素4000U，次，2次，d，连用7d，其后改华法林口服维持治疗，同时辅以中药大秦艽汤治疗；对照组口服阿斯匹林200mg／d，7d后改为150mg，d。治疗前及治疗后30d进行神经功能缺损评分，以及疗效评定。结果 临床结果显示，低分子肝素联合大秦艽汤治疗组疗效明显优于对照组（P〈0．05），且严重出血并发症的发生率未增加。结论对于曾经规范应用阿司匹林预防脑梗死失败的进展性脑梗死患者，应用低分子肝素配合中药治疗较为安全有效。

Objective To observe the clinical effects and safety of preventing progressive cerebral infarction failure to be controlled by Aspirin with the low-molecular-weight heparin combined with traditional Chinese medicine. Methods All cases diagnosed by CT scan to be progressive cerebral infarction were randomly recruited into a control group and a treatment group, with 48 cases in each group. The treatment group was treated with low molecular heparin of 4000u/times, twice/day for 7 days MS and then was administrated with warfarin and Daqinjiao decoction. The control group was treated with aspirin of 200mg/day for 7 days and 150mg/day for the rest. Neurological deficit score and efficacy evaluation was assayed 30 days before and after the treatment. Results Clinical results showed that the therapeutic effects of the treatment group was much better than the control group（P〈0.05）. Besides the incidence of serious bleeding complications were increasing. Conclusion Low molecular heparin combined with traditional Chinese medicine is effective and safe to treat the patients of progressive cerebral infarction whose disease failed to be controlled by Aspirin.