三七皂甙联合阿司匹林治疗脑梗塞的临床观察

Clinical observation on treating cerebral infarction with arasaponin plus acetylsalicylic acid

目的:探讨三七皂甙联合阿司匹林治疗脑梗塞的临床疗效及安全性。方法:将84例临床诊断为脑梗塞的中老年患者随机分为3组,其中阿司匹林组29例,口服拜阿司匹灵;三七皂甙组27例,口服三七通舒胶囊;三七皂甙联合阿司匹林组28例,联合服用拜阿司匹灵和三七通舒胶囊。比较三组患者的临床疗效,并分析药物安全性。结果:三组患者治疗后神经功能缺损积分与治疗前相比,均显著降低(P<0.01)。III组与I组和II组相比,积分降低显著(P<0.05)。与I组相比,II组、III组PT明显延长,且较I组效果显著(P<0.01)。在PT-INR比较中,三组患者PT-INR均呈现升高的趋势(P<0.01),其中以III组效果最佳,与I组和II组相比有显著性差异(P<0.01)。三组治疗后D-D、PAg T水平均明显下降(P<0.01)。I组患者PAg T水平优于II组(P<0.05),III组患者PAg T明显低于I组和II组患者(P<0.01)。结论:三七皂甙联合阿司匹林对于抗血小板聚集、颈动脉内膜中层厚度的影响明显优于单用阿司匹林或三七皂甙,且不提高不良反应的发生率,具有良好的疗效性及安全性,为临床抗血栓治疗选择提供依据。

Objective： To discuss the clinical efficacy and safety of the arasaponin plus acetylsalicylic acid on cerebral infarction. Methods： 84 gerontal patients in cerebral infarction were randomly divided into three groups; 29 cases in the acetylsalicylic acid group were given the aspirin treatment; 27 cases in the arasaponin group were given the smooth fluent comfortable panax notoginseng capsule treatment; 28 cases in the arasaponin plus acetylsalicylic acid group were given the aspirin plus the smooth fluent comfortable panax notoginseng capsule treatment. The clinical efficacies in three groups were compared, and analyzed safety of medicine. Results： After treatment, the neurologic deficit score in three groups were decreased obviously （P〈0.01）. Comparing with the group I and the group II, the deficit score in group III was decreased obviously （P〈0.05）. Comparing with the group I, PT in the group III was lengthen significantly （P〈0.01）. PT-INR in three groups were increased （P〈0.01）, and the effects in the group III was best. There was a significant difference comparing with the group I and the group II （P〈0.01）. After treatment, D-D, PAgT levels in three groups were significantly decreased （P〈0.01）. PAgT levels in the group I were better than that in the group II （P〈0.05）. PAgT levels in the group III were lower than those in the group I and group II significantly （P〈0.01）. Conclusion： The effects of arasaponin plus acetylsalicylic acid on platelet aggregation and intima-media thickness were better than applying arasaponin or acetylsalicylic acid simply, with less adverse reactions, showing an good efficacy and safety, provided proof for method selection of clinical anti-thrombus treatment.