中风防治灵胶囊防治颈动脉狭窄支架植入术后再狭窄的疗效观察

Effect of Zhongfeng Fangzhiling Capsule on Prevention and Treatment of Restenosis After Stent Implantation for Carotid Artery Stenosis

目的:观察中风防治灵胶囊防治颈动脉狭窄支架植入术后再狭窄的临床疗效。方法:60例颈动脉狭窄支架植入术后患者,随机分为治疗组和对照组,各30例。对照组单纯常规用阿司匹林、氯吡格雷治疗;治疗组在对照组基础上口服中风防治灵胶囊。两组均治疗180 d,观察患者再狭窄率、颈动脉彩超、经颅多普勒(TCD)检测、神经功能缺损评分、血栓素A2(TXA2)、前列腺素I2(PGI2)、血液流变性学的变化,所有患者临床随访1年。结果:治疗组总有效率90.0%,对照组总有效率73.3%,治疗组优于对照组(P<0.05)。治疗组病变处狭窄率低于对照组(P<0.05)。中风防治灵胶囊合西药临床疗效,中医证候积分,风痰瘀阻证证候积分显著优于单纯口服西药组,可以明显减少颈内动脉不稳定斑块、斑块长度、斑块厚度,改善血液流变学,降低TXA2水平,升高PGI2水平,同时可降低近期出血并发症的发生率。术后1年临床随访无短暂性脑缺血发作(TIA)和脑梗死发生患者。结论:中风防治灵胶囊合西药防治支架置入后再狭窄有较好疗效,同时可降低近期出血并发症的发生率。

Objective： To observe the effect of Zhongfeng Fangzhiling capsule on preventing and treating restenosis after stent implantation for carotid artery stenosis. Method： The 60 postoperative patients with stent implantation for carotid artery stenosis were randomly divided into 2 groups,with 30 cases in each group. Patients in control group were treated with aspirin and clopidogrel. Patients in treatment group were also treated with Zhongfeng Fangzhiling capsule by orally taking based on the treatment in control group. Patients in both groups were treated for 180 days. Patients in both groups were observed for restenosis rate, carotid color Doppler ultrasound,transcranial doppler（ TCD） detection,thromboxane A2（ TXA2）,prostaglandin I2（ PGI2）,and blood rheology changes. Result： Total effective rate was 90. 0% by combined Chinese and western medicine in treatment group,higher than 73. 3% in control group（ P〈 0. 05）. The stenosis rate in lesion of control group higher than in treatment group（ P〈 0. 05）. The clinical efficacy,TCM symptom scores,and scores of windphlegm stasis syndrome in Zhongfeng Fangzhiling capsule combined with western medicine group were significantly superior to those in western medicine alone group. In addition, Zhongfeng Fangzhiling capsule combined with western medicine could significantly reduce the unstable plaque of internal carotid, plaque length, plaque thickness,improve blood rheology, lower the TXA2 level, increase the level of PGI2,and can reduce the incidence of recent bleeding（ complication）,with better effect than western medicine alone. One year after the implantation,no transient ischemic attack（ TIA） or cerebral infarction was found in patients in the clinical followup. Conclusion： Zhongfeng Fangzhiling capsule combined with western medicine has better efficacy in preventing and treating restenosis after stent implantation for carotid artery stenosis,and can reduce the incidence of recent bleeding（ complication）.