两种感冒药对华法林抗凝效果的影响研究

Study on influence of Chinese patent medicine for cold on anticoagulation effect in postoperative patients with mechanical valve replacement

目的研究中成感冒药板蓝根颗粒和感冒清热颗粒治疗机械瓣膜置换术后急性上呼吸道感染患者过程中,对华法林抗凝效果的影响,从而为临床用药提供理论参考。方法选取首次接受主动脉瓣置换、二尖瓣置换或双瓣置换术,术后长期服用华法林抗凝治疗,且并发急性上呼吸道感染的患者。将60例患者分为两组,每组各30例,A组采用口服板蓝根颗粒治疗,B组采用口服感冒清热颗粒治疗,疗程为3d,两组分别在服药前、服药后72h、停药后72h监测国际标准化比值(INR)和观察有无并发出血或栓塞反应,比较各时间点两组患者INR值及各组3个时间点INR值。结果服用板蓝根颗粒组72h后与该组其余两个时间点及同一时间点服用感冒清热颗粒组的INR值比较差异有统计学意义(P<0.05),服药前与服药后72hINR值比较差异无统计学意义(P>0.05),30例患者均无并发症发生;服用感冒清热颗粒组各时间点比较差异无统计学意义(P>0.05),30例患者无并发症发生。结论华法林与板蓝根颗粒联用导致INR值升高,而华法林联用感冒清热颗粒则对INR值无影响,因此提示临床中板蓝根颗粒与华法林联用时需谨慎。

Objective To evaluate the influence of Chinese patent medicine Banlangen Granules and Ganmao Qingre Granules on warfarin anticogulation effect during the process for treating acute upper respiratory tract infection in the postoperative patients with mechanical valve replacement in order to provide the theoretical reference for clinical medication. Methods The patient receiving mitral valve replacement,aortic valve replacement or double-valve replacement and long term postoperative oral warfarin anticoagulation treatment were selected, moreover the symptoms of complicating acute upper respiratory tract infection occurred. The patients were divided into 2 groups, 30 cases in each group. The group A adopted oral Banlangen Granules, while the group B was treated by oral Ganmao Qingre Granules. The treatment course was 3 d. The International Normalized Ratio（INR） in the two groups was monitored before medication, at 72 h after medication and at 72 h after drug withdrawal. Complicating bleeding or embolism reaction was observed. The INR values at various time points were compared between the two groups and the INR values in each group were compared among 3 time points. Results The INR values in the Banlangen Granules group had statistical differences between 72 h and other two time points, and the INR values at the same time point had statistical difference compared with the Ganmao Qingre Granules group （P〈0.05） ;the INR value in the Banlangen Granules group had no statistical difference between before medication and at 72 h after medication（P〉0. 05）. Thirty cases had no complication occurrence. The Ganmao Qingre Granules group had no statistical difference among various time points （P〉0. 05）, thirty cases had no complication occurrence. Conclusion The warfarin combined with Banlangen Granules causes the INR value increase, while warfarin combined with Ganmao Qingre Granules has no impact on the INR value, therefore which suggests that the combination use of warfarin and Banlangen Granules should be cautious in clinic.