利伐沙班联合桂枝茯苓丸治疗缺血性脑卒中的效果及对患者静脉血栓栓塞症的预防效果

Effect of Rivaroxaban combined with Guizhi Fuing pills on ischemic stroke and prevention of venous thromboembolism

目的探究利伐沙班联合桂枝茯苓丸治疗缺血性脑卒中的效果及对患者静脉血栓栓塞症(VTE)的预防效果。方法采用方便抽样方法选取2017年3月至2020年1月本院收治的120例缺血性脑卒中患者作为研究对象,采用随机数字表法分为对照组与观察组,每组60例。两组均给予卒中基础治疗,对照组给予利伐沙班治疗,观察组给予利伐沙班联合桂枝茯苓丸治疗,比较两组下肢深静脉血栓形成(DVT)发生率、症状评分、血液流变学指标[红细胞压积(HCT)、红细胞聚集指数(RCAI)、血浆黏度(CP)]及凝血功能指标[纤维蛋白原(FIB)、凝血酶时间(TT)、凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、D-二聚体]。结果观察组DVT发生率低于对照组(5.00%vs.23.33%,P<0.05),治疗总有效率高于对照组(93.33%vs.80.00%,P<0.05)。治疗3周后,观察组肢围、视觉模拟评分法(VAS)评分均低于对照组(P<0.05)。治疗3周后,两组D-二聚体、FIB水平均低于治疗前,TT、PT、APTT均长于治疗前,且观察组D-二聚体、FIB水平均低于对照组,TT、PT、APTT均长于对照组(P<0.05)。治疗3周后,两组HCT、RCAI、CP均小于治疗前,且观察组小于对照组(P<0.05)。结论利伐沙班联合桂枝茯苓丸治疗缺血性脑卒中患者效果显著,能改善血液血流变学及凝血功能指标,降低DVT发生率,改善肢体肿胀及疼痛程度,值得临床推广应用。

Objective To explore the effect of Rivaroxaban combined with Guizhi Fuling pill in ischemic stroke and the prevention of venous thromboembolism(VTE).Methods 120 patients with ischemic stroke admitted to our hospital from March 2017 to January 2020 were selected as the research subjects,and they were divide into the control group and the observation group according to the random number table method,with 60 cases in each group.Both groups were given basic stroke treatment,in addition,the control group was given rivaroxaban,and the observation group was given rivaroxaban combined with Guizhi Fuling pill,the incidence of deep venous thrombosis(DVT),symptom score,blood rheology indexes(hematocrit[HCT],erythrocyte aggregation index[RCAI],plasma viscosity[CP])and coagulation function indexes(fibrinogen[FIB],thrombin time[TT],prothrombin time[PT],activated partial thromboplastin time[APTT],D-Dime)were compared between the two groups.Results The incidence of DVT in observation group was lower than that in control group(5.00%vs.23.33%,P<0.05),and the total effective rate was higher than that in control group(93.33%vs.80.00%,P<0.05).After 3 weeks of treatment,limb circumference and visual analog scale(VAS)scores in the observation group were lower than those in the control group(P<0.05).After 3 weeks of treatment,the D-dimer and FIB levels of the two groups were lower than before treatment,TT,PT and APTT were longer than before treatment,and the D-dimer and FIB levels in the observation group were lower than the control group,TT,PT and APTT were longer than control group(P<0.05).After 3 weeks of treatment,HCT,RCAI and CP in two groups were smaller than before treatment,and observation group was smaller than control group(P<0.05).Conclusion Rivaroxaban combined with Guizhi Fuling pill has significant effect in the treatment of ischemic stroke patients,which can improve blood hemorheology and coagulation function indexes,reduce the incidence of DVT,improve limb swelling and pain degree,and is worthy of clinical promotion and application.