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目的:观察补阳还五汤与氯吡格雷联合预防脑血管支架术后气虚血瘀型再狭窄的作用。方法:82例脑血管支架术后气虚血瘀型患者随机分为2组,对照组39例应用氯吡格雷加阿司匹林预防治疗,观察组43例服用补阳还五汤加氯吡格雷预防治疗。术后1年复查支架处血管狭窄程度,同时检测患者治疗前后血浆中血栓素A2(TXA2)、前列环素(PGI2)及TXA2/PGI2比值变化。结果:观察组治疗后TXA2及TXI2/PGI2比值明显降低,与治疗前比较,差异有显著性意义(P<0.05);2组治疗后比较,差异无显著性意义(P>0.05)。对照组有5例消化性溃疡,2例颅内出血,6例皮肤及口腔出血而被迫中断西药治疗。观察组1例消化性溃疡,2例皮肤及口腔出血,未见颅内出血。与对照组比较,观察组的并发症明显较少(P<0.05)。血管支架置入术后1年左右复查脑血管造影,观察组支架段血管直径与对照组比较,差异有显著性意义(P<0.05)。再狭窄率、再介入率2组比较,差异均无显著性意义(P>0.05)。结论:补阳还五汤干预脑血管支架术后气虚血瘀型再狭窄,降低再狭窄发生有一定的效果,且有较少的消化性溃疡与出血等并发症。
Objective: To observe the effect of Buyang Huanwu Decoction combined with clopidogrel in preventing restenosis of Qi deficiency and blood stasis type after cerebral vascular stenting. Methods: 82 cases of cerebral vascular stent after Qi deficiency and blood stasis type were randomly divided into two groups, the control group 39 cases of clopidogrel plus aspirin prophylaxis, 43 cases of observation group taking Buyang Huanwu Decoction plus clopidogrel prevention and treatment. The degree of stenosis at the stent was reexamined 1 year after operation, and the plasma levels of TXA2, PGI2 and TXA2 / PGI2 were also measured before and after treatment. Results: The ratio of TXA2 and TXI2 / PGI2 in the observation group was significantly lower than that before treatment (P <0.05). There was no significant difference between the two groups after treatment (P> 0.05). The control group had 5 cases of peptic ulcer, 2 cases of intracranial hemorrhage, 6 cases of skin and oral bleeding were forced to interrupt western medicine treatment. Observation group 1 case of peptic ulcer, 2 cases of skin and oral bleeding, no intracranial hemorrhage. Compared with the control group, the complication of the observation group was significantly less (P <0.05). Cerebral angiography was rechecked about 1 year after stent implantation. The diameter of vessel in the stent segment of the observation group was significantly different from that of the control group (P <0.05). Restenosis rate, re-intervention rate of two groups, the difference was not significant (P> 0.05). Conclusion: Buyang Huanwu decoction can restrain the restenosis of qi deficiency and blood stasis after cerebrovascular stenting and reduce the occurrence of restenosis, and there are fewer complications such as peptic ulcer and bleeding.