| 张丽娟,王燕,黄凌波,等.补气活血化瘀止血方对经皮冠状动脉介入治疗术后主要不良心血管事件及出血的影响[J].安徽医药,2021,25(11):2286-2289. |
| 补气活血化瘀止血方对经皮冠状动脉介入治疗术后主要不良心血管事件及出血的影响 |
| Study of the effect of supplementing Qi and hemostatic formula on MACE and bleeding after PCI |
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| DOI：10.3969/j.issn.1009-6469.2021.11.039 |
| 中文关键词: 经皮冠状动脉介入治疗 补气活血化瘀止血 手术后出血 临床疗效 |
| 英文关键词: Percutaneous coronary intervention Supplementing Qi and hemostatic formula Postoperative hemorrhage Clinical |
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| 中文摘要: |
| 目的探究补气活血化瘀止血配方对经皮冠状动脉介入治疗( PCI)术后主要不良心血管事件( MACE)及出血的影响。方法以 2019年 1月至 2020年 1月在成都市第五人民医院行 PCI的冠心病病人 124例为研究对象，病人的中医症候表现为气虚血瘀证。采用随机数表法将病人随机分为两组，每组 62例。观察组给予补气活血化瘀止血配方和泮托拉唑钠肠溶胶囊安慰剂，对照组给予补气活血化瘀止血配方安慰剂和泮托拉唑钠肠溶胶囊。观察两组 MACE、术后出血及 PCI术后第 7天、第 30天腺苷二磷酸( ADP)抑制率、花生四烯酸( AA)抑制率、 ADP诱导的血凝块强度( MAADP)。结果观察组 MACE发生率(3.2%)与对照组( 9.7%)比较，差异无统计学意义( P>0.05)。观察组出血事件发生率( 29.0%)、出血类型、出血部位与对照组出血事件发生率( 24.2%)、出血类型、出血部位比较，差异无统计学意义( P>0.05)。观察组 PCI术后 30 d MAADP、ADP抑制率、 AA抑制率与 PCI术后 7d比较，差异无统计学意义( P>0.05)。对照组 PCI术后 30 d MAADP与 PCI术后 7d比较显著升高， PCI术后 30 d ADP抑制率与 PCI术后 7d比较显著降低( P<0.05)。结论补气活血化瘀止血配方预防 PCI术后出血的效果与泮托拉唑钠肠溶胶囊相似。此外，由于潜在的 CYP450酶依赖性机制，补气活血化瘀止血配方对氯吡格雷的干扰作用较泮托拉唑钠肠溶胶囊小。 |
| 英文摘要: |
| Objective To explore the effect of supplementing Qi and hemostatic formula on major adverse cardiovascular events(MACE) and bleeding after percutaneous coronary intervention (PCI).Methods A total of 124 patients with coronary heart diseasewho underwent PCI in the Fifth People's Hospital of Chengdu from January 2019 to January 2020 were selected as the research subjects. The TCM syndromes of the patients were qi deficiency and blood stasis syndrome. Random number table method was used to randomly divide the patients into 2 groups, with 62 cases in each group. Patients in the study group were given supplementing Qi and hemostatic formula and pantoprazole sodium enteric-coated capsules placebo, and patients in the control group were given supplementingQi and hemostatic formula placebo and pantoprazole sodium enteric-coated capsules. The MACE, gastrointestinal bleeding, and adenosine diphosphate (ADP) inhibition rate, arachidonic acid (AA) inhibition rate, ADP-induced blood clot intensity (MAADP) on day 7 and day 30 after PCI were observed.Results There was no significant difference between the incidence of MACE (3.2%) in the studygroup and the incidence of MACE (9.7%) in the control group (P>0.05). There was no significant difference between the incidence ofbleeding events (29.0%), bleeding types, bleeding sites in the study group and the incidence of bleeding events (24.2%), bleedingtypes, bleeding sites in the control group (P>0.05). There was no significant difference in MAADP, ADP inhibition rate and AA inhibition rate between the 30 days after PCI and 7 days after PCI in the study group (P> 0.05). The MAADP at 30 days after PCI was significant higher than that at 7 days after PCI, and the ADP inhibition rate at 30 days after PCI was significantly lower than that at 7 days after PCI in the control group (P <0.05).Conclusions The effect of supplementing Qi and hemostatic formula for preventing gastrointestinal bleeding in PCI is similar to that of pantoprazole sodium enteric-coated capsules. In addition, the supplementing Qi and hemostatic formula has less interference with clopidogrel than pantoprazole sodium enteric-coated capsules due to the potential CYP450-independent mechanism. |
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