| Objective:1.To study the status quo of ASA treatment in secondary prevention of recurrent cerebral infarction,and to explore the compliance of ASA treatment and related influencing factors.2.To study the distribution of TCM constitution in patients with recurrent cerebral infarction,to understand the main TCM constitution,and to study the relationship between ASA treatment compliance and TCM constitution.Methods:1.A total of 527 patients with recurrent cerebral infarction complicated with hypertension hospitalized in the department of neurology of the Central Theater Command general hospital of the Chinese People’s Liberation Army from January 2014 to December 2018 were selected,to collect their secondary prophylactic medication.Analyze the status quo of ASA treatment program compliance of patients and the reasons for patients not taking medicine or not taking medicine regularly.According to patients’ compliance,divide them into compliance group(N=99)and non-compliance group(N=428)to study the influencing factors of secondary prevention ASA treatment program compliance.2.To determine the TCM constitutions of 527 patients with recurrent cerebral infarction,analyze the distribution of TCM constitutions of the patients with recurrent cerebral infarction,and understand their main TCM constitutions.Patients were divided into compliance group and non-compliance group according to their compliance with antiplatelet drugs,statins and antihypertensive drugs before recurrence,to study the relationship between adherence to statins,antiplatelet aggregation drugs and traditional Chinese medicine constitution.Results:1.In secondary prevention of patients with recurrent cerebral infarction,257(48.8%)patients took antiplatelet drugs,183(34.7%)patients took statins,and 419 patients(79.5%)took antihypertensive drugs.There were 129(24.5%)patients who used the ASA regimen,333(63.3%)who did not regularly use the ASA regimen,and 65(12.3%)who did not use the ASA regimen.In the ASA treatment regimen,the most common treatment option for patients was to take antihypertensive drugs alone,with 161(30.6%).2.Univariate analysis between the compliance group and the non-compliance group showed that there were statistically significant differences between the two groups in factors such as education level,solitary,sequela of cerebral infarction,grade of hypertension before recurrence,and whether the blood pressure was monitored(P<0.05 or P<0.01).Further Logistic regression analysis showed that education level,solitary,and grade of hypertension before recurrence were independent risk factors for ASA treatment compliance.3.There were 270 cases of patients who did not use antiplatelet aggregation drugs,and the main reason was that they did not think they need to take drugs for the improvement of the disease,with 98 cases(36.3%).In addition,64 cases(23.7%)did not take medicine due to the presence or fear of side effects.There were 30 cases of patients who took antiplatelet aggregation drugs irregularly,and the main reason was that they forgot to take the drugs,with 20 cases(66.7%).Secondly,6 cases(20.0%)took medicine irregularly due to the occurrence or fear of side effects.Of the 227 patients who took their medication regularly,aspirin was the most frequently used drug.4.There were 344 cases of patients who did not use statins,mainly due to doctors’ unprescription,with 109 cases(31.7%).In addition,98 cases(28.5%)did not take medicine because they did not think it was necessary for them to get better.There were 41 cases of patients who took statins irregularly,and the main reason was that they forgot to take statins,with 25 cases(61.0%).Secondly,10 cases(24.4%)took medicine irregularly due to the occurrence or fear of side effects.There were 142 patients who took the drug regularly,and the most frequently used drugs were atorvastatin and resuvastatin.5.There were 108 cases of patients who did not use antihypertensive drugs,and the main reason was that 58 cases(53.7%)did not think it was necessary to take medicine after getting better.In addition,there were 19 cases(17.6%)who did not take medicine instead of taking traditional Chinese medicine or proprietary Chinese medicine.There were 71 cases of patients taking antihypertensive drugs irregularly,and 34 cases(47.9%)were affected by cognitive impairment.The second was taking medicine irregularly because of forgetting to do so,with 22 cases(31.0%).There were 419 patients taking antihypertensive drugs,including 340 patients taking single drug antihypertensive therapy,and nifedipine was the most frequently used drug.There were 348 cases of patients who took antihypertensive drugs regularly,among which 235 cases(67.5%)were not monitored due to irregular blood pressure management.Secondly,there were 228 cases(65.5%)without healthy lifestyle.Blood pressure in the third place was not up to the standard,with 199 cases(57.2%).6.Of the 527 patients with recurrent cerebral infarction,160(30.4%)had qi deficiency,9(1.7%)had qi stagnation,5(0.9%)had phlegm-heat,182(34.5%)had phlegm-dampness,54(10.2%)had blood stasis,19(3.6%)had Yang deficiency,98(18.6%)had Yin deficiency,0 had specific quality and 0 had mild quality.7.The number of patients with phlegm dampness and blood stasis in the compliance group was less than that in the non-compliance group,and the difference was statistically significant(P<0.05 or P<0.01).The number of patients with qi deficiency and phlegm-dampness in the statin treatment compliance group was less than that in the non-compliance group,and the difference was statistically significant(P<0.05).The number of patients in the compliance group with antihypertensive drugs was less than that in the non-compliance group,and the difference was statistically significant(P<0.05).Conclusions:1.ASA compliance in secondary prevention for patients with recurrent cerebral infarction is not optimistic and needs to be further improved.Factors such as education level,solitary,sequelae of cerebral infarction,grade of hypertension before recurrence,and whether blood pressure is monitored are factors influencing the compliance of ASA treatment regimen in patients with cerebral infarction,among which education level,solitary,and grade of hypertension before recurrence are independent risk factors.By strengthening the publicity,education and follow-up management of such people with low education level,living alone,sequela of cerebral infarction and mild hypertension,and educating them to regularly monitor blood pressure,it will be beneficial to improve the compliance of ASA treatment program of patients.2.The main reason for patients with recurrent cerebral infarction not taking ASA drugs or not taking ASA drugs regularly is the lack of correct understanding of diseases and drugs.Through popular science education and the development of individualized secondary prevention and treatment programs for patients,the compliance of patients with treatment programs can be enhanced and the recurrence risk of cerebral infarction can be reduced.3.In the secondary prevention of recurrent cerebral infarction,most patients who regularly take antihypertensive drugs have no standardized blood pressure management,which is mainly reflected in the failure to monitor the morning peak blood pressure,the lack of healthy lifestyle and blood pressure not up to the standard.By developing standardized blood pressure management,the control rate of hypertension of patients can be improved and the risk of recurrence of cerebral infarction can be reduced.4.The main TCM constitution of patients with recurrent cerebral infarction is phlegm and dampness,followed by qi deficiency and Yin deficiency and blood stasis.5.ASA treatment compliance closely related to the TCM constitution of patients with recurrent cerebral infarction. |
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