| Objective:To observe the therapeutic effect of panax notoginseng total saponins combined with antiplate drugs in the treatment of mild to moderate acute ischemic cerebral infarction patients with early recovery(2 months),and to explore the feasibility of using panax notoginseng total saponins on the basis of routine antiplate secondary prevention of ischemic stroke.Methods:(1)According to the inclusion and exclusion criteria,120 patients with first-stage acute ischemic cerebral infarction admitted to the Department of Neurology of the Affiliated Hospital of Youjiang Medical College for Nationalities from October 1,2021 to December 1,2022 were collected.(2)Were randomly divided into experimental group and control group,After the first day of admission,1 month ±3 days of treatment,and 2 months± 3 days of treatment,an experienced clinclinist measured the neurological impairment,self-care ability,and quality of life of the patients before and after treatment according to the National Institutes of Health Stroke Scale NIHSS,Rankin Scale(m RS),modified Barthel Index scale,and TCM Syndrome Score scale And TCM syndrome score.(3)On the first day of admission and after 2 months ± 3 days of treatment,the thromboelastography was completed.At the same time,5ml of 2 tubes of venous blood were taken from the patient during fasting in the morning,and the vascular endothelial growth factor(VEGF-A)and brain-derived neurotrophic factor(BDNF)were detected by ELLSA within 3 months.(4)The two groups of patients were treated with conventional treatment for cerebral infarction:anti-plate,regulating lipid,controlling blood pressure,controlling blood sugar,improving circulation,removing oxygen free radicals,etc.The experimental group was given oral Xuesaitong softgel capsule(total saponin of Panax notoginseng as the main component)on this basis.(5)After 2 months of continuous treatment,the follow-up data were sorted out and statistical analysis was performed using SPASS27.0 software.Results:(1)Of the 120 patients screened for the study,110 participants were included in the final analysis,57 in the experimental group and 53 in the control group.There were no significant differences in gender,age,smoking history,hypertension,hyperglycemia and dyslipidemia between the two groups(p>0.05).(2)Before treatment,there were no significant differences between the two groups in NIHSS score,m RS Score,Barthel score,TCM syndrome score,clinical trial index and main symptom distribution(P>0.05).(3)The two groups had a time main effect on the improvement of various scales.After 1 month of treatment,NIHSS score,m RS Score,Barthel index score and TCM syndrome score were significantly decreased in the two groups compared with before treatment(p<0.05),but there was no significant difference in the improvement degree between the two groups(p>0.05).After 2 months of treatment,the scores between the two groups were significantly lower than before treatment(p<0.05),the reduction degree of scores in the experimental group was significantly better than that in the control group,and there was statistical significance between the two groups(p<0.05).(4)In terms of the overall efficacy of TCM syndrome,after2 months of treatment,the significant efficiency of the experimental group was 84.2%,the overall effective rate reached 98.2%,the significant efficiency of the control group was 45.3%,the overall effective rate was 94.3%,the experimental group was significantly higher than the control group,the difference was statistically significant(p<0.05).(5)Changes of thrombologram: There was no statistically significant difference in thrombus elasticity between the two groups before treatment(p>0.05),but after 2 months of treatment,the changes in R value,K value,α Angle and MA value of the two groups were significant(p<0.001).Compared between the two groups,the changes in R value and MA value of the experimental group were more significant than those of the control group(p<0.05),which was statistically significant.There was no significant difference in K value and α Angle(p>0.05).(6)Before treatment,there were no significant differences in serum VEGH-A and BDNF contents between the two groups,with no statistical significance(p>0.05).After 2months of treatment,serum VEGH-A and BDNF levels in both groups were significantly increased compared with before treatment,with statistical significance(p<0.05),and VEGH-A and BDNF levels in the experimental group were significantly increased compared with the control group after treatment,with statistical significance(p<0.05).(7)Prognosis:Through telephone and outpatient follow-up 2 months after onset,the recurrence rate of the experimental group was 7.0%,87.7% of patients with good prognosis,and the incidence of adverse events was about 12.3%.In the control group,the recurrence rate was 11.3%,the good prognosis was 71.7%,and the incidence of adverse events was 15.1%.Other blood routine,coagulation,blood lipid and other tests were generally within the normal range,and no gastrointestinal hemorrhage,cerebral hemorrhage or obvious drug reaction occurred.Conclusion:(1)Total saponins of panax notoginseng combined with routine secondary prophylaxis can reduce the recurrence rate of patients with acute ischemic cerebral infarction to a certain extent,promote the recovery of neurological function,improve the prognosis of patients,and have good safety.(2)The total saponins of panax notoginseng combined with conventional secondary prophylaxis can effectively improve the R value and MA value of thrombus graph,which confirms that the combined administration can enhance the effect of anti-platelet aggregation and anti-thrombus,and does not increase the risk of bleeding in clinical observation.(3)Total saponins of panax notoginseng combined with conventional secondary prophytics can promote the repair of nervous system by up-regulating the expression of VEGF-A and BDNF. |
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