Clinical Research Of The Effect Of The Puerarin On The Treatment And Prophylaxis Of The Cerebral Vasospasm After Subarachnoid Hemorrhage

Subarachnoid hemorrhage (SAH) affects about 10 out of 100,000 adults annually, account for 12%-20% of the total incidence of the cerebral vascular disease. With the great development of the morden medicine,although most of the causes which lead to the SAH are effectively removed, up to 17%-40% of the patients develop a syndrome of focal and/or cognitive deficits due to cerebral vasospasm after the SAH (delayed ischemic neurological deficit, symptomatic vasospasm).As a result, many die or suffer permanent morbidity. The mechanism of vasospasm has now been partly elucidated, Possibilities include neuronal apoptosis, scavenging or decreased production of nitric oxide, increased endothelin levels, direct oxidative stress on smooth muscle cells, free radical production and lipid peroxidation of cell membranes, modification of potassium and calcium channels and differential up-regulation of genes. And CVS has been described as the important cause of morbidity and mortality in patients with SAH.Objective:To investigate the effect of the puerarin on the treatment and prophylaxis of the CVS after SAH.Methods:Select 36 patients with SAH from the department of neurosurgry in Jiangsu Province hospital of TCM. Random grouping and parallel contrast are employed.In the basis of fundamental treatment, All patients were administered 250ml of puerarin by intravenous injection once a day and/or 10mg of nimoton by continuous intravenous infusion twice a day for 14 days following surgery or intravascular therapy. Comparison of clinical datas between per and post-therapy in the two groups was done by the statistical analysis,such as NO,ET,TXB2,6-Keto-PGF1α,TCD and clinical outcomes.Results:Compared with the control, the treatmeat group reduces the incidence of the CVS in patient with SAH,significantly improve the levels of the CVS-related vascular active factor and the prognosis of the patients. Moreover, there is no significant difference of security index such as the examination of liver and kidney functions before and after the treatment, it indicates that puerarin has safe clinical efficacy and no significant side effects.Conclusion:This clinical research demonstrates that puerarin is a safe and effective agent for the treatment and prophylaxis of the CVS in patients after subarachnoid hemorrhage.This drug may provide a new therapeutic modality for treating patients suffering from cerebral vasospasm after subarachnoid hemorrhage and for improving the functional prognosis of these patients. Meanwhile the research provides the clinical basis for the application of Traditional Chinese Medicine to the patients with SAH.