Clinical And Experimental Study Of The Puerarin On The Treatment And Prophylaxis Of The Cerebral Vasospasm After Subarachnoid Hemorrhage

Subarachnoid hemorrhage (SAH) is a critical cerebrovascular event with acute onset, serious illness and severe complications. And the cerebral vasospasm (CVS) is the leading cause of mortality and morbidity following SAH. Puerarin has been widely used in various types of cardiovascular and cerebrovascular diseases, since it extracted from a sort of traditional Chinese herbal medicine named Pueraria lobata. The purpose of this study is to investigate the effect of the puerarin on the treatment of the CVS after SAH through clinical trials and animal experiment.Part one:clinical trialsObjective:To investigate the effect of the puerarin on the treatment of the CVS after SAH. Methods:27cases patients with subarachnoid hemorrhage were selected and randomly divided into treatment group (n=14) and control group (n=13). In the basis of fundamental treatment, All Patients were administered250ml of Puerarin by intravenous injection once a day and/or lOmg of nimoton by continuous intravenous infusion twice a day for14days. Comparison of clinical datas between Per and Post therapy in the two groups was evaluated by the statistical analysis, such as TCD,CT and relevant clinical scores. Results:Puerarin group got better neural function defect score and prognostic score than that in control group. Meanwhile, the cerebral blood supply and absorbed rate of blood was also improved following Puerarin administration.Part two:animal experimentObjective:To exam the vasospasm preventive effect for rat in different period after puerarin treatment.Methods:The experimental SAH in rats was established by a double cisterna magna hemorrhage injection method. A total of56male SD rats were randomly divided into7groups by various time point:control group, SAH3d group, SAH5d group, SAH7d group, puerarin grain3d group, puerarin grain5d group and puerarin grain7d group. Once a day of puerarin in the puerarin consociation sibeline cure to treatment. The basal arteries of rat were harvested on each time point after perfusion-fixed procedure, then stained with H&E. The diameter of basilar arteries and the thickness of vessel walls were determined by an image analysis system. Results:The inner perimeter of basilar artery in Puerarin7d treatment group was significantly greater than that in subarachnoid hemorrhage group (P<0.05). The pathological and histological results showed that, the morphology of spasm vessel was greatly improved.Conclusion:The research shows that the puerarin is an effective agent for the treatment of the CVS after SAH, can obviously improve the clinical symptoms and prognosis and its effect in the role are confirmed in rat SAH model. The research of the modernization of Chinese traditional medicine provides clinical and experimental basis to the treatment of patients with SAH.