| Objective: To observe the effect and safety of activating blood circulation and removing blood stasis on vascular recanalization rate,vascular reocclusion rate,neurological function,platelet count and blood coagulation function in patients with acute cerebral infarction treated by intravenous thrombolysis.to provide a basis for the ultra-early application of activating blood circulation and removing blood stasis in patients with acute cerebral infarction after intravenous thrombolysis.Methods: According to inclusion and exclusion criteria,54 inpatients with acute cerebral infarction of the Department of Encephalopathy,Wuhu Traditional Chinese Medicine Hospital were randomly divided into two groups.They are observation group(29 cases)and control group(25 cases).Both groups has been received the treatments of rt-PA intravenous thrombolysis and conventional treatment of acute cerebral infarction.The observation group has received another one treatment of Blood circulation and stasis removal Chinese medicine injection.The course of treatment is one week.After the treatments,it was recorded that inpatients still got the situation of Vascular recanalization and reinfarction occur.Neurological deficit at the end of thrombolysis,24 hours and 1 week at the end of thrombolysis in the two groups was evaluated,as well as the ADL score and ischemic stroke syndrome changes before and after thrombolysis.The changes of PLT,PT,INR,APTT,TT,Fib,D-D and other parameters before and after 1 week after thrombolysis were observed.The Adverse events that occurred during hospitalization wil be recorded carefully to evaluate the treatments.Results:1.There are 20 patients with recanalization in the observation group,while 10 patients in another group,the recanalization rate of blood vessels in observation group was higher than that in control group [69.0%(20/29)versus 40%(10/25),P<0.05];There were 2 cases of reocclusion after vascular recanalization in the observation group and 5 cases in the control group.The rate of vascular reocclusion in the observation group was lower than that in the control group [10.0%(2/20)versus 50.0%(5/10),P<0.05]..2.At the end of thrombolysis,it was no significant difference for the efficacy of the two groups(P>0.05);the efficacy of the observation group was significantly higher than control group 24 hours after thrombolysis(P<0.05)and 1 week after thrombolysis(P<0.05),and the basic healing and significant improvement of the observation group at these two time points were greater than control group.The ADL scores at 1 week after thrombolysis were significantly higher than those before thrombolysis in both groups(P<0.05),and the observation group was higher than the control group(P<0.05).3.In both groups,internal wind,phlegm-damp,and blood stasis symptoms were predominant at the beginning of the acute phase,and wind symptoms decreased sharply in both groups after treatment(P<0.05);internal fire symptoms increased slightly(P>0.05),and qi deficiency symptoms increased significantly in both groups after 1 week(P<0.05);the blood stasis evidence in the observation group was significantly less than the other group after 1 week(P<0.05);the changes of phlegm-dampness and yin-deficiency evidence in both groups before and after treatment were not significant.4.PLT in the control group was significantly lower than the one before thrombolysis 1 week after thrombolysis,and PLT in the control group was lower than that in the observation group 1 week after thrombolysis(P<0.05);there was no significant difference between INR and TT in the two groups before and after treatment(P>0.05);PT and APTT in the observation group 1 week after thrombolysis were higher than before thrombolysis(P<0.05),PT and APTT in the observation group for 1 week after thrombolysis were higher than those in the control group(P<0.05),and the levels of D-D and Fib in the control group 1 week after thrombolysis were significantly higher than those before thrombolysis(P<0.05),and the levels of Fib and D-D in the control group 1 week after thrombolysis were higher than those in the observation group(P<0.05).5.Patients in both observation group and control group had gingival bleeding during thrombolysis.It was no difference in the incidence of gingival bleeding [41.4%(12/29)versus 36.0%(9/25),P>0.05],and there were no cases of skin mucosa,urinary tract,gastrointestinal bleeding,or intracranial bleeding during hospitalization.Conclusions:1.The method of activating blood circulation and removing blood stasis in the ultra-early stage after thrombolysis can effectively increase the recanalization rate and reduce the occurrence of vascular reocclusion after thrombolysis.2.After thrombolysis,the ultra-early combination of blood circulation and stasis removal method can effectively improve the symptoms of neurological deficits and the daily life ability of patients.3.In the early stage of stroke disease,internal stroke,sputum dampness,and blood stasis symptoms are the main symptoms.wind and blood stasis can be improved by the early application of blood circulation and stasis.4.After thrombolysis,the ultra-early combined blood activation and stasis removal method can improve the blood hypercoagulability state and inhibit thrombosis inpatients with acute cerebral infarction.5.After thrombolysis,the ultra-early combined blood circulation and stasis removal method is safe. |
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