Cerebral Thrombosis Patients Research Articles

Clinical study of Qixie-Huoxue-Tongluo decoction combined with ozagrel sodium injection in treatment of cerebral thrombosis

Objective To study the clinical efficacy of Qixie-Huoxue-Tongluo decoction combined with ozagrel sodium injection in treatment of cerebral thrombosis. Methods According to the random number table method, 91 cerebral thrombosis patients who met the inclusion criteria were divided into the control group (45 cases) and the study group (46 cases). The control group was treated with ozagrel sodium injection on the basis of routine treatment, while the study group was treated with Qixie-Huoxue-Tongluo decoction on the basis of the control group. The two groups were treated for 7 days. The National Institute of Health Stroke Scale (NIHSS)was used to assess the degree of neurological impairment, the Activity of Daily Living (ADL) was used to assess the quality of life; and the levels of MDA, SOD, NO, neuron-specific enolase (NSE) and neuronal protein (S-100β)were detected by ELISA.The clinical efficacy was evaluated. Results The total effective rate was 93.5% (43/46) in the study group and 71.1% (32/45) in the control group, there was significant difference between the two groups (χ2=7.853, P=0.005). After treatment, the NIHSS score in the study group was significantly lower than that in the control group (16.1 ± 5.0 vs. 20.3 ± 5.3; t=3.889, P<0.01), and the ADL score in the study group (51.9 ± 9.3 vs. 45.3 ± 8.6, t=3.461) was significantly higher than that in the control group (P<0.01); the serum level of MDA (3.10 ± 0.48 mmol/L vs. 4.25 ± 0.76 mmol/L, t=11.427) and NO (41.14 ± 6.74 U/L vs. 62.20 ± 8.43 U/L, t=10.028) in the study group were significantly lower than those in the control group (P<0.01), the SOD (204.36 ± 21.29 vs. 163.39 ± 17.45, t=13.177) level in the study group was significantly higher than that of the control group (P<0.01); the serum NSE (4.85 ± 1.03 μg/L vs. 7.93 ± 1.14 μg/L, t=13.529) and S-100β protein (0.18 ± 0.03 μg/L vs. 1.02 ± 0.15 μg/L, t=37.232) levels in the study group were significantly lower than those in the control group (P<0.01). Conclusions Qixie-Huoxue-Tongluo decoction combined with ozagrel sodium injection can improve the degree of neurological impairment in patients with cerebral thrombosis, improve the quality of life clinical efficacy. And the mechanism may be related to inhibition of lipid peroxidation, anti-free radicals and so on. Key words: Intracranial thrombosis; Qixie-Huoxue-Tongluo decoction; Brain ischemia; Quality of life; Clinical studies

Standardized traditional Chinese medicine rehabilitation nursing for 200 cases of cerebral thrombosis patients

Objective The main purpose of the study is to investigate and analyze the traditional Chinese medicine nursing methods and measures for the 200 cases of cerebral thrombosis patients. Methods A total of 200 cases of patients with cerebral thrombosis treated in our hospital from November 2012 to November 2014 were selected as the research objects and divided into the observation group and the contol group, 100 cases in each group. The patients of the two groups were all given the traditional clinical nursing.While the observation group was treated with traditional Chinese medicine nursing on the basis of the traditional clinical nursing.Then the score of the hospitalization time and quality of life and the patients' satisfaction for nursing of the two groups were compared. Results The average hospitalization time of the observation group was (10.5±4.9) days, and the average hospitalization time of the control group was(16.5±5.1) days, and the difference between the two groups was statistically significant. Conclusions Traditional Chinese medicine nursing intervention for patients with cerebral thrombosis can promote the rehabilitation process, and improve the quality of life of patients, which shows a reference value for nursing. Key words: Patients with cerebral thrombosis; Standardization; Traditional Chinese medicine rehabilitation nursing

Medication compliance in cerebral thrombosis patients with diabetes mellitus after discharge

Objective To investigate the medication compliance in cerebral thrombosis patients with diabetes mellitus after discharge. Methods We established the medication compliance scale and medication use situation questionnaire. And then, we followed up the types and compliance of medication in cerebral thrombosis patients with diabetes mellitus after discharge who had been in this hospital from 1995 to 2015. Results The average age was (65.28±10.01) among 40 patients (23 males and 17 females). The rate of medication compliance good was 2.5% along with compliance bad accounting for 97.5%. The good of medication compliance accounted for 60.0% and the medium for 40.0% according to the total score. The major types of medication which the patients took after discharge included oral antidiabetic drug and/or insulin, statins, aspirin and/or clopidogrel, hypotensor with the average of 4.2 types. There was no significant difference in medication types between the group within one year and the group over one year, between males and females. The rate of noncompliance was from 5.0% to 56.2% in different types of medication. The rates of medication compliance of antidiabetic drug and/or insulin, aspirin and/or clopidogrel, statins, hypotensor were 95.0%, 82.5%, 80.0%, 43.8% and the hypotensor for the highest at the rate of noncompliance. There was a statistically significant difference in drug-use rate of hypotensor between the group within one year and the group over one year. Conclusions The medication compliance in cerebral thrombosis patients with diabetes mellitus after discharge is poor along with the high rate of noncompliance. The results illustrate that the patients lack understanding on long-term medication treatment for the prevention of cerebral thrombosis and palindromia. Propaganda and education should be enhanced by taking comprehensive measures so as to improve medication compliance. Key words: Intracranial thrombosis; Diabetes mellitus; Patient discharge; Patient compliance

鍼通電療法が脳卒中患者の血管弾性に与える影響

[Objective] It seems that in Japan’s aging society, investigating the position of acupuncture and moxibustion for the treatment of arteriosclerotic diseases is important. In this report we evaluated the effects of electroacupuncture (EA) on stroke patients by measuring changes in pulse wave velocity (PWV), brachial-ankle PWV (baPWV), ankle brachial pressure index (ABI), blood pressure (BP) and heart rate (HR). [Method] The subjects were 210 initial stroke patients. Stroke patients were randomly allocated to three groups, those only taking drug therapy (drug group), those taking drug therapy combined with rehabilitation (rehab group), and those taking drug therapy and rehabilitation combined with EA (EA group). 81 cerebral thrombosis patients (drug group n = 25, rehab group n = 28, EA group n = 28), 68 cerebral embolus patients (drug group n = 24, rehab group n = 20, EA group n = 24) and 61 cerebral hemorrhage patients (drug group n = 20, rehab group n = 21, EA group n = 20) were examined. For the evaluation method blood pressure pulse wave measuring equipment was used to measure PWV, baPWV, ABI, BP, and HR after two months, four months, and six months from the onset of treatment. [Results] After two months and four months there was no significant difference in blood vessel elasticity of the three cerebral thrombosis groups. Whereas after six months, compared to the drug group, the baPWV in cerebral thrombosis patients significantly decreased for the rehab group (P < 0.05) and EA group (P < 0.01). There were no significant differences in ABI, BP, or HR. Cerebral hemorrhage and cerebral embolism patients showed no significant difference in baPWV, ABI, BP, and HR. [Conclusion] We examined the effects of adding EA to the treatment of patients who suffered cerebral thrombosis, cerebral embolism, or cerebral hemorrhage. These results show that adding EA to drug treatment and rehabilitation significantly improves blood vessel elasticity and suggests that using EA would reduce the risk of cerebral thrombosis and its reoccurrence.

脳血栓症急性期に対する抗トロンビン薬アルガトロバンの治療効果

Effect of argatroban on neurological symptoms and activities of daily living (ADL) was evaluated in 68 acute cerebral thrombosis patients. Disturbance of consciousness and nurological symptoms improved significantly as a result of treatment with argatroban. ADL evaluated using the Barthel Index improved significantly from day 3 of treatment.Stratified analysis of ADL was conducted with respect to infarct region, time of starting treatment after onset, and types of cerebral thrombosis. For infarcts in the territory of deep perforators, ADL improved significantly from day 3 of treatment regardless of whether treatment started within 12 hours or more than 12 hours after onset. Cortical infarction improved significantly only when treatment started within 12 hours after onset. Both of lacunar and atherothrombotic infarction improved significantly from day 7 of treatment. The evaluation suggested that argatroban is useful for the treatment of acute cerebral thrombosis. In the case of cortical infarction, which results in severe ischemia and rapidly progresses from ischemic penumbra to infarction, it is important to start treatment with argatroban as soon as cerebral thrombosis is diagnosed.

抗血小板薬連続内服による血小板凝集能の経時的変動 粒子計測型血小板凝集能測定装置（ＡＧ‐１０）による検討

アスピリン (ASA) およびチクロピジン (TIC) の効果発現時期を明らかにするため, 経口投与後の血小板凝集能の経時的変動を検討した.慢性期脳血栓症患者18名 (ASA330mg/日連日投与10名, TIC200mg/日連日投与8名) を対象として, 投与前, 投与後1, 2, 4, 7, 14日目に採血し, 比濁法と血小板凝集塊を小, 中, 大に分類し測定可能なレーザー法 (AG-10, Kowa) で測定した.凝集惹起物質の終濃度は, collagen1, 2μg/ml, ADP0.5, 5μMを使用し, 以下の結果を得た. (1), ASAは, collagen1μg/ml凝集で投与1日目から血小板凝集能 (比濁法とレーザー法の中凝集塊, 大凝集塊) を抑制し, 投与12時間以内の検討ではcollagen2μg/ml凝集で投与1時間後から血小板凝集能 (比濁法とレーザー法の大凝集塊) を抑制した. (2), TICは, ADP0.5, 5μM凝集の比濁法で投与2日目以降に抗血小板作用を示し始め, 4日目で最も強い作用を示した.

Participation of serum albumin and LDL-cholesterol in impaired blood cell-filterability affected by white blood cells in patients with cerebral thrombosis.

We examined the effect of white blood cells (WBCs) on the red blood cell (RBC)-filterability, and the influence of plasma components on their interaction of their microcirculatory behaviour in cerebral thrombosis patients. Subjects studied were 20 patients with a history of cerebral thrombosis (60 +/- 4.7 years old) (mean +/- SD) and 28 healthy controls (59 +/- 5.4 years old). Filterability indices of RBC suspension (RFI) and suspension with RBCs plus WBCs (RWFI) were measured by the method of Nuclepore filtration. The values of RFI in patients and controls were 0.44 +/- 0.12 and 0.56 +/- 0.16 ml min-1 (mean +/- SD), and RWFIs were 0.33 +/- 0.092 and 0.40 +/- 0.11 ml min-1, respectively. The differences in both of these values between patients and controls were significant (p < or = 0.01 for RFI and p < or = 0.05 for RWFI, based on Student's t test, respectively). Both RFI and RWFI in bed-ridden patients were lower than those in the more active counterparts (p < or = 0.05, based on Student's t test). In patients, RFI and RWFI correlated positively with serum albumin (r = +0.515, p < 0.05; r = +0.533, p < 0.05, based on Student's t test, respectively). The net lowering effect of WBCs on RFI (RFI-RWFI) correlated positively with serum LDL-cholesterol in patients (r = +0.574, p < 0.01, based on Student's t test). WBCs play a significant role in reducing RFI, and its effect is related to the pathemas of patients.(ABSTRACT TRUNCATED AT 250 WORDS)

Hypercoagulability in acute ischemic stroke: Analysis of the extrinsic coagulation reactions in plasma by a highly sensitive automated method

The coagulability of plasmas from 63 patients with acute ischemic stroke (cerebral thrombosis and cerebral embolism) was analyzed by an automated method for prothrombin time using a fluorogenic peptide substrate. The fluorogenic prothrombin time (FPT) of patients' plasmas collected within 48 hr after onset, as expressed as percent of control plasma, was significantly higher in cerebral thrombosis than in an age-matched control group (p<0.01). The high values of FPT in cerebral thrombosis patients were observed until the 30th day after onset. On the other hand, FPT values in cerebral embolism patients were not significantly different than that of the control group. Factor VII activity levels in cerebral thrombosis patients were significantly higher than those of the control group and cerebral embolism patients, while levels of factor X activity were not significantly different among these groups. Although FPT and factor VII activity in these stroke patients did not significantly correlate, factor VII activity did correlate well with factor VII antigen. Decreased levels of antithrombin III and elevated levels of FDP and α 2-antiplasmin-plasmin complexes were observed only in cerebral embolism patients. Our findings strongly suggest that patients with cerebral thrombosis have been in a hypercoagulable state before the onset of symptoms, which was caused in part by an increase of factor VII activity/antigen, and in part by other unknown mechanisms. In contrast, patients with cerebral embolism were in a low grade consumptive coagulopathy.

Effects of hot bathing on blood viscosity, clotting and fibrinolytic system in patients of cerebral thrombosis

Effects of hot bathing on blood viscosity, clotting and fibrinolytic system in patients of cerebral thrombosis

Variations of α2-plasmin inhibitor, antithrombin III, plasminogen in the serum of patients of cerebral thrombosis infused with urokinase

Urokinase (UK) was kindly provided by Kowa Shinyaku Co., Ltd., Tokyo, Japan. International units were used. The preparation contains UK of molecular weight of 54,000 in 70 % and that of 33,000 in 30 %.

Rorschach Signs of Brain Damage in Cerebral Thrombosis

A study was made of 275 atherosclerotic patients between 40 and 80 yr. of age, 139 with brain damage (cerebral thrombosis) and 136 without known brain damage (myocardial infarction). The brain-damaged patients were found to have higher scores on a checklist of 46 Rorschach signs associated with disrupted cerebral functioning. The checklist was refined to include only 10 relatively independent items which had singly differentiated the two groups. The revised checklist discriminated the groups at approximately the same level of significance, and with the scores divided at the optimum point, 71% of the patients were correctly classified. Among the cerebral thrombosis patients only, an association was noted between race and Rorschach impairment scores (Negroes higher than whites); but with scores adjused for race, the checklist still significantly discriminated the brain-damaged from the non-damaged. The 139 cerebral patients had significantly higher scores than 20 patients without known atherosclerosis or neurological involvement, but they did not differ from 12 patients with transient cerebral symptoms. Conversely, the 136 cardiac patients had significantly lower scores than patients with transient cerebral symptons, but they did not differ from patients without known atherosclerosis or neurological defect. The perfection of psychological test signs of brain damage continues to be limited by the absence of an infallible criterion for selecting Ss for study. Despite that limitation, certain aspects of Rorschach responses were shown to distinguish between patients with presumed brain damage and those without known damage.