蛭龙活血通瘀胶囊干预阿司匹林抵抗的临床试验及机制探讨

目的:观察蛭龙活血通瘀胶囊对阿司匹林抵抗患者的干预效果及并探讨可能的机制。方法:将60例阿司匹林抵抗患者随机分为加大阿司匹林用量组30例;蛭龙活血通瘀胶囊组30例。加大阿司匹林用量组:拜阿司匹林300mg/d;蛭龙活血通瘀胶囊组1.6g,tid。各组均连续用药4周。观察对比血小板平均聚集率、血栓素B₂、6-酮-前列腺素F1α。结果:治疗组有效率显著高于对照组;治疗组治疗1个月后以AA和ADP诱导的血小板聚集率及其下降值均显著低于对照组。与治疗前比较,阿司匹林加量组和蛭龙活血通瘀胶囊治疗组TXB₂均升高明显（P<0.01）。6-K-PGF₁α:蛭龙活血通瘀胶囊治疗组与阿司匹林加量组相比升高（P<0.05）;与治疗前比较,阿司匹林加量组降低明显（P<0.01）。与治疗前比较,阿司匹林加量组和蛭龙活血通瘀胶囊治疗组TXB₂/6-K-PGF₁α均降低（P<0.01,0.05）。治疗组药物不良反应发生率显著低于对照组。结论:蛭龙活血通瘀胶囊治疗阿司匹林抵抗有较好的疗效及安全性,其机制可能与其可降低TXB₂同时升高6-K-PGF₁α,降低TXB₂/6-K-PGF₁α的作用有关,从而有效改善AR。

CLINICAL EXPERIMENT INTERVENTION OF ZHILONG HUOXUE TONGYU CAPSULE ON ASPIRIN RESISTANCE AND ITS MECHANISM

Objective:To observe the intervention of Zhilong Huoxue Tongyu capsale on aspirin resistance and its mechanism MethodS:60 patients with aspirin resistance were randomly divided into increasing aspirin dosage group,given Aspirin 300 mg/d;and Zhilong Huoxue Tongyu capsule group,given Zhilong Huoxue Tongyu capsule 1.6g,tid.After 4 consecutive weeks;PAG,TXB₂,6-K-PGF1αand drug safety were observed and compared. Results:The effective rate in treatment group was significantly higher;AA and ADP induced platelet aggregation rate and its decreased value were significantly lower than that of the control group.After treatment TXB₂ increased significantly in both groups（P<0.01）.6-K-PGF₁αin Zhilong Huoxue Tongyu capsule group was higher than increaseing group in aspirin dosage（P<0.05）;after treatment,it was significantly lower in increasing aspirin dosage group（P<0.01.） After treatment,the amount of TXB₂/6-K-PGF₁αwas lower in both groups（P<0.01,0.05）, The incidence of adverse drug reactions was significantly lower in treatment group than in control group.Conclusion: Zhilong Huoxue Tongyu capsule intreating aspirin resistance has better efficacy and safety,which may relate to the decrase of TXB₂,increase of 6-K-PGF₁α,and the decrease of TXB₂/6-K-PGF₁αthus effectively improving the AR.