Prevention Of In-stent Restenosis On Ischemic Stroke With Self Designed Precription Combined With Western Medicine

Objective:1.To investigate whether the treatment of self-designed Qi Gui Tongluo prescription combined with antiplatelet aggregation drugs has a more positive effect on the prevention of restenosis after stenting compared with the simple application of antiplatelet aggregation drugs,so as to improve the postoperative quality of life of stroke patients and reduce the rate of disease recurrence;2.Whether adding self-designed prescription on the basis of conventional western medicine treatment can improve the symptoms of qi deficiency and blood stasis more effectively.Methods: 70 patients diagnosed with ischemic stroke of qi deficiency and blood stasis in the first affiliated hospital of anhui university of traditional Chinese medicine from December 2018 to August 2019 were selected,who were screened by natrectomy criteria and were suitable for cerebrovascular stent implantation.All the included cases were divided into observation group(0.1g aspirin enteric-coated tablets +clopidogrel tablets)and control group(0.1g aspirin enteric-coated tablets + clopidogrel tablets)and control group(35 cases)according to the method of random number table.After admission to routine blood,urine,stool,blood clotting tests,liver and kidney function,immune combination,electrocardiogram,chest X-ray,cerebral CTA,brain magnetic resonance,test National Institute of Health stroke scale(NIHSS score)and the Stroke efficacy evaluation form.All patients need take three days of oral aspirin enteric-coated metformin hydrochloride 100 mg/d(qd)and clopidogrel bisulfate tablet 75 mg/d(qd)or oral aspirin a day,300 mg/d(qd)before the surgery.Postoperative review of routine hemuria,NIHSS score,stroke diagnosis and efficacy evaluation standard score,oral clopidogrel 75mg/d(qd)for 3 months,aspirin100mg/d(qd)and atorvastatin calcium tablets 20mg/d(qn)for life,and in the morning and evening with warm water to take a dose of self-designed Qi Gui Tongluo prescription,continuous use for 6 months.Drugs should be paid attention to during thepresence of subcutaneous bleeding and gastrointestinal adverse reactions,and drug use after 2 weeks,3 months to check blood coagulation routine,liver and kidney function,line 6 months of digital subtraction angiography stents blood vessel diameter,the measurement and detection coagulation routine,liver and kidney function,retest the score of the form of Stroke efficacy evaluation form.Results:1.In the study of 70 subjects for 6 months,1 patient in the observation group lost clinical follow-up and 3 patients did not review DSA.In the control group,4patients were clinically lost to follow-up,and 2 patients were not reviewed with DSA.Finally,a total of 60 subjects were included,31 in the observation group and 29 in the control group.All the patients included in the final study took medicine and followed up according to the test requirements.All patients were tested forsafety index and efficacy index before and after operation,and the stent was successfully implanted.No serious adverse reactions occurred in the two groups;2.There was no statistically significant difference between the two groups in the comparison of age,gender,basic diseases and lesion blood vessel length before surgery;3.Among the 31 patientsin the observation group,1 patient in total had in-stent restenosis,while among the 29 patients in control group,6 patients had instent restenosis.P=0.049<0.05 wasmeasured by Fisher’s accurate test;4.There was no statistical difference between the two groups in NIHSS score and the score of quantitative diagnostic criteria for apoplexy syndrome between the two groups before surgery,which was comparable.The postoperative scores of two groups compared with the preoperative scores of the same group decreased significantly,and the difference was significant in the statistics.Therefore,it can be considered that stent implantation has a significant advantage in improving the neurological impairment symptoms in these patients with the ischemic stroke;5.The mean scores of the quantitative diagnostic standard table of apoplexy syndrome after 6 months of medication were all reduced compared with those before the comparison,indicating that the two treatment regimens could reduce the clinical symptoms of patients(P<0.05).The decrease of symptom score was moreobvious in the observation group,and the difference was statistically significant.Conclusion: the self-designed treatment of Qi Gui Tongluo prescription combined with antiplatelet aggregation drugs may have a more positive effect on the prevention of ISR without increasing the clinical adverse reactions of patients,and can more effectively relieve the clinical symptoms of qi deficiency and blood stasis in patients.