| Objective: To investigate the clinical efficacy and safety on prethrombotic state inhypertensive patients and patients with hypertension and Type2diabetes mellitus, withthe interference of leech granules and aspirin on platelet aggregation, in order to find anew way for reducing the incidence of cardio-cerebrovascular thrombus events inhigh-risk patients based on integrated traditional Chinese and western medicine.Methods:100cases were selected into this research by visiting order and medicalhistory.One group included50hypertensive patients（group A), the other group included50hypertensive patients with type2diabetes mellitus (group B), they were bothcharactered by qi asthenia, yin deficiency, and stagnated blood in TCM. They hadalready received aspirin100mg, qd>2weeks routinely. In our study, besides routineaspirin100mg, qd. per os, they were also treated with3leech granules with water, tidfor4weeks. Meanwhile, we observed the integral of TCM symptom of the patients andmeasurement of blood pressure of the patients was undertaken before and aftermedication respectively, the same as those indexes for recognizing prethrombotic stateas blood platelet count (BPC), the platelet aggregation(PAG) rates, blood coagulationcomplete set, CD36(CD61gating), and other related indexes: blood glucose,lowdensity lipoprotein cholesterol (LDL-C),glycosylated hemoglobin（HbA1c）, Carotidintimal medial thickness (IMT), etc. Results:1. TCM symptom: leech capsules could induce the integral of TCM symptom of thepatients in the two groups, improving symptoms of qi asthenia, yin deficiency, stagnatedblood, etc., especially for those patients with hypertension and Type2diabetes mellitus.2. indexes of prethrombotic state2.1Blood platelet count (BPC): After treatment,no significant difference was found inBlood platelet count (BPC) of patients in group A and group B (P>0.05). Comparedwith group A and group B before treatment or after treatment, Blood platelet count(BPC) of patients was no significant difference (P>0.05)..2.2Platelet aggregation(PAG) rates: After treatment, PAG rates induced byarachidonic acid(AA) in the two groups were obviously lower than those beforemedication(P<0.05). Compared with group A and group B before treatment, the PAGrates in group A were lower than those in group B, the difference had statisticalsignificance(P<0.05), but no significant difference was shown between group A andgroup B after treatment(P>0.05).2.3CD36(CD61gated platelets): CD36in the two groups after treatment with leechgranules was significantly lower than those before treatment (P<0.05). Compared withgroup A and group B before medication with leech granules, CD36in group A werelower than those in group B, the difference has statistical significance (P<0.05); aftertreatment with leech granules, no significant difference of CD36was shown in group Aand group B(P>0.05).2.4Coagulation function:After medication, D-dimer, FIB and APTT in the two groupshave been significantly improved (P<0.05); TT and PT in the two groups have nosignificant improvement (P>0.05). Compared with group A and group B beforemedication, D-dimer and coagulation four indices(PT, APTT, TT, FIB) had nosignificant difference (P>0.05); after treatment, the reduction of FIB in group B is moresignificant than that in group A (P<0.05), and the reduction of APTT and D-dimer in thetwo group had no significant difference (P>0.05).3. relevant indexes 3.1Blood pressure: blood pressure of the patients had no significant differencebetween group A and group B before and after treatment (P>0.05), but after medication,the mean value of blood pressure decreased and had a declining trend. Compared withgroup A and group B, blood pressure of patients in two groups had no significantdifference before and after medication (P>0.05), but after treatment, the mean value ofblood pressure in group B was lower than that in group A.3.2Blood glucose,LDL-C,HbA1c：FPG/PG-2h,LDL-C,HbA1c in group A and group Bhad no statistical significance before and after treatment (P>0.05), but there was adownturn in FPG/PG-2h,LDL-C,HbA1c in group B after treatment, and it had adeclining trend. Compared with group A and group B, the FPG/PG-2h,LDL-C,HbA1c ingroup A were lower than those in group B both before medication and after medication,it showed significant difference (P<0.05).3.3Carotid intimal medial thickness (IMT) Carotid intimal medial thickness (IMT)in the two groups had no significant difference before and after treatment(P>0.05);Compared with group A and group B, the IMT in group A were lower than those ingroup B both before and after treatment, the difference had statistical significance(P<0.05).4. safety evaluation indexesALT and SCr: Both no significant difference was shown about ALT and SCr indexes inthe two groups before and after treatment (P>0.05). Compared with group A and groupB, After treatment or before treatment, ALT and SCr indexes of patients in two groupshad no significant difference.(P>0.05).Conclusion1.This study implied that Capsules of compound Cortex Moutan&Leech couldsignificantly improve the clinical symptoms of the patients with qi asthenia, yindeficiency, and stagnated blood, especially for those patients with hypertension andType2diabetes mellitus.2. Capsules of compound Cortex Moutan&Leech co-administered with Aspirin could further improve prethrombotic state in hypertensive patients and patients withhypertension and Type2diabetes mellitus, which was more effective than aspirin alone,and it would be more beneficial for patients with hypertension and Type2diabetesmellitus. There is another breakthrough in this study that the treatment of prethromboticstate in patients with qi asthenia, yin deficiency, and stagnated blood alone could alsobenefit from Capsules of compound Cortex Moutan&Leech.3. Capsules of compound Cortex Moutan&Leech were relatively safer for the aged.Further studies are necessary to evaluate its safety. |
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