Combination of pharmacological and non-pharmacological approaches in patients with hypertensive encephalopathy and hemorheological disorders

objective. To study the impact of complex treatment (acetylsalicylic acid, hirudotherapy, phytotherapy) on the functional activity of thrombocytes in patients with hypertensive encephalopathy. design and methods. An open prospective study included 25 patients with hypertensive encephalopathy and dysfunction of thrombocytes activity. All patients took acetylsalicylic acid. A simultaneous course of hirudotherapy (10 sessions, 2,5 months; own patent of the Russian Federation № 2327494) and a course of phytotherapy (polycomponent infusion, for 2,5 months; own patent of the Russian Federation № 2542423) were conducted. Functional activity of thrombocytes was studied by the phase contrast microscope at baseline and after the treatment was completed. Results. Initially, 25 patients with hypertensive encephalopathy showed abnormal platelet functional activity in the presence of acetylsalicylic acid: a decrease in the number of intact platelets — discocytes in 9 patients; increased number of activated cells with discoquinocyte sprouts on the surface — in 18 people; active forms in 17 patients; platelet aggregates — in 15 patients; increased number of small aggregates per 100 free thrombocytes — 13 patients; large aggregates — in 2 patients. After hirudotherapy and herbal medicine were applied in addition to acetylsalicylic acid, complete normalization of platelet functional activity was achieved in 11 of 25 patients, and partial normalization — in 12 subjects. conclusions. The complex approach, including both drug treatment (acetylsalicylic acid) and the course of hirudotherapy and phytotherapy showed a positive impact on the intravascular platelet activity in patients with hypertensive encephalopathy and initial disturbances of the platelet functional activity. As a result, the number of intact forms of platelets increased, the number of early and late active forms (discoquinocytes, spheroechinocytes and bipolar cells) decreased. Also the number of platelet aggregates and small aggregates reduced. Such a multimodal approach can be implemented in aspirin resistance, a high risk of primary and recurrent vascular events. The method is safe and well tolerated by patients. 

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