2. Antiplatelet aggregation agents can reduce the occurrence of microembolization. If there is no ulcer or hemorrhagic disease, aspirin is often used for treatment of 50 mg to 300 mg per day. Most people think that a smaller dose is more appropriate, and long-term use can reduce the dose. Dipyridamole (25mg, three times a day) combined with aspirin can produce synergistic effect and reduce the dosage of aspirin. If aspirin is not suitable for patients or the effect of aspirin is not satisfactory, ticlopidine (200-250 mg, 65438+ 0-2 times a day) or ticlopidine (250 mg, 65438+ 0 times a day) can be used instead. Attention should be paid to the prevention and treatment of toxic and side effects such as bleeding during treatment.
3. Anticoagulant therapy is of positive significance for patients with frequent attacks, serious illness and gradual aggravation, and there is no obvious contraindication to anticoagulation therapy. Early anticoagulation therapy is of positive significance for reducing attacks and preventing cerebral infarction. Heparin 12500U is usually added to 5% glucose saline for slow intravenous drip. At the same time, 300mg neocoumarin or 100-200 mg dicoumarin or 4-6 mg warfarin can be taken orally on the first day. Check the prothrombin time and activity every day, and once a week after stabilization, so as to adjust the oral dose. Venous coagulation time should be maintained at 20-30 minutes, and prothrombin activity should be 65,438+05-25%. The maintenance amount in the future is dicoumarin 150-225mg, dicoumarin 25-75mg or warfarin 2-4mg. Attention should be paid to the prevention and treatment of bleeding complications during treatment. Drug withdrawal should be gradually reduced to avoid "rebound". Because the dosage is difficult to control and there are many bleeding complications, this treatment method is rarely used in China at present.
4. Calcium antagonists can selectively act on calcium channels of cerebral vascular smooth muscle, prevent calcium ions from flowing into cells from the outside, and have the functions of preventing cerebral artery spasm, dilating blood vessels, increasing cerebral blood flow and maintaining erythrocyte deformability. Sibelium 5- 10 mg is usually once a day.
5. Other traditional Chinese medicines can also be selected, such as external counterpulsation, ultraviolet quantum therapy, hemodilution, Chuanxiong and Danshen.
Third, surgical treatment.
Angiography confirmed that the carotid artery had obvious stenosis or occlusion, and the drug effect was poor. The general situation of the patient allows, and if conditions permit, internal carotid endarterectomy, stent implantation or intracranial and extracranial vascular anastomosis can be considered. It has certain curative effect on eliminating microemboli, improving cerebral blood flow and establishing collateral circulation. Because it is not a radical method, the indications and effects of surgery have not been confirmed, so it is rarely used in China.