Lumbrokinase has been proven to have good clinical application value. It is a multi-molecular recombinant oral preparation that has a special affinity with thrombus (fibrin). It can track thrombolysis, effectively dissolve microemboli, improve microcirculation, and strengthen the heart. , Cerebrovascular collateral circulation, open repair of damaged endothelial cells of blood vessels, increase blood vessel elasticity, improve blood vessel oxygen supply function, reduce blood viscosity, reduce platelet aggregation rate, and inhibit thrombus formation again. Repair peripheral necrotic brain cells after thrombosis, and save the penumbra. At present, it has been widely used clinically, and is increasingly used in the prevention and treatment centers of heart, cerebrovascular, endocrine, respiratory system and other diseases.
Coronary heart disease
t-PA and PAI are mainly a pair of biological regulators synthesized and secreted by vascular endothelial cells, which are of great significance to the function of fibrinolytic system. t-PA can specifically bind to fibrin in thrombus and has selective thrombolytic effect. PAI is its rapid inhibitor that can irreversibly combine with t-PA and urokinase to inactivate it, and can inhibit the function of urokinase, which plays a decisive role in regulating the fibrinolytic system. Increase the activity of PAI in patients with coronary heart disease, inhibit the activity of t-PA, and lead to low fibrinolysis. Urokinase mainly activates plasminogen in plasma to convert it into plasmin with thrombolytic activity, thereby degrading fibrinogen and fibrin clots, and melting thrombus. And lumbrokinase can also directly melt fibrin. Studies have shown that the plasma t-PA activity of patients in the AMI group increased significantly after 12 hours of treatment, and the difference was still significant on the 3rd day, and it was not until the 7th day that it gradually returned to the original level. After 5 days of treatment with lumbrokinase, the function of fibrinolytic system can be significantly improved. Therefore, thrombolysis with urokinase and oral administration of lumbrokinase will help improve the function of the fibrinolytic system and reduce the occurrence of re-infarction after thrombolysis.
cerebral infarction
Cerebral infarction is the most common cerebrovascular disease, accounting for about 50% to 60% of cerebrovascular diseases. Stroke has become the main cause of death for middle-aged and elderly people in many countries, and the incidence of ischemic stroke accounts for 60% to 80% of the total stroke incidence, and the disability rate is very high. In the acute stage of cerebral infarction, measures such as controlling cerebral edema, increasing cerebral blood flow and oxygen saturation of cerebral tissue are definitely beneficial to patients. Clinical observations showed that 665 patients with cerebral infarction were treated with lumbrokinase capsules orally for 15-28 days, the effective rate was 60.94%-73.66%, and the total effective rate was 88.0%-98.88%. 98.6% of patients had significantly reduced embolism volume, and the average embolism volume reduction rate was 74.1%. The improvement rate of crooked mouth and eyes and limb numbness after taking the medicine for 3-5 days accounted for 79.85%. After treatment, the improvement rate for patients with dizziness and headache was 95.95%. The improvement rate of tongue stiffness was 94.7%, mouth and eye crookedness was 91.3%, hemiplegia was 92.3%, limb numbness was 92.9%, and hand and foot urgency was 85.7%. Clinical studies have confirmed that lumbrokinase has a special affinity with fibrin, does not affect the normal blood coagulation system function of the body, and can significantly reduce the range of ischemic penumbra. The use of lumbrokinase in the treatment of cerebral infarction has a significant effect on the recovery of paralyzed limbs of patients, can effectively improve the clinical symptoms and signs of patients with cerebral infarction, reduce the disability rate of patients, and the sequelae are mild, and the marked rate and effective rate are significantly better than those of the anti-abdominal snake. Thrombozyme and Xueshuan Xinmaining, the recurrence rate is significantly lower than common aspirin therapy and ticlopidine hydrochloride and other drugs, with mild side effects, it is an ideal oral anti-thrombolytic drug similar to t-PA for the prevention and treatment of cerebral infarction .
Diabetes
Plasma GMP140 is one of the activated release products of platelets or endothelial cells. Studies have shown that the determination of GMP140 content in plasma can also reflect the activation degree of platelets and the tendency of thrombosis in vivo, while TXB2 is the metabolic end product of XA2, which has a strong Promotes platelet aggregation and vasoconstriction. Many reports have shown that the levels of plasma GMP140 and TXB2 in diabetic patients are significantly increased, indicating that platelets in diabetic patients are in an activated state. Increased platelet adhesion and aggregation function is one of the reasons why diabetic patients have early and high incidence of arteriosclerosis and are prone to complicated microvascular diseases. Lumbrokinase is a group of acidic proteins extracted from artificially reared Eisenia earthworms. Plasma TXB2 levels in diabetic patients decreased significantly after oral administration of lumbrokinase for 2 weeks, and there was no significant difference with the control group, suggesting that lumbrokinase had a significant inhibitory effect on platelet adhesion and aggregation. Plasma GMP140 levels also decreased significantly after treatment, indicating that lumbrokinase can inhibit platelet activation in diabetic patients to a certain extent.
Nephrotic syndrome
Lumbrokinase is a group of proteolytic enzymes extracted from special earthworms. In 1984, the preliminary research results of Tsinghua University and other units showed that lumbrokinase has the functions of thrombolysis, anticoagulation and defibrillation. At present, its mechanism of action has been confirmed. First, it has the effect of plasminogen activator (similar to t-PA); second, it combines with fibrin to rapidly degrade fibrin. It has direct and indirect thrombolytic function. Patients with nephrotic syndrome often have increased coagulation activity of the internal coagulation system. Increased fibrinogen promotes blood coagulation and microthrombosis in glomerular capillaries. Most NS patients are in a hypercoagulable state and have a tendency to form thrombosis. The research results of Hou Ming and others in the Affiliated Hospital of Shandong Medical University proved that the decrease of fibrinolytic kinase activity (mainly t-PA) and the enhancement of fibrinolytic inhibitory activity (mainly a2-PA) are the reasons for the formation and progression of blood hypercoagulability in chronic glomerular diseases. One of the important reasons. The experimental examination of this group showed that the fibrinogen and blood viscosity indexes were significantly increased, which was basically consistent with the reports of some domestic scholars. It is assumed that the role of this group in treating PNS with lumbrokinase is to supplement or increase the content of t-PA in the blood, so that the imbalance of activation and inhibition factors in the blood fibrinolytic system in NS can be rebalanced, and it can play an anticoagulant and anticoagulant role. Thrombolysis improves glomerular microcirculation, reduces urinary protein and improves renal function. In 1983, Hisashi Mihara of Miyazaki University in Japan used earthworm extracts to treat thousands of cases of thromboembolic diseases clinically, with an effective rate of over 80%. In 1993, Zhu Changlian et al. reported 9 cases of primary glomerular diseases. After oral administration of lumbrokinase extract, the 24-hour urine protein quantification was significantly reduced compared with that before treatment. 2 cases of renal insufficiency were significantly improved after lumbrokinase treatment. The therapeutic effect is encouraging. The total effective rate of 20 cases of PNS in this group after treatment was 95%, which was significantly higher than 65% in the control group, and there was a significant difference at P<0.05. As for the difference in curative effect between type Ⅰ and type Ⅱ, it may be related to the long course of the disease, the degree of renal damage, and the different pathological types. Due to various reasons, the research on the relationship between pathological classification and curative effect has not been done, which needs to be further explored.
Pulmonary heart disease
The clinical research of lumbrokinase on cor pulmonale confirmed that the blood rheology index of the patient changed significantly, the clinical symptoms improved, and the total effective rate of treatment was 88.4%. The phenomenon of redness was improved, the oxygen content in the patient’s body increased, chest tightness, shortness of breath, cyanosis symptoms were alleviated, and no adverse reactions occurred. It is a safe and effective anti-thrombolytic drug for the treatment of pulmonary heart disease.
Lower extremity deep vein thrombosis
The onset of lower extremity deep vein thrombosis is acute within 3 to 7 days, and the onset of more than 7 days is chronic. Thrombolytic therapy such as urokinase is effective in acute cases, but basically ineffective in chronic cases. Chronic deep vein thrombosis is common clinically, and there is no ideal therapy yet. Simple oral administration of 2 capsules of lumbrokinase tid for 21 days showed that the total effective rate for lower extremity deep vein thrombosis was 79.99%, markedly effective 28.57%, and the total effective rate was close to subcutaneous injection of small molecule heparin (82.20%). Lumbrokinase is effective.
