摘要
目的探讨益气活血通脉汤联合经皮腔内血管成形术治疗脉络瘀阻型下肢动脉硬化闭塞症的疗效。方法选取上海中医药大学附属普陀医院收治的下肢动脉硬化闭塞症患者184例,随机分为对照组(93例,经皮腔内血管成形术)和观察组(91例,益气活血通脉汤联合经皮腔内血管成形术),两组持续治疗4周,对比两组临床疗效、中医证候积分、下肢动脉血流量和血管内径、血液流变学指标及血清肿瘤坏死因子(TNF-α)、白细胞介素1(IL-1)和超敏C反应蛋白(hs-CRP)水平变化。结果治疗后,观察组总有效率较高(P<0.05);治疗前两组足背动脉、股浅动脉的血流量和血管内径差异无统计学意义(P>0.05);治疗后两组足背动脉、股浅动脉的血流量和血管内径显著升高(P<0.05);并且观察组升高较明显(P<0.05)。治疗前两组中医证候积分差异无统计学意义(P>0.05);两组治疗后两组肢体酸胀、疼痛、麻木、肤色异常积分显著降低(P<0.05);并且观察组降低更明显(P<0.05)。治疗前两组血清TNF-α、IL-1和hs-CRP水平差异无统计学意义(P>0.05);治疗后两组血清TNF-α、IL-1和hs-CRP水平明显降低(P<0.05);且观察组降低较明显(P<0.05)。治疗前两组血浆黏度(PV)、纤维蛋白原(FIB)和全血黏度(WBV)水平差异无统计学意义(P>0.05);治疗后两组PV、FIB和WBV水平明显降低(P<0.05);且观察组降低较明显(P<0.05)。结论采用益气活血通脉汤联合经皮腔内血管成形术治疗下肢动脉硬化闭塞症具有较好的疗效,改善血液高凝状态。
Objective To investigate the efficacy of Yiqi Huoxue Tongmai Decoction(益气活血通脉汤)combined with percutaneous endovascular angioplasty in the treatment of arteriosclerosis obliterans of lower limbs with chorostasis.Methods A total of 184 patients with Arteriosclerosis obliterans of lower limbs admitted to the hospital were selected and randomly divided into control group(93 cases,percutaneous endovascular angioplasty)and observation group(91 cases,Yiqi Huoxue Tongmai Decoction combined with percutaneous endovascular angioplasty).The two groups were treated for 4 weeks.The clinical efficacy,TCM syndrome score,lower limb arterial blood flow and vascular diameter,hemorheology indexes and serum levels of tumor necrosis factor-α(TNF-α),interleukin 1(IL-1)and hypersensitive C-reactive protein(hs-CRP)were compared between the two groups.Results After treatment,the total effective rate of the observation group was higher(P<0.05).Before treatment,there were no differences in the blood flow,vascular diameter of dorsal foot artery or superficial femoral artery between the two groups(P>0.05).After treatment,the blood flow and vascular diameter of dorsal foot artery and superficial femoral artery in both groups were significantly increased(P<0.05).And those of the observation group increased significantly(P<0.05).Before treatment,there was no significant difference in TCM syndrome scores between the two groups(P>0.05).After treatment,the scores of limb distention,pain,numbness and abnormal skin color in both groups were significantly decreased(P<0.05).The decrease was more significant in the observation group(P<0.05).There were no significant differences in serum levels of TNF-α,IL-1 or hs-CRP between the two groups before treatment(P>0.05).After treatment,the serum levels of TNF-α,IL-1 and hs-CRP in two groups were significantly decreased(P<0.05).And those of the observation group decreased significantly(P<0.05).There were no significant differences in levels of plasma viscosity(PV),fibrinogen(FIB)or whole blood viscosity(WBV)between the two groups before treatment(P>0.05).After treatment,the levels of PV,FIB and WBV in two groups were significantly decreased(P<0.05).And those of the observation group decreased significantly(P<0.05).Conclusion Yiqi Huoxue Tongmai Decoction combined with percutaneous endovascular angioplasty in the treatment of arteriosclerosis obliterans of lower limbs has a good effect,and can improve the blood hypercoagulability state.
作者
黄毅
曾光
金永志
胡俊晟
黄荣
HUANG Yi;ZENG Guang;JIN Yongzhi;HU Junsheng;HU Rong(Department of Vascular Surgery,Putuo Hospital,Shanghai University of Traditional Chinese Medicine,Shanghai 200062,China)
出处
《辽宁中医杂志》
CAS
2022年第9期126-129,共4页
Liaoning Journal of Traditional Chinese Medicine
基金
上海市普陀区特色专病建设项目(2020tszb01)
国家自然科学基金面上项目(81973625)
上海市普陀区中心医院院级课题(2019305)
关键词
益气活血通脉汤
经皮腔内血管成形术
脉络瘀阻型
下肢动脉硬化闭塞症
临床研究
Yiqi Huoxue Tongmai Decoction(益气活血通脉汤)
percutaneous endovascular angioplasty
choroid stasis type
lower extremity arteriosclerosis occlusive disease
clinical research
作者简介
黄毅(1981-),男,安徽蚌埠人,副主任医师,学士,研究方向:下肢动脉硬化闭塞症、周围血管疾病的诊治;通讯作者:黄荣(1980-),男,上海人,副主任医师,学士,研究方向:肢动脉硬化闭塞症、周围血管疾病的诊治,E-mail:15900559818@163.com。
