摘要
目的:评价软坚清脉颗粒对下肢动脉硬化闭塞症(ASO)血运重建术后患者的疗效,并探讨其对患者血清炎性因子水平的影响。方法:纳入ASO血运重建术后患者118例,随机分为对照组60例和治疗组58例。治疗组患者予以西医常规治疗联合软坚清脉颗粒口服,对照组患者予以西医常规治疗联合安慰剂口服,治疗周期为180 d。以踝肱指数(ABI)为主要疗效指标,以下肢经皮氧分压(TcpO_(2))、生活质量问卷评分、临床症状体征积分为次要疗效指标,同时检测两组患者治疗前后的血清白介素(IL)-1β、IL-6、IL-10、肿瘤坏死因子-α(TNF-α)和C反应蛋白(CRP)水平。结果:①治疗后,两组患者的ABI水平较治疗前均显著降低(P<0.05),但治疗组患者的ABI水平显著高于对照组(P<0.05)。②治疗后,两组患者的TcpO_(2)、生活质量问卷评分较治疗前均显著降低(P<0.05),但治疗组患者的TcpO_(2)、生活质量问卷评分均高于对照组(P<0.05)。③治疗后,两组患者的临床症状体征积分均较治疗前升高(P<0.05),但治疗组患者的临床症状体征积分低于对照组(P<0.05)。④治疗后,治疗组患者的血清IL-1β、IL-6、TNF-α、CRP水平较治疗前明显降低(P<0.05),血清IL-10水平明显升高(P<0.05);对照组患者的血清IL-1β、TNF-α水平较治疗前明显升高(P<0.05),血清IL-10水平明显降低(P<0.05);治疗组患者的血清IL-1β、IL-6、TNF-α、CRP水平明显低于对照组(P<0.05),血清IL-10水平明显高于对照组(P<0.05)。结论:软坚清脉颗粒能够改善ASO血运重建术后患者的ABI、TcpO_(2)及临床症状和体征,提高患者的生活质量,延缓患者的下肢缺血进程,其作用机制可能与调控患者的体内炎症状态有关。
Objective:To evaluate the efficacy of Ruanjian Qingmai Granules on arteriosclerosis obliterans(ASO)after revascularization,and explore its influence on the levels of serum inflammatory factors of the patients.Methods:One hundred and eighteen patients with ASO after revascularization were included and randomly divided into the control group(60 cases)and the treatment group(58 cases).The patients in the treatment group were treated with conventional western medicine combined with Ruanjian Qingmai Granules orally,and the patients in the control group were treated with conventional western medicine combined with placebo orally,with a course of 180 d.The ankle-brachial index(ABI)was taken as the primary efficacy indicator,and the transcutaneous oxygen pressure(TcpO_(2))of lower limbs,the scores of life quality questionnaire and the scores of clinical symptoms and signs were taken as the secondary efficacy indicators,meanwhile the levels of serum interleukin(IL)-1β,IL-6,IL-10,tumor necrosis factor-α(TNF-α)and C-reactive protein(CRP)of the patients in the two groups were detected before and after treatment.Results:①After treatment,the ABI values in the two groups were significantly decreased compared with those before treatment(P<0.05),while the ABI value of the treatment group were significantly higher than that of the control group(P<0.05).②After treatment,the TcpO_(2) and scores of life quality questionnaire in the two groups were significantly decreased compared with those before treatment(P<0.05),while the TcpO_(2) and scores of life quality questionnaire in the treatment group were higher than those in the control group(P<0.05).③After treatment,the scores of clinical symptoms and signs in the two groups were increased compared with those before treatment(P<0.05),while the scores of clinical symptoms and signs in the treatment group were lower than those in the control group(P<0.05).④After treatment,the levels of serum IL-1β,IL-6,TNF-αand CRP in the treatment group were significantly decreased compared with those before treatment(P<0.05),and the level of serum IL-10 was significantly increased(P<0.05).The levels of serum IL-1βand TNF-αin the control group were significantly increased compared with those before treatment(P<0.05),and the level of serum IL-10 was significantly decreased(P<0.05).The levels of serum IL-1β,IL-6,TNF-αand CRP in the treatment group were significantly lower than those in the control group(P<0.05),and the level of serum IL-10 was significantly higher than that in the control group(P<0.05).Conclusion:Ruanjian Qingmai Granules can improve the ABI,TcpO_(2) and the clinical symptoms and signs of the patients with ASO after revascularization,enhance the life quality of the patients,and prolong the ischemic process of lower limbs.Its mechanisms may be related to regulating the inflammatory status of the patients.
作者
张永康
刘家睿
殷康力
王御震
宗媛
曹烨民
ZHANG Yongkang;LIU Jiarui;YIN Kangli;WANG Yuzhen;ZONG Yuan;CAO Yemin(Shanghai University of Traditional Chinese Medicine,Shanghai 201203,China;Diagnosis and Treatment Center of Vascular Disease,Shanghai TCM-Integrated Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 200082,China)
出处
《上海中医药大学学报》
CAS
2023年第6期19-26,共8页
Academic Journal of Shanghai University of Traditional Chinese Medicine
基金
国家自然科学基金资助项目(82174382)
国家科技重大专项项目(2019ZX09201004-002-091)
上海市科委科技计划项目(20Z21900200)
上海市卫健委科研项目(20224Y0387)。
关键词
下肢动脉硬化闭塞症
血运重建术
软坚清脉颗粒
炎性因子
踝肱指数
arteriosclerosis obliterans
revascularization
Ruanjian Qingmai Granules
inflammatory factor
ankle-brachial index
作者简介
张永康,男,博士,主治医师,主要从事中医药治疗脉管病的临床与基础研究;通信作者:曹烨民,主任医师、教授,博士生导师,E-mail:caoyemin@shutcm.edu.cn。
