静脉腔内射频消融术联合中药治疗下肢静脉曲张伴溃疡疗效观察

Observation on the curative effect of intravenous radiofrequency ablation combined with traditional Chinese medicine on lower extremity varicose veins with ulcers

目的观察静脉腔内射频消融术联合中药治疗下肢静脉曲张伴溃疡患者的临床疗效。方法选取2018年10月—2019年12月河北省中医院周围血管科收治的符合标准的下肢静脉曲张伴溃疡患者80例,随机分为对照组和治疗组,每组40例。对照组给予射频消融加曲张静脉点状剥脱术治疗,治疗组在上述基础上联合中药内服外洗治疗,2组均以14 d为1个疗程。比较2组溃疡面积、中医症状积分、静脉临床严重程度评分(VCSS)和临床疗效、不良反应情况。结果术后3 d,2组患者溃疡面积均明显小于治疗前(P均<0.05),但2组间比较差异无统计学意义(P>0.05);术后7 d,治疗组溃疡面积明显小于对照组(P<0.05);术后14 d,治疗组溃疡均完全愈合,对照组剩余2例未完全愈合。术后3,7,14 d,2组中医症状积分和VCSS评分均逐渐降低,且治疗组各时间点的中医症状积分和VCSS评分均明显低于同期对照组,差异均有统计学意义(P均<0.05)。术后14 d,治疗组的总有效率为97.5%(39/40),对照组为90.0%(36/40),治疗组明显高于对照组(P<0.05)。2组术后均未出现严重不良反应及并发症。结论静脉腔内射频消融术联合中药治疗下肢静脉曲张伴溃疡临床效果显著,可有效促进溃疡愈合,且安全。

Objective It is to observe the clinical efficacy of intravenous radiofrequency ablation combined with traditional Chinese medicine in the treatment of lower extremity varicose veins with ulcers.Methods 80 patients with lower extremity varicose veins with ulcers who were admitted to the Department of Peripheral Blood Vessels of Hebei Provincial Hospital of Traditional Chinese Medicine from October 2018 to December 2019 were selected and randomly divided into control group and treatment group,with 40 cases in each group.The control group was treated with radiofrequency ablation and varicose vein point stripping.The treatment group was treated with traditional Chinese medicine orally and externally on the basis of the control group.Both groups took 14 days as a course of treatment.The ulcer area,TCM symptom score,venous clinical severity score(VCSS),clinical efficacy and adverse reactions were compared between the two groups.Results In 3 days after operation,the area of ulcers in the two groups was significantly smaller than those before treatment(P<0.05),but there was no significant difference between the two groups(P>0.05);in 7 days after operation,the area of ulcers in the treatment group was significantly smaller than that in the control Group(P<0.05);in 14 days after operation,the ulcers in the treatment group were completely healed,but there were 2 cases whose wound did not heal completely in the control group.At 3,7,and 14 days after operation,the TCM symptom scores and VCSS scores of the two groups were gradually decreased,and the TCM symptom scores and VCSS scores of the treatment group at each time point were significantly lower than those of the control group during the same period,and the differences were statistically significant(all P<0.05).At 14 days after operation,the total effective rate of the treatment group was 97.5%(39/40),and the control group was 90.0%(36/40),the treatment group was significantly higher than the control group(P<0.05).No serious adverse reactions and complications occurred in the two groups.Conclusion Intravenous radiofrequency ablation combined with traditional Chinese medicine has a significant clinical effect in the treatment of lower extremity varicose veins with ulcers.It can effectively promote ulcer healing with good safety.