丹参注射液治疗红斑性肢痛病的微循环观察

Microcirculation change of erythromelalgia treated by Salvia miltiorrhiza injection

目的：探讨红斑性肢痛病的发病机制并提供新的治疗方法与途径。方法：红斑性肢痛病58例,随机分2组。另设正常对照组30例。丹参组予丹参注射液20～30 mL加入5%葡萄糖注射液500 mL中静脉滴注,每日1次。传统用药组,使用阿司匹林、苯噻啶、吲哚美辛、美西麦角等药物治疗,2组疗程均为3 wk。观察2组的临床疗效,并检测3组血液流变学指标。结果：58例红斑性肢痛病病人全血粘度、血浆粘度、血细胞比容、红细胞变形指数及红细胞聚集指数与正常对照组比较均有显著差异(P＜0.05)。治疗后,丹参组有效率为91%,传统用药组为50%,2组疗效有非常显著差异(P＜0.01)。丹参组治疗后血液流变学指标均显著改善(P＜0.01),而传统用药组治疗后指标则无明显变化(P＞0.05)。2组不良反应发生率差异显著(0 vs 27%,P＜0.05)。结论：红斑性肢痛病病人存在微循环障碍,丹参注射液治疗该病疗效良好且安全,值得推广应用。

AIM： To study the pathogensis and treatments of erythromelalgia. METHODS： Fifty-eight patients with erythromelalgia were randomly divided into Salvia miltiorrhiza treated group and conventionally treated group,and another 30 normal persons served as control group. The patients in Salvia mihiorrhiza treated group were infused intravenously with Salvia miltiorrhiza injection 20-30 mL in 5 %glucose solution 500 mL for a course of 3 wk and the patients in conventionally treated group were treated with aspirin, pizotifen, indomethacin,methysergide and so on also for 3 wk. Finally the clinical effects of the two groups were observed and comparisons of hemorhology among the three groups were carried out. RESULTS： There were significant differences in 6 indices of hemorheology （high shear of whole blood,reduced viscosity at low shear, hematocrit, deformation index and aggregate index of erythrocyte）between 58 patients with erythromelalgia and 30 normal persons in control group（P 〈 0.05）. The effective rate of Salvia miltiorrhiza treated group（91%）was more superior to that of conventionally treated group （50 %）（P 〈 0.01 ）. The indices of hemorheology in Salvia miltiorrhiza treated group were more ameliorable after the treatment （P 〈 0.01 ）, but there was no change after the treatment in conventionally treated group （P 〉 0.05）. The difference of adverse reaction rates existed between two groups was obviously （P 〈 0.05）. CONCLUSION： Salvia miltiorrhiza injection is effective in treating the disturbance of microcirculation in patients with erythromelalgia.