穴位注射自体周血干细胞治疗下肢动脉闭塞症

Combined treatment of lower limb arteriosclerosis obliterans with Chinese acupoint injection and autologous peripheral blood stem cell transplantation

目的:研究中医经络理论与自体周血干细胞移植相结合治疗下肢动脉闭塞症疗效,并探讨其作用机制。方法:通过下肢动脉血管造影或彩色多普勒检查确诊并发现闭塞血管的部位及程度,测量最大血流速度,所有病例移植前均接受过药物治疗:盐酸丁咯地尔,西洛他唑,前列地尔,阿斯匹林,肝素等2个疗程以上无效或症状加重者,干细胞采集量68～82ml,MNC(0.98～5.60)×108/kg;CD34+细胞(1.2～4.8)×106/kg,沿中医经络:足太阳、足阳明、足少阳走行进行下肢肌肉内穴位注射术。结果:治疗后患者间歇性跛行,无痛行走距离,皮肤溃疡愈合,彩色多普勒观察下肢血流情况均有明显改善,不良反应轻微,未发生恶性不良反应事件。结论:中医穴位注射与自体周血干细胞移植术相结合治疗外周动脉疾病疗效确切,并有着药物治疗无法替代的作用,且安全、可行。

Objective：To study the effectiveness of combined treatment of lower limb arteriosclerosis obliterans （ASO） with Chinese acupoint injection.and autologous peripheral blood stern cell transplantation and discuss its mechanism. Methods：The site and degree of occlusive arteries were determined by lower limb angiography or color Doppler examination and the maximum blood flow speed was detected. All the patients had received drug treatment before transplantation, including buflomedil hydrochloride, cilostazol, alprostadil, aspirin and heparin. The stem cell collection quantity of patients who had no improvement or symptoms increased after two or more courses of drug treatment was 68-82mi MNC was 0.98-5.6 × 10^8/kg, and the quantity of CD34＋ was 1.2-4. 8 × 10^6/kg. Patients received intramusculary Chinese acupoint injection of stem cell suspension mainly along meridian of foot taiyang, yangming and shaoyang acupoint. Results：After combined treatment, intermittent claudication, painless waling distance, dermal ulcer healing and low limb blood flow observed by color Doppler were all obviously improved. Patients had mild adverse reactions. Conclusion： Combined treatment of peripheral artery diseases with Chinese acupoint injection and autologous peripheral blood stem cell transplantation had precise effectiveness and irreplaceable effect by drug treatment, and it was safe and feasible,