中西医结合治疗动脉硬化闭塞症临床观察

Clinical Study on Treatment of Atherosclerosis Obliterans by Integrated Traditional Chinese and Western Medicine

目的 :探讨中西医结合治疗动脉硬化闭塞症的作用机理。方法 :观察 4 0例动脉硬化闭塞症(ASO)患者治疗前后血浆内皮素 (ET)、一氧化氮 (NO)等血管活性因子水平、载脂蛋白及血管造影影像学的变化。结果 :所有患者均存在高ET、低NO血症 ,存在载脂蛋白的代谢异常 ,存在患肢主干动脉闭塞、侧枝循环减少的现象 ;治疗后 30例显效患者血浆ET、NO等血管活性因子、载脂蛋白水平均恢复正常 (与治疗前比较 ,P <0 0 1) ,患肢侧枝循环增多、末梢循环明显改善。结论 :中西医结合治疗ASO的作用机理可能与其保护血管内皮细胞、调节脂质代谢、促进侧枝循环建立。

Objective: To investigate the mechanism in treating atherosclerosis obliterans (ASO) with integrated traditional Chinese and western medicine (TCM WM). Methods: The changes in level of vasoactive factors, such as endothelin (ET), nitric oxide (NO), apoprotein and the iconographic changes in angiography before and after treatment were observed in 40 patients of ASO. Results: All patients had high levels of plasma ET and low level of NO, abnormal metabolism apoproteins, and showed the signs of trunk artery obstruction and marked decrease of collateral circulation in affected limb. After treatment, the plasma ET, NO and apoprotein levels recovered to normal range in 30 markedly effective cases, as compared with those before treatment, the difference was significant (P<0 01) and their collateral circulation in the affected limb significantly increased, showing obvious improvement of peripheral circulation. Conclusion: The therapeutic mechanism of TCM WM in treating ASO might be related with its effects on vascular endothelium, lipid metabolism adjustment, collateral circulation establishment and microcirculation improvement.