通脉汤口服与通脉散熏洗治疗阳虚寒凝雷诺氏病随机平行对照研究

TongMaiTang Oral in Combination with Tong Mai San Fumigation Treating Raynaud's Disease Random Parallel Control Study

[目的]观察通脉汤口服与通脉散熏洗治疗阳虚寒凝雷诺氏病疗效。[方法]使用随机平行对照方法，将40例门诊患者按就诊顺序编号抽签简单随机分为两组，减少寒冷及情绪刺激，患肢保温及戒烟。对照组20例复方丹参片，3片／次，3次／d，温开水送服。。治疗组20例通脉汤口服（辽宁中医药大学制剂室，黄芪50g，当归25g，白芍、炙甘草各15g，细辛5g，路路通10g，桂枝、吴茱萸各15g，柴胡10g，丹参12g，生姜15g，大枣10g），1剂／d，水煎lOOmL，早晚口服；通脉散熏洗（生川乌头、生草乌头各50g，威灵4＆30g，艾叶25g，伸筋草25g，桂枝15g），1剂／d，水煎1500mL，水温约55℃，浸泡熏洗患肢10～15min／次，1次／d。连续治疗2周为1疗程。观测临床症状、患肢端皮色、冷感、肿胀感、麻木、疼痛、症状分级量化评分、冷水实验、握拳试验、不良反应。连续治疗2疗程，判定疗效。[结果]治疗组临床痊愈8例，显效4例，有效6例，无效2例，总有效率90．00％。对照组临床痊愈5例，显效6例，有效4例，无效8例，总有效率60．00％。治疗组疗效优于对照组（P〈0．05）。证候积分两组均有改善（P〈O．01），治疗组改善优于对照组（P〈0．05）。握拳实验、冷水实验两组均有改善（P〈0．01），治疗组改善优于对照组（P〈0．05）。[结论]通脉汤口服与通脉散熏洗治疗阳虚寒凝雷诺氏病，疗效满意，无严重不良反应，值得推广。

[Objective]To observe TongMaiTang oral in combination with TongMaiSan fumigation treating Raynaud＇ sdisease.[Methods]Using random parallel control method, 40 cases of hospitalized patients were randomly divided into two groups according on treatment sequence number lottery. Reducing the cold and emotional stimulation of limb preservation and paying attention to quit smoking,the control group of 20 cases of FuFangDanShenPian, 3pill/time, rid,Warm boiling water delivery service;The treatment group are treated with Tongmai soup（preparated of Affiliated Hospital of Liaoning University of Traditional Chinese Medicine,HuangQiS0g, DangGui25g, BaiSao15g, ZhiGanCao15g, XiXin5g, LuLuTong10g, GuiZhilSg, WuZhuYu15g, CaiHul0g, GanShen12g, ShengJiang15g, DaZhaolOg）ldose/d, Water decoctionl0Oml, Sooner or later oral; Chinese medicine TongMaiSan fumigation （ChuanWu 50g, ChaoWu50g, WeiLingXian30g, AiChao25g, ShenJingChao25g, GuiZhilSg）, 1dose/d, Water deeoetionlS00ml,The water temperature of about 55℃,for fumigation limb of 10-15min / time, 1 times/d. Continuous treatment of 14d for 1 course of treatment. Observation of clinical symptoms, Patients with acral skin color, cold, numbness, pain, swelling,grading index, cold experimental fisting experimentadverse reactions. Continuous 2 courses of treatment, judge curative effect. [Results]8 cases were cured after treatment in the treatment group, 4 cases were markedly effective, effective 6 cases, invalid 2 cases, the total efficiency of 90.00%. The control group 5 cases were cured, 6 cases markedly effective, effective 4 cases, invalid 8 cases, the total efficiency of 60.00% .The treatment group curative effect is better than that of control group （P〈0.05）. Grading index in the two groups were improved （P〈0.01）, the treatment group is better than that of control group （P〈0.05）.A cold experimental, experimental group two were improved（P〈0.05）, the treatment group is better than that of control group （P〈0.01）.[Conclusion]TongMaiSan wash joint TongMaiTang pill treatment of Raynaud ＇ sdisease effect is remarkable, no serious adverse reaction ,is worth promoting.