中药外洗治疗阳虚寒凝型动脉硬化性闭塞症60例

Sixty Cases of Arterial Sclerosis Occlusion of Yang Deficiency and Cold Coagulation Syndrome Treated with TCM for External Washing

目的:观察中药外洗治疗阳虚寒凝型动脉硬化性闭塞症的临床疗效。方法:选取符合纳入标准的阳虚寒凝型动脉硬化性闭塞症患者120例,随机分为治疗组和对照组,每组各60例。治疗组予脱疽诊疗常规治疗,配合中药外洗温阳散寒、活血通络治疗,对照组予脱疽诊疗常规治疗及安慰剂疗法。观察两组患者的临床疗效,比较两组患者治疗前后临床症状积分、踝肱指数(ankle brachial index,ABI)及第一趾PPG波形变化情况。结果:治疗组与对照组有效率比较,差异无统计学意义(P>0.05),但治愈率比较,差异有统计学意义(P<0.05)。两组患者治疗后肢体皮肤发凉、肢体肿胀、间歇性跛行及静息痛等临床症状积分低于治疗前,且对照组低于治疗组,差异有统计学意义(P<0.05)。两组患者治疗后ABI在0.7~0.9范围内下降率比较,差异有统计学意义(P<0.05)。治疗组在波幅正常、切迹消失者治疗后人数上升,与对照组比较,差异有统计学意义(P<0.05)。结论:中药外洗治疗阳虚寒凝型动脉硬化闭塞症可提高临床愈显率,改善患者临床症状。

Objective： To observe the clinical curative effect of TCM for external washing on arterial sclerosis occlusion of yang deficiency and cold coagulation syndrome（ASO）. Methods： One hundred and twenty patients with arterial sclerosis occlusion（ASO） of yang deficiency and cold coagulation syndrome who conformed to the inclusion criteria were chosen as the research subjects,and randomly divided into the treatment group and the control group,with 36 cases in each group. The ones in the treatment group received routine diagnosis and treatment of gangrene of finger or toe combined with TCM for external washing in order to warm yang and disperse cold,circulate blood circulation and dredge meridians. The ones in the treatment group received routine diagnosis and treatment of gangrene of finger or toe combined with placebo therapy. Then the clinical curative effects of the two groups were observed. The clinical symptom scores,ankle brachial index,（ABI） and the first toe＇s PPG waveform changes of the two groups before and after the treatment were compared. Results： There was no significant difference in efficiency between the treatment group and the control group,but the difference of cure rate between was statistically significant（P 0. 05）. After the treatment,the limb skin cooling,limb swelling,intermittent claudication and resting pain and other clinical symptom scores of the two groups were lower than those before the treatment,and the control group was lower than the treatment group,and all the differences were statistically significant（P 0. 05）. After the treatment,the decrease rates of ABI in the 0. 7 ~ 0. 9 range of the two groups were statistically significant（P 0. 05）. In the treatment group,the number of people with normal amplitude and disappearance of incisor increased after the treatment. Compared with the control group,the difference was statistically significant（P 0. 05）. Conclusion： TCM for external washing can improve the markedly effective rate of patients with arterial sclerosis occlusion of yang deficiency and cold coagulation syndrome,and enhance the clinical symptoms of the patients.