通脉穴贴膏治疗下肢动脉硬化闭塞症的临床观察

Clinical Observation on Lower Extremity Arterial Occlusive Disease by Tongmai Xuetie Plaster(通脉穴贴膏)

目的:观察通脉穴贴膏治疗下肢动脉硬化闭塞症(LEASOD)的临床疗效。方法:将180例LEASODⅡ期(间歇跛行期)患者随机分成A、B、C组,每组60例,A组予通脉穴贴膏穴位贴敷治疗;B组予通脉穴贴膏穴位贴敷、前列地尔注射液治疗。C组予前列地尔注射液治疗,3组均以40 d为1个疗程。结果:A组与C组疗效比较,差异无统计学意义(P>0.05),B组治痊率、显效率均优于A组、C组,差异有统计学意义(P<0.01);B组总有效率优于A组、C组,差异有统计学意义(P<0.05)。3组治疗后症状体征积分均较治疗前降低(P<0.05或P<0.01)、踝肱指数均较治疗前升高(P<0.05或P<0.01);A、B组治疗后CHOL、TG、LDL均较治疗前降低(P<0.05),HDL均较治疗前升高(P<0.05);C组血脂治疗前后比较,差异均无统计学意义(P>0.05)。A、B组治疗后全血黏度、血浆黏度、红细胞压积、Fib均较治疗前降低(P<0.05);C组血液流变学治疗前后比较,差异均无统计学意义(P>0.05)。3组治疗后双侧胫前、胫后、足背动脉峰值流速(PSV)均较治疗前升高(P<0.05或P<0.01)。结论:通脉穴贴膏穴位贴敷治疗LEASOD有较好疗效,与前列地尔治疗的疗效相当,联合前列地尔治疗的疗效优于两者单独应用;具有调节血脂、降血黏度、提高动脉血流量等作用。

Objective： To observe the effect of Tongmai Xuetie Plaster on lower extremity arterial occlusive disease （LEASOD） patients. Methods： The 180 cases of patients with LEASOD II （intermittent claudication period） were randomly divided into group A, B and C, 60 cases in each group. The patients were treated by Tongmai Xuetie Plaster in group A, Tongmai Xuetie Plaster combined Alprostadil injection in group B, and Alprostadil Injection in group C. The treatment course was 40 days in three groups, 1.C treated by alprostadil intravenous drip, dosage, usage, course of treatment with the B group. Results： The difference on efficacy between group A and C was not statistical （P〉0.05）. Group B showed higher healing rate and explicit efficiency rate than the group A and C, with statistical difference （P〈0.01）. Group B showed higher total effective rate than the group A and C, with statistical difference （P〈0.01）. The symptom scores were reduced and the ankle brachial index was increased in the three groups （P〈0.05 or P〈0.01）. The CHOL, TG and LDLC were reduced and HDL was increased in group A and B after treatment （P〈0.05）. The change of blood fat showed no statistical difference in group C （P〉0.05）. The whole blood viscosity, plasma viscosity, hematocrit and Fib were reduced in group A and B after treatment （P〈0.05）. The change of hemorheology index showed no statistical difference in group C （P〉0.05）. The peak velocity of bilateral anterior tibial artery, posterior tibial artery and dorsum artery increased in three groups （P〈0.05 or P〈0.01）. Conclusion： Tongmai Xuetie Plaster shows good curative effect on LEASOD, with equivalent to the effect of Alprostadil injection. Combined application with Alprostadil injection showed better curative effect than two separate applications; It has function of regulating blood fat, reducing blood viscosity and improving arterial blood flow.