血府逐瘀汤加减辅助经皮腔内血管成形术及支架植入术对下肢动脉硬化闭塞症的疗效

Effect of Xuefu Zhuyu Decoction with Modified Percutaneous Transluminal Angioplasty and Stent Implantation on Lower Extremity Arteriosclerosis Obliterans

目的探究血府逐瘀汤加减辅助经皮腔内血管成形术及支架植入术治疗下肢动脉硬化闭塞症患者的效果。方法选取镇平县第二人民医院2018年7月至2019年7月收治的108例下肢动脉硬化闭塞症患者,将其中接受经皮腔内血管成形术及血管支架植入术的53例患者纳入对照组,另55例在经皮腔内血管成形术及血管支架植入术基础上接受血府逐瘀汤加减辅助治疗的患者纳入观察组。比较两组治疗效果、术前及术后3个月踝肱指数、临床症状积分、凝血功能、术后并发症及不良反应。结果观察组临床痊愈率(63.64%)高于对照组(43.40%),差异有统计学意义(P<0.05)。术后3个月两组踝肱指数、肢体麻木、间歇性跛行、静息痛症状评分均有所改善,且观察组踝肱指数高于对照组,肢体麻木、间歇性跛行、静息痛症状评分低于对照组(P<0.05)。术后3个月观察组纤维蛋白原(Fib)水平低于对照组(P<0.05),两组活化的部分凝血酶原时间(APTT)、凝血酶原时间(PT)水平差异无统计学意义(P>0.05)。观察组术后并发症发生率(1.82%)低于对照组(15.09%),差异有统计学意义(P<0.05)。结论血府逐瘀汤加减辅助经皮腔内血管成形术及血管支架植入术治疗下肢动脉硬化闭塞症患者效果较好,可有效改善临床症状、凝血功能,预防术后血管再狭窄。

Objective To explore the effect of percutaneous transluminal angioplasty and stent implantation assisted by Xuefu Zhuyu Decoction in the treatment of patients with lower extremity arteriosclerosis obliterans.Methods A total of 108 patients with lower extremity arteriosclerosis obliterans who were admitted to the Second People’s Hospital of Zhenping from July 2018 to July 2019 were selected.Among them,53 patients who underwent percutaneous transluminal angioplasty and vascular stent implantation were included in control group,and the other 55 patients who received Xuefu Zhuyu Decoction on the basis of percutaneous transluminal angioplasty and vascular stent implantation were included in observation group.The treatment effect,ankle-brachial index,clinical symptom score,coagulation function,postoperative complications and adverse reactions were compared between the two groups before and 3 months after the operation.Results The clinical cure rate of observation group was higher than that of control group(63.64%vs.43.40%,P<0.05).Three months after the operation,the ankle-brachial index,limb numbness,intermittent claudication,and resting pain symptom scores were improved in the two groups(P<0.05).The ankle-brachial index of observation group was higher than that of control group(P<0.05),and the symptom scores of limb numbness,intermittent claudication,and resting pain were lower than those of control group(P<0.05).The level of fibrinogen(Fib)in observation group was lower than that in control group(P<0.05).There was no statistical difference in the levels of activated partial prothrombin time(APTT)and prothrombin time(PT)between the two groups(P>0.05).The incidence of postoperative complications in observation group was lower than that in control group(1.82%vs.15.09%,P<0.05).Conclusion The percutaneous transluminal angioplasty and vascular stent implantation assisted by Xuefu Zhuyu Decoction is effective in treating patients with lower extremity arteriosclerosis obliterans,which could effectively relieve clinical symptoms,improve coagulation function,and prevent postoperative restenosis of blood vessels.