通脉活血方加减联合前列地尔治疗下肢动脉硬化闭塞症临床研究

Clinical Study on Modified Tongmai Huoxue Prescription Combined with Alprostacil for Arteriosclerosis Occlusion of Lower Limbs

目的:观察通脉活血方加减联合前列地尔治疗下肢动脉硬化闭塞症患者的临床疗效。方法:将收治的102例下肢动脉硬化闭塞症患者,采用随机数字表法分为2组。2组均给予基础治疗,对照组50例在基础治疗上给予前列地尔治疗;联合组52例在对照组治疗的基础上加用通脉活血方加减治疗。观察2组临床疗效,评价比较2组治疗前后踝肱指数(ABI),股浅动脉血管内径、峰值流速,以及血小板环磷酸鸟苷(cGMP)、环磷酸腺苷(cAMP)水平。结果:临床疗效总有效率联合组92.31%,显著高于对照组74.00%,差异有统计学意义(P<0.05)。治疗后,2组ABI、股浅动脉血管内径,以及血小板cAMP水平较治疗前均明显上升,联合组ABI、血管内径、cAMP均显著高于对照组,差异均有统计学意义(P<0.05);2组股浅动脉峰值流速、血小板cGMP较治疗前均明显降低,联合组峰值流速、cGMP均显著低于对照组,差异均有统计学意义(P<0.05)。结论:通脉活血方加减联合前列地尔治疗下肢动脉硬化闭塞症,可显著改善患者肢体缺血情况,优于单纯使用前列地尔治疗。

Objective:To observe the clinical effect of Tongmai Huoxue prescription combined with alprostadil on patients with arteriosclerosis occlusion of lower limbs. Methods:A total of 102 cases with arteriosclerosis occlusion of lower limbs were divided into two groups according to random number table method. Both groups were given basic treatment. Fifty cases in the control group were additionally given alprostadil for treatment;fifty-two cases in the combination group were additionally treated with modified Tongmai Huoxue tang according to syndrome differentiation based on the treatment of the control group. The clinical effect was observed, and the levels of anklebrachial index(ABI), superficial femoral artery diameter,peak flow rate,cyclic guanosine monophosphate(cGMP) and cyclic adenosine monophosphate(cAMP) of platelets before and after treatment were evaluated and compared between the two groups. Results: The total effective rate was92.31% in the combination group, significantly higher than that of 74.00% in the control group, the difference being significant(P<0.05). After treatment,the levels of ABI,superficial femoral artery diameter,and cAMP of platelet in the two groups were significantly increased when compared with those before treatment, while the above three levels in the combination group were significantly higher than those in the control group,differences being significant(P<0.05). The levels of peak flow rate of superficial femoral artery and cGMP of platelets in the two groups were significantly decreased when compared with those before treatment,while the above two levels in the combination group were significantly lower than those in the control group, differences being significant(P<0.05). Conclusion: The therapy of modified Tongmai Huoxue prescription combined with alprostanil for patients with arteriosclerosis occlusion of lower limbs,can significantly improve the limb ischemia,which is better than alprostanil alone.