芪蛭固本通脉汤联合前列地尔注射液治疗糖尿病下肢血管病变临床研究

Clinical Study on Qizhi Guben Tongmai Tang Combined with Alprostadil Injection for Lower-Extremity Arterial Disease in Diabetes Mellitus

目的:观察芪蛭固本通脉汤联合前列地尔注射液治疗糖尿病下肢血管病变(DLEAD)的临床疗效及对下肢血流动力学的影响。方法:选取106例DLEAD患者,按随机数字表法分为对照组及治疗组各53例。对照组给予前列地尔注射液,治疗组在对照组基础上给予芪蛭固本通脉汤。比较2组临床疗效,比较2组治疗前、治疗1个疗程、治疗2个疗程后踝肱指数(ABI)、趾肱指数(TBI)、足背动脉血管情况、血液流变学指标的变化。结果:对照组总有效率为75.47%,治疗组总有效率为96.23%,2组比较,差异有统计学意义(P<0.05)。治疗1、2个疗程后,2组ABI、TBI指标较治疗前升高(P<0.05);治疗组ABI、TBI指标均高于同一时间段的对照组,差异均有统计学意义(P<0.05)。治疗1、2个疗程后,2组血流量、峰值流速、血管内径均治疗前升高(P<0.05);治疗组血流量、峰值流速、血管内径均高于同一时间段的对照组指标值,差异均有统计学意义(P<0.05)。治疗1、2个疗程后,2组全血黏度、血浆黏度、红细胞聚集指数均较治疗前下降(P<0.05);治疗组的全血黏度、血浆黏度、红细胞聚集指数均低于同一时间段的对照组指标值,差异均有统计学意义(P<0.05)。结论:芪蛭固本通脉汤联合前列地尔注射液治疗气虚血瘀证DLEAD疗效较好,能改善足背动脉血管血流情况,缓解患者临床症状。

Objective:To observe the clinical effect of Qizhi Guben Tongmai tang combined with alprostadil injection for diabeticlower extremity arterial disease(DLEAD) and its effect on hemorrheology in lower extremity. Methods: A total of 106 cases of patients with DLEAD were divided into the control group and the treatment group according to the random number table method, with 53 cases in each group. The control group was treated with alprostadil injection, and the treatment group was additionally treated with Qizhi Guben Tongmai tang based on the treatment of the control group. The clinical effects in the two groups were compared. Before treatment and after one and two courses of treatment,the changes in ankle brachial index(ABI),toe brachial index(TBI),vascular condition of dorsalis pedis artery and hemorrheology in the two groups were compared. Results: The total effective rate was 75.47% in the control group and 96.23% in the treatment group,the difference being significant(P<0.05). After one and two courses of treatment,the levels of ABI and TBI in the two groups were increased when compared with those before treatment(P<0.05);the levels of ABI and TBI in the treatment group were higher than those in the control group at the same time period,differences being significant(P<0.05). After one and two courses of treatment,the blood flow,peak systolic flow velocity and blood vessel diameter in the two groups were increased when compared with those before treatment(P<0.05);the blood flow, peak systolic flow velocity and blood vessel diameter in the treatment group were higher than those in the control group at the same time period, differences being significant(P<0.05). After one and two courses of treatment,the whole blood viscosity,blood plasma viscosity and red cell aggregation in the two groups were decreased when compared with those before treatment(P<0.05);the whole blood viscosity,blood plasma viscosity and red cell aggregation in the treatment group were lower than those in the control group at the same time period,differences being significant(P<0.05). Conclusion:Qizhi Guben Tongmai tang combined with alprostadil injection has a good curative effect in treating DLEAD with qi deficiency and blood stasis syndrome, improves vascular condition of dorsalis pedis artery and relieves clinical symptoms.