针药联合治疗下肢动脉硬化闭塞症的临床疗效及对血流动力学指标、踝肱指数的影响

Clinical efficacy of acupuncture combined with traditional Chinese medicinal materials in the treatment of lower extremity arteriosclerosis obliterans and its influences on hemodynamics indexes and ABI index

目的:观察针灸联合中药治疗寒凝血瘀型下肢动脉硬化闭塞症的临床疗效及其对血流动力学指标、踝肱指数(Ankle Brachial Index,ABI)的影响。方法:将60例下肢动脉硬化闭塞症患者按照随机数字表法分为两组,即观察组和对照组。观察组30例,采用中药+夹脊穴电针治疗;对照组30例,采用中药+西医常规静脉滴注治疗;两组患者均治疗2周为一个疗程,治疗后评价两组的临床疗效、中医证候(疼痛、麻木、冷感、间歇性跛行缓解时间)积分、间歇性跛行距离、ABI、足背动脉内径、峰值流速及血流量变化。结果:治疗后,观察组总有效率93.33%优于对照组的76.67%(P<0.05),观察组总有效率明显优于对照组(P<0.05);治疗后,两组患者四项中医证候(疼痛、麻木、冷感、间歇性跛行缓解时间)评分均下降(P<0.05),观察组下降幅度更明显(P<0.05);治疗后,两组患者的ABI、最大跛行距离均较治疗前升高,观察组优于对照组(P<0.05);治疗后,两组患者足背动脉血管内径、峰值流速、血流量等血流动力学指标均较治疗前有改善,且观察组优于对照组(P<0.05)。结论:针药联合疗法对下肢动脉硬化闭塞症疗效良好,可明显减轻患者主要症状及体征,同时,对患者血流动力学指标具有一定的辅助调节作用。

Objective:To observe the clinical effect of acupuncture combined with traditional Chinese medicinal materials in the treatment of cold coagulation and blood stasis type lower extremity arteriosclerosis obliterans and its influences on hemodynamics indexes and ABI index.Methods:A total of 60 patients with lower extremity arteriosclerosis obliterans were divided into two groups,namely the observation group and the control group,according to random number table method.The observation group of 30 patients was treated with traditional Chinese medicinal materials combined with Jiaji point(EX-B2)electroacupuncture.The control group were treated with traditional Chinese medicinal materials and Western medicine intravenous infusion.Two groups of patients with lower extremity arteriosclerosis obliterans were treated with a course of two weeks.After treatment,the clinical efficacy,the scores of TCM syndrome scores(including pain,numbness,cold sensation,intermittent claudication relief time,and intermittent claudication distance),ABI index,internal diameter of dorsal foot artery,peak velocity and blood flow in the two groups were evaluated.Results:After treatment,the total effective rate in the observation group was 93.33%,the total effective rate in the control group was 76.67%,the total effective rate in the observation group was significantly better than the control group(P<0.05).After treatment,the scores of four TCM syndromes(pain,numbness,cold sensation,intermittent claudication relief time)in the observation group and the control group were significantly reduced than untreated,and TCM syndromes(pain,numbness,cold sensation,intermittent claudication relief time)scores in the observation group was better than the control group(P<0.05).After treatment,ABI index and maximum claudication distance in the observation group and the control group were higher than before treatment,and the observation group indicators were improved more significantly than the control group(P<0.05).After treatment,three hemodynamic parameters(Dorsal foot artery internal diameter,peak velocity,blood flow)measured in both groups were better than before treatment,and the observation group was better than the control group(P<0.05).Conclusion:Acupuncture combined with traditional Chinese medicinal materials has good clinical effects on lower extremity arteriosclerosis obliterans,which can significantly reduce the main symptoms and signs of patients.Meanwhile,it has a certain auxiliary regulation effect on hemodynamic indexes of patients.