活血防塞汤改善气虚痰瘀型老年2型糖尿病下肢血管腔内治疗术后症状的临床观察

Clinical observation of Huoxue Fangsai decoction on improving the postoperative symptoms of elderly diabetes patients with Qi Deficiency and Phlegm Stasis after endovascular therapy of lower extremity

目的探讨活血防塞汤对气虚痰瘀型老年糖尿病下肢血管腔内治疗术后临床症状的影响。方法选取2019年9月-2020年9月于天津中医药大学第二附属医院行下肢血管腔内治疗的老年2型糖尿病足患者88例,以数字表随机法分为对照组和观察组,每组44例。对照组行术后常规治疗,观察组在对照组基础上加用活血防塞汤治疗,2组均治疗2周。比较2组治疗后的临床疗效、经皮氧分压、肢体水肿以及症状评分。比较2组治疗前及治疗2周后患者血清白介素-6(IL-6)、C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)水平。结果治疗2周后,观察组有效率显著高于对照组(P<0.05),经皮氧分压水平显著高于对照组(P<0.05),肢体水肿评分显著低于对照组(P<0.05),足部单项症状(疼痛、冷感)评分低于对照组(P<0.05),CRP、IL-6、TNF-α表达水平低于对照组(P<0.05或P<0.01)。结论活血防塞汤能够显著改善老年糖尿病下肢血管腔内治疗术后的临床症状,其机制可能与抑制炎症因子IL-6、TNF-α、CRP表达有关。

Objective To investigate the effects of Huoxue Fangsai decoction on the clinical symptoms of elderly diabetes patients with Qi Deficiency and Phlegm Stasis after endovascular therapy of lower extremity.Methods 88 elderly patients with type 2 diabetic foot who underwent endovascular therapy of lower extremity in Second Affiliated Hospital of Tianjin University of Traditional Chinese Medicine from September 2019 to September 2020 were selected and divided into control group and observation group by random numerical table method,with 44 cases in each group.The control group received routine treatment after operation,and the observation group was treated with Huoxue Fangsai decoction on the basis of the control group.Both groups were treated for 2 weeks.The clinical efficacy,percutaneous partial pressure of oxygen,limb edema and symptom score were compared between the two groups after treatment.The levels of serum interleukin-6(IL-6),C-reactive protein(CRP)and tumor necrosis factor-α(TNF-α)were compared between the two groups before treatment and 2 weeks after treatment.Results After 2 weeks of treatment,the effective rate of the observation group was significantly higher than that of the control group(P<0.05),the percutaneous oxygen partial pressure level was significantly higher than that of the control group(P<0.05),the score of limb edema was significantly lower than that of the control group(P<0.05),the score of single symptoms(pain and cold sensation)of the foot was lower than that of the control group(P<0.05),and the expression levels of CRP,IL-6 and TNF-αwere lower than those of the control group(P<0.05 or P<0.01).Conclusion Huoxue Fangsai decoction can significantly improve the clinical symptoms of elderly patients with diabetes after endovascular therapy of lower limbs,and its mechanism may be related to inhibiting the expression of inflammatory factors IL-6,TNF-αand CRP.