加味桂枝茯苓汤治疗下肢动脉硬化闭塞症的疗效观察

Observation on the therapeutic effect of modified Guizhi Fuling decoction on lower limb arteriosclerosis obliterans

目的:观察加味桂枝茯苓汤治疗下肢动脉硬化闭塞症FontaineⅡ期痰瘀阻络证患者的临床效果。方法:纳入2019年12月—2021年12月就诊于我院且诊断为下肢动脉硬化闭塞症FontaineⅡ期脱疽病痰瘀阻络证的患者共48例,随机均分为两组,对照组接受盐酸沙格雷酯片治疗,治疗组加服加味桂枝茯苓汤。比较两组患者治疗前、治疗4周后的临床症状总评分、间歇性跛行距离、下肢红外热像温度、踝肱指数(ABI)、动脉粥样硬化指数(AI)、纤维蛋白原(Fbg)水平。结果:治疗组患者总有效率(90.9%),明显高于对照组(81.8%),差异有统计学意义(P<0.05);与对照组相比,治疗组患者治疗后,下肢红外热像温度、ABI升高;临床症状总评分、AI、Fbg下降,差异有统计学意义(P<0.05);治疗组治疗后的AI低于对照组(P<0.05)。结论:加味桂枝茯苓汤可显著改善下肢动脉硬化闭塞症FontaineⅡ期痰瘀阻络证患者的临床症状、下肢红外热像温度、ABI、AI及Fbg等结局指标,且效果优于单纯应用盐酸沙格雷酯片。

Objective To observe the clinical efficacy of modified Guizhi Fuling decoction about lower limb arteriosclerosis occlusion(ASO)patients who caused by sputum stasis obstruction and in FontaineⅡ.Methods Fontaine II who visited our hospital from December 2019 to December 2021 and was diagnosed with phlegm and blood stasis blocking ASO.A total of 48 patients with desputum disease(sputum stasis obstruction)were viewed as research objects,which was randomly divided into two groups,the control group received sagrexide hydrochloride tablets,and the second group was orally add traditional Chinese medicine than before group.Total score of TCM symptoms,intermittent claudication distance,infrared thermos image temperature of lower extremity,ABI,Fbg,AI levels were compared before treatment and after 4 weeks between the two groups.Results The total effective rate is 90.9%of the treatment group patients,which was significantly higher than the result 81.8%in contral group(P<0.05).Compared with the control group,the infrared thermal image temperature and ABI of the lower extremities were upregulated after treatment.Symptoms total score,AI,Fbg decreased,and the degree of improvement was more obvious(P<0.05).The AI of the treatment group after treatment was lower than that of the control group(P<0.05).Conclusion The addition of flavored Poria cinnamon decoction can significantly improve the clinical symptoms,lower extremity temperature,ABI,AI and Fbg outcomes in patients with lower extremity arteriosclerotic occlusion Fontaine stage II.sputum obstruction,and the effect is better than that of salgredate hydrochloride tablets alone,which has certain clinical application value better than that of tablets alone.It has certain clinical application value.