EFFECT OF ACU-MOXIBUSTION ON BLOOD RHEOLOGY IN PATIENTS WITH AORTO-ARTERITIS

In the present paper, the authors compared the therapeutic effects of acu moxibustion and medication in the treatment of 80 cases of aorto arteritis and observed their effects on blood rheology of the limbs. Results showed that in acu moxibustion group (n=40) and medication group (n=40), the cure rates were 15% and 0, the markedly effective rates 62.5% and 12.5%, and the total effective rates 95% and 75% respectively. The therapeutic effect of acu moxibustion group was significantly superior to that of medication group (P<0.01). Following acu moxibustion treatment, the blood pressure and blood flow velocity of the brachial artery, the amplitude of the air volume wave of the wrist and the amplitude of the digital volume pulse wave increased remarkably compared with pre treatment (P<0.01), and after treatment with medication, only the blood velocity of brachial artery increased evidently in comparison with pre treatment (P<0.05). Comparison between two groups showed that values of the 4 indexes of acu moxibustion group were all significantly higher than those of medication group (P<0.01), displaying that the therapeutic effect of acu moxibustion is superior to that of medication. It provides experimental evidence for clinical effective treatment of aorto arteritis (branchiocephalic artery type) with acupuncture and moxibustion.

EFFECT OF ACUPUNCTURE PLUS MOXIBUSTION OF YONGQUAN POINT ON DYSCINESIA AND BLOOD RHEOLOGY IN STROKE PATIENTS

Objective: To observe the therapeutic effect of acupuncture plus moxibustion of Yongquan (KI 1) in improving stroke patients’ dyskinesia and blood rheology. Methods: 78 cases of stroke patients were treated by acupuncture and moxibustion of Yongquan (KI 1), once daily, with 20 days being a therapeutic course. Indexes of whole blood viscosity, plasma viscosity, platelet aggregation rate, packed cell volume and fibrinogen were detected before and after treatment. Changes of the functional activity were assessed using Barthel marking method. Results: After 2 courses of acupuncture treatment, all the above mentioned indexes and functional activity were improved significantly (P<0.05～0.01). Conclusion: Acupuncture and moxibustion of Yongquan (KI 1) has an active effect in improving stroke patients’ dyskinesia and blood rheology.

EFFECTS OF INJECTION OF LIGUSTRAZINE INTO GESHU (BL 17) POINT ON BLOOD RHEOLOGY IN PATIENTS OF CORONARY HEART DISEASE

In the present paper, the therapeutic effects of point-injection and electro-acupuncture(EA) were compared in 100 patients of coronary heart disease with abnormal increases of indexes ofblood rheology. Results indicated that after one therapeutic course, the increases of indexes of bloodrheology were reduced in Geshu-ligustrazine group, Geshu-saline group, Geshu-EA group and Feishu-ligustrazine group (P【0. 05 - 0. 01 ) and there was no this action in Feishu-EA group. Among them,the Geshu-EA group had the best therapeutic effect.

OBSERVATION ON CLINICAL THERAPEUTIC EFFECT OF MRI-AIDED ENCLOSURE NEEDLING IN THE TREATMENT OF STROKE AND ITS INFLUENCE ON BLOOD RHEOLOGY

Objective: To observe clinical therapeutic effect of magnetic resonance imaging (MRI) aided enclosure needling in the treatment of stroke patients and changes of the related blood rheology. Methods: A total of 61 stroke patients were randomized into MRI aided enclosure needling group (MRI aided acupuncture group) (n=31) and conventional acupuncture group (n=30). For patients of MRI aided acupuncture group, acupuncture needles were inserted into the subcutaneous tissues around the focus projection scalp area displayed by MRI, with the needle tips toward the center of the projection region and with two needles being about 2 cm apart, combined with other acupoints according to the concrete syndromes or symptoms. For patients of conventional acupuncture group, Motor Area (MS 6) and Sensory Area (MS 7) on the contralateral side of the focus were punctured. The treatment was conducted once daily, continuously for 30 days. Results: After treatment, of the 31 cases in MRI aided acupuncture group, 20 were cured basically, 10 responded with significant improvement of symptoms and signs, one case had some improvement. While in conventional acupuncture group, of the 30 cases, 11 were cured basically, 15 responded with striking amelioration of symptoms and signs and 4 had some amelioration. Ridit analysis showed that the therapeutic effect of MRI aided acupuncture group was significantly superior to that of conventional acupuncture group (P<0.05). After treatment, the whole blood viscosity, plasma viscosity, hematocrit, whole blood reduction viscosity, hemagglutination index, and the total score of the two groups all decreased significantly in comparison with those of pre treatment of each group, while whole blood viscosity, hematocrit, vascular sclerosis index and the total score of MRI aided acupuncture group were obviously lower than those of conventional acupuncture group (P<0.05-0.01), suggesting that the effect of the former group in bettering blood rheology was pronouncedly superior to that of conventional acupuncture group. Conclusion: MRI aided acupuncture group is obviously superior to that of conventional acupuncture group in improving clinical symptoms and signs and blood rheology in stroke patients.

Detection and significance of blood rheology and coagulation function index in elderly patients with type 2 diabetes mellitus complicated with cerebral infarction

Objective: To investigate the level of blood rheology and coagulation function in elderly patients with type 2 diabetes mellitus (T2DM) and cerebral infarction and its significance. Methods: A total of 81 elderly patients with T2DM and cerebral infarction were selected as the observation group, 80 cases of T2DM patients without cerebral infarction were selected as T2DM group, and 80 healthy elderly people as control group. According to the Adama classification, the patients in the observation group were divided into three groups: lacunar infarction group (n=28), small infarction group (n=39) and large infarction group (n=14). The blood rheology and coagulation function indexes levels among the groups were compared. Results: The single factor variance analysis showed that the differences of the high shear whole blood viscosity, plasma viscosity, low shear whole blood viscosity, APTT, PT, FIB and D-D levels among the control group were significant, T2DM group and observation group were statistically significant. Compared with the control group, the high shear whole blood viscosity, plasma viscosity, low shear whole blood viscosity, FIB and D-D levels in the T2DM group and observation group were significantly increased, PT and APTT were decreased sharply, and in the observation group high shear whole blood viscosity, plasma viscosity, low shear whole blood viscosity, FIB and D-D levels were significantly higher than that of T2DM group APTT, and PT were significantly lower than those of T2DM group. Lacunar infarction group, small infarction group and large infarction group with increased infarct size, with high shear whole blood viscosity, plasma viscosity, low shear whole blood viscosity, FIB and D-D levels were significantly increased, while APTT and PT were significantly decreased. Conclusion: T2DM and cerebral infarction patients with abnormal blood rheology and coagulation function, the index examination has important clinical value for cerebral infarction area evaluation.

Effect of Dan seven soft capsule adjuvant therapy on serum inflammatory factors, coagulation function and blood rheology indexes in patients with acute hemorrhagic cerebrovascular disease

Objective: To investigate the effect of Dan seven soft capsule on the treatment of acute hemorrhagic cerebrovascular disease and the influence of serum inflammatory factors, coagulation function and blood rheology indexes. Methods: A total of 112 cases of patients with acute hemorrhagic cerebrovascular disease, according to the random data table were divided into the control group (n=57) and observation group (n=55), the patients in the control group received routine treatment combined with edaravone, on the basis of the treatment of the control group, the observation group was treated with Dan seven soft capsule. The serum levels of inflammatory factors, coagulation function and blood rheology indexes were compared between the two groups before and after treatment. Results: Before treatment, there were no significant difference in the inflammatory factors (hs-CRP, TNF-α and IL-6), blood coagulation function (FIB, PT and APTT) and hemorheology (high cut whole blood viscosity, low cut whole blood viscosity and plasma viscosity) levels between the control group and observation group. Compared with the levels of the same group before treatment, two groups of hs-CRP, TNF-α, IL-6, FIB, high cut whole blood viscosity, low cut whole blood viscosity and plasma viscosity level after treatment were significantly decreased, and levels in the observation group were significantly lower than those in the control group;Compared with the group before treatment, the levels of PT and APTT in the two groups were significantly increased, and the observation group was significantly higher than the control group. Conclusion: Dan seven soft capsule in the treatment of acute hemorrhagic cerebrovascular disease can effectively reduce the level of serum inflammatory factors, improve coagulation function and blood rheology index, it has an important clinical value.

Physical-Chemical Aggressiveness of Solutions of Medicines as a Factor in the Rheology of the Blood inside Veins and Catheters

In experiments in vitro and observations in the clinic in vivo studied the state of the lumen of subcutaneous veins and blood rheology of patients after their interaction with vascular catheters and solutions of medicines based on the values of temperature, volume, concentration, osmotic activity and pH. It is shown that heparin injection in blood not prevent, but solution of 4% sodium bicarbonate injection prevents blood clotting, blood clots and blockage blood clots of veins and of catheters. It is shown that the heating to a temperature of＋42 ℃ with the solution of 4% sodium bicarbonate provides softening action on old dry blood clots in 1 min, and their subsequent irrigation with a warm solution of 4% sodium bicarbonate and 3% hydrogen peroxide provides complete destruction and discoloration of the remaining spots of blood during 2 s. Proposed new medicines and hygiene products for the protection of the veins and installed in them vascular catheters from blockage of blood clots, and for removing blood stains from clothes and body surface patients.

Effects of Nitroglycerine on Erythrocyte Rheology:A Novel Mechanism to Explain the Enhancement of Nutrient Blood Flow to Ischemic Zones

Objectives Nitroglycerine (NTG) enhances coronary blood flow to compromised myocardium is important in relieving ischemia. However, the mechanism for this increase in myocardial blood flow (MBF) is not well defined. In small vessels and capillaries, relative blood viscosity plays a very important role in determining myocardial vascular resistance (MVR). MVR reduce is due partly to the increase in negative charge of erythrocyte surface. We therefore hypothesized that the enhancement of nutrient blood flow to zones of myocardial ischemia during NTG is partly secondary to reduced MVR and blood flow viscosity. The latter is affected by the negative charge of erythrocyte surface. Methods 6 dogs with LAD flow-limiting stenosis (group 1) and 6 dogs with LAD flow-limiting stenosis and LCx occmusion (group 2) were studied. At baseline and during intracoronary infusions of NTG (0.3-0.6 μg·kg-1·min-1), hemodynamics, MBF (mL·min-1·g-1), whole blood viscosity (WBη, mPa. S), elongation index (EI), eletrophoretic mobility of erythocytes (EME, [μ.s-1)/(V.cm-1)]) and percent wall thickening (%WT) were determined. MVR was calculated using driving pressure/MBF. Results As compared to baseline, no changes in hemodynamics were seen during NTG. MBF increased and MVR decreased significantly in normal bed, the central 25% and the entire of stenosed bed (P<0.05), with a decrease in WBη in both group 1 and group 2 dogs (18.6±9.7 % and 19.2±14.5 %, respectively). However, the % decrease in WBη was proportioned to the % increase in MBF or the % decrease in MVR only in the central 25% of stenosed bed (r=0.87, P<0.001), but not in the entire stenosed bed and normal bed. EI did not show statistically significant differences between during NTG and at baseline, but EME did increase. And the % decrease in WBη during NTG was related to the % increase in EME (r=0.83, P=0.01). Conclusions NTG reduced myocardial vascular resistance and blood viscosity due to the change of negative charge of erythrocyte surface may, in part, be the mechanism of the enhancement of nutrient blood flow to zones of myocardial ischemia. These results provide additional insights into the complex anti-ischemic effects of NTG.

Effects of Xuezhikang (Red Yeast Rice) on Blood lipids, Hemorheology and the Expression of P65 and Tissue Factor in Atherosclerotic Rats

Objective: To observe the effects of Xuezhikang (red yeast rice) on blood lipids, blood rheology, and expression of P65 and tissue factor, and to explore the anti-atherosclerosis effect and related mechanisms of Xuezhikang (red yeast rice). Methods: 32 Wistar rats were randomly divided into normal control group, Xuezhikang treatment group, lovastatin treatment group and atherosclerosis model group (8 in each group). Blood lipids, blood rheology, malondialdehyde (MDA), total antioxidant capacity (T-AOC), and expression of aortic tissue factor (TF) and P65 were measured in each group. Results:(1) Both Xuezhikang and lovastatin could reduce blood lipid levels, but there was no significant difference between the two groups;(2) Both Xuezhikang and lovastatin can improve the hemorheology of atherosclerotic rats, but the difference between the two groups is not significant;(3) Compared with lovastatin, Xuezhikang inhibited the expression of TF and P65 in aorta of rats with atherosclerosis;(4) Compared with lovastatin, the Xuezhikang group had lower MDA levels and higher T-AOC. Conclusion: Xuezhikang can improve blood lipid levels and hemorheology in rats with atherosclerosis. Compared with lovastatin, Xuezhikang has stronger effects on inhibiting oxidative stress and down-regulating the expression of tissue factor and P65.

Effects of low frequency electrical stimulation on monoamine neurotransmitters,cerebral blood flow and hemorheology in children with cerebral palsy

Objective: To investigate the effects of low frequency electrical stimulation on monoamine neurotransmitters, cerebral blood flow and hemorheology in children with cerebral palsy. Methods: A total of 83 children with cerebral palsy were divided into the control group (n=42) and the observation group (n=41) according to the random data table, patients in the control group were treated with routine rehabilitation treatment, on this basis;the children in the observation group were treated with low-frequency electric stimulation. Before and after the treatment, the levels of monoamine neurotransmitter [dopamine (DA) and 5-hydroxy tryptamine (5-HT) and norepinephrine (NE)], cerebral blood flow [the average blood flow velocity of anterior cerebral artery (ACA), middle cerebral artery (MCA) and posterior cerebral artery (PCA)] and blood rheology index [high/low shear whole blood viscosity, plasma viscosity and fibrinogen (FIB)] of two groups were compared. Results: Before treatment, there were no significant difference of the levels of DA, 5-HT, NE, the average blood flow velocity of ACA/MCA/PCA, high/low shear whole blood viscosity, plasma viscosity and FIB between the two groups. After treatment, two groups of DA, 5-HT and NE levels were significantly higher than those in the same group before treatment, and the observation group of DA, 5-HT and NE levels were significantly higher than those of the control group, the difference was statistically significant;The average blood flow rate of ACA/MCA/PCA in the observation group after treatment was significantly higher than those in the same group before treatment;After treatment, the levels of high shear/low shear blood viscosity, plasma viscosity and FIB of the two groups were significantly lower than those in the same group before treatment, and the levels of observation group after treatment were significantly lower than that in the control group, the difference was statistically significant. Conclusion: Low frequency electrical stimulation can effectively increase the level of monoamine neurotransmitter, improve the level of cerebral blood flow and hemorheology, has an important clinical value.

Effect of general anesthesia on hemorrheology,hemodynamics and levels of blood E,NE and COS in patients undergoing gynecological surgery

Objective: To investigate the influence of general anesthesia on hemorheology, hemodynamics and blood E, NE and COS levels in patients undergoing gynecological surgery. Methods: A total of 87 cases of gynecologic laparoscopic surgery in our hospital from November 2015 to June 2017 were selected as subjects,all patients underwent general anesthesia for surgery, at the time of T1, T2, T3,the index of EDI, ηP, whole blood viscosity of blood rheology (high, middle and low shear), hemodynamic indexes of HR, BP, E, NE, SPO2 and serum COS level were measured. Results: (1) Compared with T1, 87 patients' HSV, MSV, LSV, ηP, EAI levels were significantly lower in T2 and T3, the difference was statistically significant, but there was no significant changes in the EDI three times;(2) Compared with T1, the levels of HR, SBP and DBP in 87 patients were significantly increased at T2 and T3, the difference was statistically significant, while the change of SPO2 levels at three moments was not statistically significant;(3) Compared with T1, the blood E, NE and COS levels in 87 patients increased significantly at T2 and T3, and the difference was statistically significant. Conclusion:Application of general anesthesia in gynecological surgery, can significantly reduce the blood viscosity of patients, but will increase the heart rate and blood pressure and blood E, NE and COS levels, therefore, during the operation, the patient's signs should be monitored comprehensively and closely.

地黄叶总苷胶囊治疗糖尿病肾病的随机对照研究

目的探讨地黄叶总苷胶囊治疗糖尿病肾病的临床疗效及对患者肾功能、血糖指标的改善效果。方法2019年1月—2021年1月漯河市中心医院收治的糖尿病肾病患者150例按随机数字表法分为观察组和对照组,各75例。观察组与对照组均给予常规治疗。观察组同时给予地黄叶总苷胶囊口服治疗。两组患者均连续治疗6个月。将观察组与对照组患者各项指标(治疗后的临床疗效,治疗前后的肾功能、血糖、血液流变学、炎症因子及治疗期间的不良反应)进行统一的对比与分析。结果治疗后经组间统计学比较发现,观察组与对照组的总有效率分别为92.00%(69/75)、72.00%(54/75),观察组患者的临床总有效率明显更高;治疗后观察组与对照组患者的血肌酐(creatinine,SCr)、血尿素氮(blood urea nitrogen,BUN)、β2微球蛋白(β2 microglobulin,U-β2MG)、24 h尿蛋白总量、空腹血糖(fasting blood glucose,FBG)、餐后2 h血糖(2 h postprandial blood glucose,2 h PG)、糖化血红蛋白(glycated hemoglobin,HbA1c)、血液流变学各项指标、血清白细胞介素-6(interleukin-6,IL-6)、肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)、高敏C反应蛋白(high-sensitivity C-reactive protein,hs-CRP)、单核细胞趋化蛋白-1(monocyte chemotactic protein-1,MCP-1)、细胞内细胞黏附分子-1(intracellular cell adhesion molecule-1,ICAM-1)水平与治疗前比较,均呈现降低的趋势,且较对照组而言,观察组明显处于较低水平;两组患者内生肌酐清除率(creatinine clearance,Ccr)均呈现升高趋势,且较对照组而言,观察组明显处于较高水平,差异有统计学意义(P<0.05)。结论糖尿病肾病患者应用地黄叶总苷胶囊治疗可有效控制其血糖水平,改善肾功能,减轻炎症反应,调节血液流变学指标,具有较高的临床疗效及安全性。

参苓白术散联合肠内营养改善危重症患者营养状态和预后的研究

目的分析参苓白术散联合肠内营养改善危重症患者营养状态和预后的研究。方法纳入2020年1月—2022年8月医院收治的危重症患者60例,分为对照组和观察组,各30例,方法为随机数字表法。对照组给予标准肠内营养支持及安慰剂治疗,观察组给予标准肠内营养支持及参苓白术散治疗,两组均治疗至转出重症加强护理病房。比较两组治疗情况,治疗前、治疗后营养状态、炎症反应指标、血液流变学及预后。结果观察组呼吸机带机时间、重症加强护理病房住院时间短于对照组,肠内营养不耐受发生率低于对照组[3.33%(1/30)vs 26.67%(8/30),P<0.05]。与治疗前比较,治疗后,两组血清血红蛋白(serum hemoglobin,HGB)、前白蛋白(prealbumin,PA)、白蛋白(albumin,ALB)水平均升高,且观察组更高(P<0.05);两组全血白细胞总数(blood white blood cell count,WBC)、中性粒细胞百分比(neutrophil percentage,NEU%),急性生理功能与慢性健康评分(Acute Physiology and Chronic Health Evaluation,APACHEⅡ)得分,血清C反应蛋白(C-reactive protein,CRP)、降钙素原(procalcitonin,PCT)水平,全血高切、低切黏度、血浆黏度均降低,且观察组更低(P<0.05)。结论参苓白术散可降低危重症患者肠内营养的不耐受,改善患者营养状态,进而抑制机体炎症反应及血液黏度增加,促进患者康复,改善其预后。

突发性耳聋临床干预的队列研究

目的探讨甲泼尼松龙琥珀酸钠联合复方甘草酸苷药物在耳后注射给药方法在突发性耳聋患者中的临床效果。方法选取2020年1月至2022年6月门诊就诊的120例突发性耳聋患者为研究对象,随机数字表法分为两组,每组60例。两组均给予常规方法治疗,对照组采用耳后注射甲泼尼松龙琥珀酸钠治疗,观察组采用耳后注射甲泼尼松龙琥珀酸钠联合复方甘草酸苷治疗,比较两组纯音听阈值、血液流变学水平、同型半胱氨酸(Hcy)、D-二聚体(D-D)、耳内微循环、T淋巴细胞水平、药物安全性及复发率。结果观察组干预前后0.5、1、2及4 kHz下纯音听阈平均值的差值均好于对照组(P<0.01);观察组治疗2周后全血高切黏度、低切黏度、血浆黏度、Hcy及D-D干预前后平均值的差值均大于对照组(P<0.01);观察组治疗2周后脂质过氧化物(LPO)、胱抑素C(CysC)和内皮素(ET)水平低于对照组(P<0.01);超氧化物歧化酶(SOD)水平高于对照组(P<0.01);观察组治疗2周后CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)平均值在干预前后差值均好于对照组(P<0.01);CD8^(+)水平低于对照组(P<0.05);两组治疗过程中咽鼓管损伤、逆行感染、耳部不适、低血钾、高血压发生率差异无统计学意义(P>0.05);观察组随访6个月复发率低于对照组(P<0.05)。结论耳后注射甲泼尼松龙琥珀酸钠联合复方甘草酸苷用于突发性耳聋患者中,能降低纯音听阈值,有助于改善患者血液流变学水平和耳内微循环,降低Hcy及D-D水平,可调节患者T淋巴细胞水平,且药物安全性较高,能降低远期复发率,值得推广应用。

续骨活血汤治疗股骨粗隆间骨折的临床疗效

目的 探讨续骨活血汤治疗股骨粗隆间骨折(intertrochanteric fracture of femur,IFF)的临床疗效。方法 选取2020年3月—2022年3月沈阳市骨科医院收治的120例IFF患者为研究对象,根据不同的治疗方法分为两组,各60例。所有患者均行股骨近端防旋髓内钉(proximal femoral nail antirotation,PFNA)术治疗,对照组术后第3天起口服碳酸钙D3片治疗,观察组在对照组基础上加服续骨活血汤治疗。比较两组临床疗效、疼痛评分、髋关节功能、骨密度(股骨头局部骨密度、髋部平均骨密度)、血液流变学指标(全血高切黏度、血浆黏度、全血低切黏度)、恢复情况(肿胀消退时间、骨折愈合时间)、不良反应发生情况。结果 观察组总有效率为96.67%(58/60),高于对照组的85.00%(51/60),差异有统计学意义(χ^(2)=4.904,P=0.027)。观察组髋关节功能评分高于对照组,骨密度大于对照组,差异有统计学意义(P均<0.05)。观察组疼痛评分、血液流变学指标均低于对照组,差异有统计学意义(P均<0.05)。观察组骨折愈合时间、肿胀消退时间均短于对照组,差异有统计学意义(P均<0.05)。治疗期间两组均未见明显不良反应。结论 续骨活血汤治疗IFF效果较好,可缓解患者疼痛,促进血液循环,改善骨密度和髋关节功能,安全可靠,利于预后。

STUDY ON SCALP ELECTROACUPUNCTURE TREATMENT OF APOPLEXY AND ITS INFLUENCE ON HEMORHEOLOGY IN ISCHEMIC APOPLEXY PATIENTS

Objectives: To compare the therapeutic effect of scalp electroacupuncture with that of conventional body acupuncture for apoplexy (wind stroke) and to observe the influence of both acupuncture therapies on hemorheology of ischemic apoplexy.Methods: 183 patients, whose diseases are attributed to apoplexy according to the diagnostic criteria, are randomly divided into treatment group (93 cases) and control group (90 cases) and treated respectively with scalp electroacupuncture and conventional body acupuncture. 11 items of hemorheology of patients’ blood samples are tested with NXE-1 Viscometer which are taken in the early morning before and after treatment under fasting condition. Results: Both scalp electroacupuncture and conventional body acupuncture exert therapeutic effect for apoplexy, but the effect of scalp electroacupuncture is obviously better than that of conventional acupuncture (P< 0.05 ); both treatment group and control group are statistically significant in reducing plasma viscosity, high shear reduced viscosity, low shear reduced viscosity, erythrocyte sedimentation rate, hematocrit and fibrinogen, (P<0.01 and 0.05); while the treatment group is statistically significant in reducing whole blood viscosity, ratio of whole blood viscosity, erythrocyte index of rigidity and electrophoresis time of erythrocyte (P<0.01～ 0.05), but the control group is not significant statistically in influencing these indexes (P>0.05).

Application of buried auricular point combined with Wenjing Sanhan prescription in arteriosclerosis obliterans patients with resting pain

BACKGROUND Research on the combined use of ear acupoint embedding beans and warming meridians with cold-dispersing formulas for alleviating resting pain in patients with arteriosclerosis obliterans(ASO)remains limited.AIM To explore the therapeutic efficacy of auricular point embedding beans combined with Wenjing Sanhan prescription in alleviating resting pain in patients with lower-limb ASO.METHODS A total of 100 patients with ASO experiencing resting pain who were treated at our hospital from January 2022 to January 2023 were enrolled.They were randomly allocated into two groups using a double-blind approach.The control group was treated using a warming meridian with a cold-dispersing formula,while the study group received additional treatment with ear acupoint embedding beans.The clinical efficacy,ankle-brachial artery pressure ratio,hemorheological indicators,and traditional Chinese medicine symptom scores were compared between the two groups.RESULTS The clinical efficacy rate in the study group was significantly higher(94.00%)than that in the control group(72.00%,P<0.05).Moreover,the ankle-brachial artery pressure ratio was significantly higher in the study group after treatment(P<0.05).Hemorheological parameters,including whole blood viscosity,plasma viscosity(1.83±0.11)mPa/s,fibrinogen levels(3.30±0.21)g/L,platelet adhesion rate(49.87%±10.51%),and erythrocyte aggregation index(1.79±0)were improved in the study group compared to the control group.In addition,the scores for decreased skin temperature(1.41±0.26),intermittent claudication(1.30±0.20),and resting pain(1.23±0.31)were significantly lower in the study group than those in the control group(all P<0.05).The level of oxidative stress in the study group also exhibited significant improvement(P<0.05),and the levels of inflammatory factors were considerably lower than those in the control group.CONCLUSION The combination of ear point embedding beans and Wenjing Sanhan prescription demonstrates promising clinical efficacy in alleviating resting pain associated with ASO.

真实分岔静脉下多种血液流变模型的溶栓治疗差异数值研究

静脉血栓栓塞(VTE)是一种常见的心血管疾病,建立基于计算流体力学(CFD)的数值模型是开展血栓治疗研究的重要手段.然而,血液的流变模型众多,多种血液流变模型之间存在显著的差异.目前,针对不同血液流变模型间的差异表现尚未得到充分研究.本研究提出一种生物流体力学模型以用于静脉血栓治疗数值研究,研究考虑静脉血流、血管结构以及药物传质间的作用耦合,并将血液视为不同流变特性的7种流体、静脉瓣膜视为超弹性固体、血栓块视为多孔材料.针对患者理想化和特异性的血管模型进行数值模拟,综合分析静脉血栓的溶栓治疗数值结果.结果表明,患者特异性血管模型更接近实际血管情况,其受分岔、弯曲等局部特征的影响,流速变化明显、涡流强度和Pe较高、瓣膜位移值较大.同时,不同血液流变学模型的研究结果不同.在患者特异性模型下,牛顿模型的血液黏度较小,流速和Pe较大,物质传质更快,溶栓表现较优;非牛顿模型中Bingham流体表现差异最显著,其血液黏度值较高,Pe较小,溶栓表现较差.本研究提倡采用患者实际血管模型、考虑血液实际流变特性进行静脉血栓数值研究,以推动血栓治疗领域的数字医疗、智慧医疗技术进步.

超声造影定量分析与糖尿病患者胰岛素抵抗及足部血液流变指标的相关性

目的探讨超声造影定量分析与糖尿病足患者胰岛素抵抗及足部血液流变指标的相关性。方法前瞻性选取2020年12月至2022年1月期间80例糖尿病微血管病变患者为病变组,40例糖尿病患者为DM组,42例接受体检的作为对照组,均接受超声造影和彩色多普勒超声检查。分析超声造影定量指标、胰岛素抵抗水平以及足部血液流变指标。采用Pearson相关性分析超声造影定量分析糖尿病患者胰岛素抵抗和足部血液流变指标的相关性。结果超声造影定量指标中平均峰值强度(PI)、时间-强度曲线下面积(AUC)分别低于DM组和对照组,右足趾对比剂到达时间(AT)、达峰时间(TTP)高于DM组和对照组(P<0.05);胰岛素抵抗指标中病变组空腹血糖(FPG)、糖化血红蛋白(HbA1C)、餐后2 h血糖(2hFPG)、空腹胰岛素(FINS)水平、胰岛素抵抗指数(HOMA-IR)均高于DM组和对照组,HOMA-β低于DM组和对照组(P<0.05),足部血液流变指标中病变组D、收缩期峰值速度(PSV)、舒张末期速度(EDV)、动脉脉动指数(ARI)、动脉阻力指数(API)均低于DM组和对照组(P<0.05)。结论超声造影定量分析与胰岛素抵抗和足部血液流变指标具有相关性,且FPG与PI、AUC呈负相关,AUC与D、PSV呈正相关,FPG与D、PSV呈负相关。

阿替普酶联合依达拉奉注射液治疗急性脑梗死的效果分析

目的分析阿替普酶+依达拉奉注射液在急性脑梗死患者中的治疗效果。方法取急性脑梗死患者90例,按治疗方案不同分为参照组、联合组,各45例。参照组采用阿替普酶溶栓治疗,联合组采用阿替普酶溶栓+依达拉奉注射液治疗。比较两组治疗效果,用药安全性,治疗前后的功能评分[美国国立卫生研究院卒中量表(NIHSS)、Barthel指数(BI)、生活质量评价量表(SF-36)、Fugl-Meyer运动功能评估量表(FMA)评分]、血液流变学指标[红细胞聚集指数(AI)、全血粘度(WBV)、脑血流量(CBF)、血浆粘度(PV)、血小板聚集率(PAR)]及氧化应激指标[血清一氧化氮(NO)、总抗氧化能力(T-AOC)、超氧化物歧化酶(SOD)、活性氧簇(ROS)]。结果较参照组的治疗总有效率82.22%,联合组患者的治疗总有效率95.56%更高,有统计学差异(P<0.05)。参照组患者用药不良反应发生率8.89%与联合组患者的6.67%比较,无明显差异(P>0.05)。较治疗前,两组患者治疗后的NIHSS评分下降,BI、SF-36、FMA评分升高,且治疗后,联合组患者的NIHSS评分(8.89±1.68)分较参照组的(12.37±1.63)分更低,BI评分(73.25±3.13)分、SF-36评分(68.36±3.24)分、FMA评分(63.54±3.27)分较参照组的(62.34±3.12)、(60.13±3.27)、(59.65±3.12)分更高,有统计学差异(P<0.05)。较治疗前,两组患者治疗后的AI、WBV、PV、PAR下降,CBF升高,且治疗后,联合组患者的AI(5.23±0.45)、WBV(5.11±0.72)mPa·s、PV(1.31±0.28)mPa·s、PAR(59.59±4.36)%较参照组的(6.62±0.57)、(6.35±0.81)mPa·s、(2.01±0.41)mPa·s、(66.12±4.23)%更低,CBF(738.45±33.58)ml/min较参照组的(688.45±33.24)ml/min更高,有统计学差异(P<0.05)。较治疗前,两组患者治疗后的NO、SOD、ROS下降,T-AOC升高,且治疗后,联合组患者的NO(5.38±1.22)μmol/L、SOD(124.43±9.12)U/ml、ROS(463.19±30.26)μmol/L较参照组的(7.69±1.13)μmol/L、(156.27±9.46)U/ml、(563.24±30.42)μmol/L更低,T-AOC(18.79±1.85)nmol/L较参照组的(13.47±2.16)nmol/L更高,有统计学差异(P<0.05)。结论阿替普酶+依达拉奉注射液治疗急性脑梗死患者,可提升疗效,改善患者功能状况、血液流变学、氧化应激指标。