作　　者： (石晓明）; (赵伟）; (杨永宾）; (吕柏楠）;

机构地区： 河北省人民医院普外二科,河北石家庄050051

出　　处： 《河北中医》 2017年第8期1202-1206,1218,共6页

摘　　要： 目的观察四妙勇安汤联合法舒地尔治疗下肢动脉硬化闭塞症(ASO)的临床疗效及对患者血液流变学、凝血功能、炎症相关指标的影响。方法将80例下肢ASO患者随机分为2组,对照组40例予丹参注射液治疗,治疗组40例予四妙勇安汤联合法舒地尔治疗,2组疗程均为2周。比较2组治疗前后动脉硬化指标[踝肱指数(ABI)、足背动脉血流量]、血液流细胞变学指标[血浆黏度、全血黏度(低切)、全血黏度(高切)]﹑凝血功能指标[凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、纤维蛋白原(FIB)]、炎性因子[肿瘤坏死因子α(TNF-α)、白细胞介素6(IL-6)、白细胞介素17A(IL-17A)、C反应蛋白(CRP)]、血栓素B2(TXB2)、前列腺素F1α(PGF1α)、跛行距离变化及不良反应发生情况,统计临床疗效。结果治疗组总有效率(85.00%)显著高于对照组(57.50%,P<0.05)。治疗后2组ABI、足背动脉血流量、PGF1α均较本组治疗前显著升高(P<0.05),血浆黏度、全血黏度(低切)、全血黏度(高切)、FIB、TNF-α、IL-6、IL-17A、CRP、TXB2均显著降低(P<0.05),PT、APTT、跛行距离均显著延长(P<0.05),且治疗组上述指标变化更为显著(P<0.05)。2组不良反应比较差异无统计学意义(P>0.05)。结论四妙勇安汤联合法舒地尔治疗下肢ASO,能够促进下肢局部微循环,抑制炎症反应,延缓动脉粥样硬化进展或减轻其程度,进而明显改善患者临床症状。 Objective To observe the clinical effects of Simiao-yong’an decoction combined with fasudil on the treatment of lower extremity arteriosclerosis obliterans（ ASO） and its effects on hemorheology,blood coagulation and inflammatory response. Methods 80 patients with lower extremity ASO were randomly divided into two groups.The control group（ n = 40） were treated by Danshen injection,and the treatment group（ n = 40） were treated by Simiao-yong’an decoction combined with fasudil. Both groups were treated for 2 weeks. The arteriosclerosis indexes including ankle brachial index（ ABI）,blood flow of dorsalis pedis artery,the hemorheology indexes including plasma viscosity,whole blood viscosity（ low shear）,whole-blood viscosity（ high shear）,the blood coagulation indexes including prothrombin time（ PT）,activated partial thromboplastin time（ APTT）,fibrinogen（ FIB）,the inflammatory factors including tumor necrosis factor alpha（ TNF-α）,interleukin-6（ IL-6）,IL-17 A,the thromboxane B2（ TXB2）,the prostaglandin F1α（ PGF1α）,the changes of limp distance and the incidences of adverse reactions before and after treatment were compared in two groups. The curative effects were evaluated. Results The total effective rate in treatment group（ 85. 00%） was higher than that in control group（ 57. 50%,P 〈 0. 05）. The ABI,blood flow of dorsalis pedis artery and PGF1α after treatment were significantly increased in the two groups（ P 〈 0. 05）,and the plasma viscosity,whole blood viscosity（ low shear）,whole-blood viscosity（ high shear）,FIB,TNF-α,IL-6,IL-17 A,CRP,and TXB2 were significantly decreased（ P 〈 0. 05）,and PT,APTT and limp distance were significantly extended（ P 〈 0. 05）,and the changes of these indicators in treatment group were more obvious than that in control group（ P 〈 0. 05）. There was no statistical difference on the incidences of adverse reactions between the two groups（ P 〉 0. 05）. Conclusion Simiao-yong’an decoction com

关 键 词： 动脉硬化 闭塞性 中西医结合疗法 四妙勇安汤