朱红膏纱条外敷联合西医治疗阴虚湿热型动脉硬化闭塞症临床研究
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摘要
目的探讨在西医基础上朱红膏纱条外敷治疗阴虚湿热型动脉硬化闭塞症的临床疗效,并评估其血流变学、血流量及炎症状况的改善作用。方法选择阴虚湿热型动脉硬化闭塞症患者112例,随机分为治疗组和对照组,两组各56例,对照组患者应用常规西医治疗,治疗组患者西医治疗基础上外用朱红膏治疗。评估治疗效果,治疗前后踝肱指数(ABI)、症状体征积分、全血黏度、纤维蛋白原(Fib)、超敏c-反应蛋白(hs-CRP)及治疗前后腘动脉、股动脉和足背动脉血流量的变化。结果治疗组患者总有效率为91.07%(51/56),高于对照组82.14%(46/56),差异有统计学意义(P<0.05)。治疗组治疗后ABI为(0.92±0.18),高于对照组治疗后(0.81±0.17),差异有统计学意义(P<0.05),治疗组治疗后症状体征积分为(5.17±0.63)分,低于对照组治疗后(6.29±0.74)分,差异有统计学意义(P<0.05)。治疗组治疗后全血黏度(高切、低切)、Fib和Hs-CRP分别为(4.32±0.44)Pa·s、(9.76±1.09)Pa·s、(3.42±0.58)g/L和(7.38±0.76)mg/L,均低于对照组治疗后(4.85±0.43)Pa·s、(11.28±1.05)Pa·s、(4.10±0.62)和g/L(9.32±0.80)mg/L,差异有统计学意义(P<0.05)。治疗组治疗后腘动脉、股动脉和足背动脉血流量分别为(113.53±10.26)ml/min、(448.24±32.36)ml/min和(30.38±3.63)ml/min,高于对照组治疗后(102.42±9.84)ml/min、(430.61±31.28)ml/min和(26.08±4.17)ml/min,差异有统计学意义(P<0.05)。结论朱红膏纱条外敷结合西医治疗阴虚湿热型动脉硬化闭塞症具有较好的临床疗效,能够显著改善患者临床症状、血流变学、血流速度及炎症状态,值得临床推广应用。
Objective To explore the clinical therapeutic effects on arteriosclerosis obliterans( ASO) of yin deficiency and damp heat pattern treated with the external application of zhuhong ointment gauze and western medicine and assess the improvements in hemorrheology,blood flow and inflammatory state. Methods A total of112 patients of ASO were randomized into a treatment group and a control group,56 cases in each one. In the control group,the routine western medicine was given. In the treatment group,besides the treatment as the control group,zhuhong ointment was used for external application. The therapeutic effects,the ankle-brachium index( ABI),the score of symptoms and physical signs,the whole blood viscosity,Fib,hs-CRP and the blood flow of popliteal artery,femoral artery and dorsal artery of foot were assessed before and after treatment. Results The total effective rate was 91. 07%( 51/56) in the treatment group,higher than 82. 14%( 46/56) in the control group,indicating the significant difference( P < 0. 05). After treatment,ABI( 0. 92 ± 0. 18) in the treatment group was higher than the control group( 0. 81 ± 0. 17),indicating the significant difference( P < 0. 05). The score of symptoms and physical signs( 5. 17 ± 0. 63) in the treatment group was lower than the control group( 6. 29 ± 0. 74) after treatment,indicating the significant di-fference( P < 0. 05). The whole blood viscosity,Fib and Hs-CRP[( 4. 32 ± 0. 44) Pa/s,( 9. 76 ± 1. 09) Pa/s,( 3. 42 ± 0. 58) g/L and( 7. 38 ± 0. 76) mg/L]in the treatment group were lower than in the control group[( 4. 85 ± 0. 43) Pa/s,( 11. 28 ± 1. 05) Pa/s,( 4. 10 ± 0. 62) g/L and( 9. 32 ± 0. 80) mg/L]after treatment,indicating the significant differences( P < 0. 05). The blood flow volumes of popliteal artery,femoral artery and dorsal artery of foot[( 113. 53 ± 10. 26) ml/min,( 448. 24 ± 32. 36) ml/min and( 30. 38 ± 3. 63) ml/min]in the treatment group were higher than the control group[( 102. 42 ± 9. 84) ml/min,( 430. 61 ± 31. 28)ml/min and( 26. 08 ± 4. 17) ml/min]after treatment,indicating the significant differences( P < 0. 05). Conclusion The combined treatment of the external application of zhuhong ointment gauze and western medicine achieves the good clinical therapeutic effects on ASO. It significantly improves in the clinical symptoms,hemorrheology,blood flow and inflammatory state. This therapy deserves to be promoted in clinical practice.
Objective To explore the clinical therapeutic effects on arteriosclerosis obliterans( ASO) of yin deficiency and damp heat pattern treated with the external application of zhuhong ointment gauze and western medicine and assess the improvements in hemorrheology,blood flow and inflammatory state. Methods A total of112 patients of ASO were randomized into a treatment group and a control group,56 cases in each one. In the control group,the routine western medicine was given. In the treatment group,besides the treatment as the control group,zhuhong ointment was used for external application. The therapeutic effects,the ankle-brachium index( ABI),the score of symptoms and physical signs,the whole blood viscosity,Fib,hs-CRP and the blood flow of popliteal artery,femoral artery and dorsal artery of foot were assessed before and after treatment. Results The total effective rate was 91. 07%( 51/56) in the treatment group,higher than 82. 14%( 46/56) in the control group,indicating the significant difference( P < 0. 05). After treatment,ABI( 0. 92 ± 0. 18) in the treatment group was higher than the control group( 0. 81 ± 0. 17),indicating the significant difference( P < 0. 05). The score of symptoms and physical signs( 5. 17 ± 0. 63) in the treatment group was lower than the control group( 6. 29 ± 0. 74) after treatment,indicating the significant di-fference( P < 0. 05). The whole blood viscosity,Fib and Hs-CRP[( 4. 32 ± 0. 44) Pa/s,( 9. 76 ± 1. 09) Pa/s,( 3. 42 ± 0. 58) g/L and( 7. 38 ± 0. 76) mg/L]in the treatment group were lower than in the control group[( 4. 85 ± 0. 43) Pa/s,( 11. 28 ± 1. 05) Pa/s,( 4. 10 ± 0. 62) g/L and( 9. 32 ± 0. 80) mg/L]after treatment,indicating the significant differences( P < 0. 05). The blood flow volumes of popliteal artery,femoral artery and dorsal artery of foot[( 113. 53 ± 10. 26) ml/min,( 448. 24 ± 32. 36) ml/min and( 30. 38 ± 3. 63) ml/min]in the treatment group were higher than the control group[( 102. 42 ± 9. 84) ml/min,( 430. 61 ± 31. 28)ml/min and( 26. 08 ± 4. 17) ml/min]after treatment,indicating the significant differences( P < 0. 05). Conclusion The combined treatment of the external application of zhuhong ointment gauze and western medicine achieves the good clinical therapeutic effects on ASO. It significantly improves in the clinical symptoms,hemorrheology,blood flow and inflammatory state. This therapy deserves to be promoted in clinical practice.
引文
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[2]王乐平,罗玲,董建勋,等.朱红膏促进大鼠慢性皮肤溃疡创面愈合量效关系研究[J].中华中医药杂志,2013,28(5):1237-1240.
[3]李芬.活血通络方治疗下肢动脉硬化闭塞症的临床观察[J].中国中医急症,2015,24(4):741-742.
[4]张平,窦丹波,余小萍,等.基于症状量值矩阵的湿阻病阴虚湿热证中医证候疗效评价[J].中医杂志,2015,56(8):658-661.
[5]赵钢,高原,于文慧,等.活血通络汤治疗下肢动脉硬化闭塞症60例[J].中国中西医结合外科杂志,2015,21(3):286-287.
[6]闫珊珊,王专运.活血通痹汤联合前列地尔治疗糖尿病下肢动脉硬化闭塞症的临床研究[J].中医临床研究,2015,7(36):59-60.
[7]吕勃川,赵钢.“三因制宜”在下肢动脉硬化闭塞症防治中的应用[J].中华中医药杂志,2016,31(4):1284-1286.
[8]任青松.自拟芪蛭固本通脉丸治疗动脉硬化闭塞症58例[J].中国中西医结合外科杂志,2016,22(1):50-52.
[9]范利锋,翁庚民.从“湿热瘀毒证”论治下肢动脉硬化闭塞症急性发作期的临床研究[J].现代中西医结合杂志,2015,24(13):1404-1406.
[10]林含,张旭辉,董建勋,等.朱红膏对皮肤破损模型大鼠量毒关系研究[J].中华中医药杂志,2013,28(5):1474-1479.
[11]王桂英,林含,张旭辉,等.朱红膏治疗慢性皮肤溃疡的临床安全性研究[J].北京中医药,2016,35(1):70-72.
[12]何秀娟,林燕,吕喆,等.朱红膏对脂多糖刺激人单核细胞系THP-1细胞分泌细胞因子和黏附分子的影响[J].首都医科大学学报,2013,34(4):572-575.
[13]林含,张旭辉,董建勋,等.朱红膏对破损皮肤模型大鼠汞蓄积及肾组织形态的影响[J].中国中药杂志,2012,37(6):735-743.
[14]刘凤博,李国信.中医药治疗动脉硬化闭塞症简况[J].实用中医内科杂志,2016,30(3):117-119.
[15]林燕,戴淼可,何秀娟,等.朱红膏对基质金属蛋白酶活性及成纤维细胞分泌的影响[J].中国中药杂志,2013,38(11):1795-1799.
[2]王乐平,罗玲,董建勋,等.朱红膏促进大鼠慢性皮肤溃疡创面愈合量效关系研究[J].中华中医药杂志,2013,28(5):1237-1240.
[3]李芬.活血通络方治疗下肢动脉硬化闭塞症的临床观察[J].中国中医急症,2015,24(4):741-742.
[4]张平,窦丹波,余小萍,等.基于症状量值矩阵的湿阻病阴虚湿热证中医证候疗效评价[J].中医杂志,2015,56(8):658-661.
[5]赵钢,高原,于文慧,等.活血通络汤治疗下肢动脉硬化闭塞症60例[J].中国中西医结合外科杂志,2015,21(3):286-287.
[6]闫珊珊,王专运.活血通痹汤联合前列地尔治疗糖尿病下肢动脉硬化闭塞症的临床研究[J].中医临床研究,2015,7(36):59-60.
[7]吕勃川,赵钢.“三因制宜”在下肢动脉硬化闭塞症防治中的应用[J].中华中医药杂志,2016,31(4):1284-1286.
[8]任青松.自拟芪蛭固本通脉丸治疗动脉硬化闭塞症58例[J].中国中西医结合外科杂志,2016,22(1):50-52.
[9]范利锋,翁庚民.从“湿热瘀毒证”论治下肢动脉硬化闭塞症急性发作期的临床研究[J].现代中西医结合杂志,2015,24(13):1404-1406.
[10]林含,张旭辉,董建勋,等.朱红膏对皮肤破损模型大鼠量毒关系研究[J].中华中医药杂志,2013,28(5):1474-1479.
[11]王桂英,林含,张旭辉,等.朱红膏治疗慢性皮肤溃疡的临床安全性研究[J].北京中医药,2016,35(1):70-72.
[12]何秀娟,林燕,吕喆,等.朱红膏对脂多糖刺激人单核细胞系THP-1细胞分泌细胞因子和黏附分子的影响[J].首都医科大学学报,2013,34(4):572-575.
[13]林含,张旭辉,董建勋,等.朱红膏对破损皮肤模型大鼠汞蓄积及肾组织形态的影响[J].中国中药杂志,2012,37(6):735-743.
[14]刘凤博,李国信.中医药治疗动脉硬化闭塞症简况[J].实用中医内科杂志,2016,30(3):117-119.
[15]林燕,戴淼可,何秀娟,等.朱红膏对基质金属蛋白酶活性及成纤维细胞分泌的影响[J].中国中药杂志,2013,38(11):1795-1799.