针灸联合血府逐瘀胶囊治疗血栓闭塞性脉管炎的临床随机对照研究
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摘要
目的:探究针灸联合血府逐瘀胶囊治疗血栓闭塞性脉管炎(TAO)的临床疗效。方法:选取2017年3月至2018年4月盘锦市中心医院收治的TAO患者95例作为研究对象,按照随机数字表法随机分为对照组(n=47)和观察组(n=48)。对照组给予西医治疗,观察组在对照组的基础上给予针灸联合血府逐瘀胶囊治疗,2组均连续治疗6周。统计2组治疗后临床疗效,比较2组患者治疗前后中医证候积分,检测2组治疗前后血清ET-1、NO、hs-CRP水平,观察,2组治疗前后最大行走距离及ABI值。结果:治疗后观察组临床总有效率为91. 67%,显著高于对照组的65. 96%(P <0. 01);与治疗前比较,治疗后2组肢体疼痛、肢体麻木、肢体发凉、间歇性跛行、肢端皮色积分显著降低(P <0. 05或P <0. 01),且观察组显著低于对照组(P <0. 01);与治疗前比较,治疗后2组血清ET-1、hs-CRP水平显著降低(P <0. 01),血清NO水平显著升高(P <0. 05),且2组间比较差异有统计学意义(P <0. 01);与治疗前比较,治疗后2组ABI及观察组的最大行走距离显著升高(P <0. 01),且观察组均显著高于对照组(P <0. 01)。结论:针灸联合血府逐瘀胶囊可有效缓解TAO患者症状,抑制炎性反应,改善血管内皮细胞功能,提高下肢功能,且疗效显著优于西医治疗。
Objective: To explore the clinical efficacy of acupuncture combined with Xuefu Zhuyu Capsule in the treatment of patients with thromboangitis obliterans( TAO). Methods: A total of 95 cases TAO patients admitted to Panjin Central Hospital from March 2017 to April 2018 were selected and randomly divided into the control group( n = 47) and observation group( n = 48) according to random number table methods. The control group was treated with western medicine treatment,while the observation group was treated with acupuncture and Xuefu Zhuyu Capsule treatment on the basis of the control group. The 2 groups were treated for 6 weeks continuously. The clinical curative effects in the 2 groups were calculated after treatment; the traditional Chinese medicine( TCM) syndrome scores in the 2 groups were compared before and after treatment; the serum ET-1,NO and hs-CRP levels in the 2 groups were detected before and after treatment; the maximum walking distance and ABI value in the 2 groups were observed before and after treatment. Results: The clinical total effective rate in the observation group after treatment was 91. 67%,which was significantly higher than 65. 96% of the control group( P < 0. 01); compared with scores before treatment,the limb pain,limb numbness,limb cooling,intermittent claudication,limb end skin color scores in the 2 groups significantly decreased after treatment( P < 0. 05 or P < 0. 01),and the observation group was significantly lower than that of the control group( P < 0. 01);compared with levels before treatment,the serum ET-1 and hs-CRP levels in the 2 groups significantly decreased after treatment( P < 0. 01),the serum NO levels significantly increased( P < 0. 05),and there was a significant difference between the 2 groups( P < 0. 01); compared with values before treatment,the ABI value in the 2 groups and maximum walking distance in the observation group increased significantly after treatment( P < 0. 01). The observation group was significantly higher than that of the control group( P < 0. 01). Conclusion: Acupuncture combined with Xuefu Zhuyu Capsule can effectively alleviate the symptoms of TAO patients,inhibit the inflammatory reaction as well as improve the vascular endothelial cells function and lower limbs function. Its efficacy is superior to western medicine treatment.
Objective: To explore the clinical efficacy of acupuncture combined with Xuefu Zhuyu Capsule in the treatment of patients with thromboangitis obliterans( TAO). Methods: A total of 95 cases TAO patients admitted to Panjin Central Hospital from March 2017 to April 2018 were selected and randomly divided into the control group( n = 47) and observation group( n = 48) according to random number table methods. The control group was treated with western medicine treatment,while the observation group was treated with acupuncture and Xuefu Zhuyu Capsule treatment on the basis of the control group. The 2 groups were treated for 6 weeks continuously. The clinical curative effects in the 2 groups were calculated after treatment; the traditional Chinese medicine( TCM) syndrome scores in the 2 groups were compared before and after treatment; the serum ET-1,NO and hs-CRP levels in the 2 groups were detected before and after treatment; the maximum walking distance and ABI value in the 2 groups were observed before and after treatment. Results: The clinical total effective rate in the observation group after treatment was 91. 67%,which was significantly higher than 65. 96% of the control group( P < 0. 01); compared with scores before treatment,the limb pain,limb numbness,limb cooling,intermittent claudication,limb end skin color scores in the 2 groups significantly decreased after treatment( P < 0. 05 or P < 0. 01),and the observation group was significantly lower than that of the control group( P < 0. 01);compared with levels before treatment,the serum ET-1 and hs-CRP levels in the 2 groups significantly decreased after treatment( P < 0. 01),the serum NO levels significantly increased( P < 0. 05),and there was a significant difference between the 2 groups( P < 0. 01); compared with values before treatment,the ABI value in the 2 groups and maximum walking distance in the observation group increased significantly after treatment( P < 0. 01). The observation group was significantly higher than that of the control group( P < 0. 01). Conclusion: Acupuncture combined with Xuefu Zhuyu Capsule can effectively alleviate the symptoms of TAO patients,inhibit the inflammatory reaction as well as improve the vascular endothelial cells function and lower limbs function. Its efficacy is superior to western medicine treatment.
引文
[1]刘焱喆,王勤运,王海涛,等.血栓闭塞性脉管炎治疗进展[J].现代生物医学进展,2014,14(27):5397-5400.
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[3]Fazeli B,Ravari H.Mechanisms of thrombosis,available treatments and management challenges presented by thromboangiitis obliterans[J].Current Medicinal Chemistry,2015,22(16):1992-2001.
[4]张力,刘秀娟,李杰辉,等.血府逐瘀汤加味煮散治疗深静脉血栓形成临床研究[J].辽宁中医药大学学报,2016,18(1):11-14.
[5]刘喜民.中医治疗下肢血栓闭塞性脉管炎的应用与疗效评定[J].中西医结合心血管病杂志(连续型电子期刊),2018,6(10):155-157.
[6]陈自权,杨华有.血栓闭塞性脉管炎的诊断与治疗[M].西安:陕西科学技术出版社,1986:59-61.
[7]陈淑长.实用中医周围血管病学[M].北京:人民卫生出版社,2005:229-244.
[8]国家中医药管理局.中医病证诊断疗效标准[S].南京:南京大学出版社,1994:143-144.
[9]李光新,王辉.血栓闭塞性脉管炎的治疗进展[J].血管与腔内血管外科杂志,2017,3(6):1078-1080.
[10]秦传子,马军,姜维良.NLRP3炎性小体在血栓闭塞性脉管炎发病机制中的作用研究进展[J].疑难病杂志,2017,16(4):415-418.
[11]Yuan L,Bao J,Zhao Z,et al.Clinical results of percutaneous transluminal angioplasty for thromboangiitis obliterans in arteries above the knee[J].Atherosclerosis,2014,235(1):110-115.
[12]李春亭,罗保平,尹红,等.中西医结合治疗2期以上血栓闭塞性脉管炎54例疗效评价[J].世界中医药,2017,12(1):61-63.
[13]李光宗,庞鹤,曹建春,等.脉络通瘀汤口服联合脱疽洗剂治疗血栓闭塞性脉管炎寒凝血瘀证临床观察[J].中国中西医结合杂志,2017,37(1):119-122.
[14]李伟.清热凉血化瘀法治疗血栓闭塞性脉管炎及其对患者血清SOD、NO、t-PA影响[J].辽宁中医药大学学报,2017,19(3):91-94.
[15]Melillo E,Grigoratos C,De S F,et al.Noninvasive Transcutaneous Monitoring in Long-Term Follow-Up of Patients With Thromboangiitis Obliterans Treated With Intravenous Iloprost[J].Angiology,2015,66(6):531-538.
[16]张茜.电针夹脊穴辅助治疗Ⅰ期血栓闭塞性脉管炎的临床研究[D].哈尔滨:黑龙江中医药大学,2014.
[17]杨清,李大光,陈勃,等.血栓闭塞性脉管炎患者血清ET-1、NO和hs-CRP检测及临床意义[J].中国实验诊断学,2015,19(7):1109-1110.
[18]庄丽华,胡家才,吴昊.桃红四物汤加赤芍治疗早中期血栓闭塞性脉管炎78例疗效评估[J].中西医结合心脑血管病杂志,2015,13(5):697-698.
[2]白俊龙,王江宁.血栓闭塞性脉管炎的治疗进展[J].实用医学杂志,2015,31(10):1563-1565.
[3]Fazeli B,Ravari H.Mechanisms of thrombosis,available treatments and management challenges presented by thromboangiitis obliterans[J].Current Medicinal Chemistry,2015,22(16):1992-2001.
[4]张力,刘秀娟,李杰辉,等.血府逐瘀汤加味煮散治疗深静脉血栓形成临床研究[J].辽宁中医药大学学报,2016,18(1):11-14.
[5]刘喜民.中医治疗下肢血栓闭塞性脉管炎的应用与疗效评定[J].中西医结合心血管病杂志(连续型电子期刊),2018,6(10):155-157.
[6]陈自权,杨华有.血栓闭塞性脉管炎的诊断与治疗[M].西安:陕西科学技术出版社,1986:59-61.
[7]陈淑长.实用中医周围血管病学[M].北京:人民卫生出版社,2005:229-244.
[8]国家中医药管理局.中医病证诊断疗效标准[S].南京:南京大学出版社,1994:143-144.
[9]李光新,王辉.血栓闭塞性脉管炎的治疗进展[J].血管与腔内血管外科杂志,2017,3(6):1078-1080.
[10]秦传子,马军,姜维良.NLRP3炎性小体在血栓闭塞性脉管炎发病机制中的作用研究进展[J].疑难病杂志,2017,16(4):415-418.
[11]Yuan L,Bao J,Zhao Z,et al.Clinical results of percutaneous transluminal angioplasty for thromboangiitis obliterans in arteries above the knee[J].Atherosclerosis,2014,235(1):110-115.
[12]李春亭,罗保平,尹红,等.中西医结合治疗2期以上血栓闭塞性脉管炎54例疗效评价[J].世界中医药,2017,12(1):61-63.
[13]李光宗,庞鹤,曹建春,等.脉络通瘀汤口服联合脱疽洗剂治疗血栓闭塞性脉管炎寒凝血瘀证临床观察[J].中国中西医结合杂志,2017,37(1):119-122.
[14]李伟.清热凉血化瘀法治疗血栓闭塞性脉管炎及其对患者血清SOD、NO、t-PA影响[J].辽宁中医药大学学报,2017,19(3):91-94.
[15]Melillo E,Grigoratos C,De S F,et al.Noninvasive Transcutaneous Monitoring in Long-Term Follow-Up of Patients With Thromboangiitis Obliterans Treated With Intravenous Iloprost[J].Angiology,2015,66(6):531-538.
[16]张茜.电针夹脊穴辅助治疗Ⅰ期血栓闭塞性脉管炎的临床研究[D].哈尔滨:黑龙江中医药大学,2014.
[17]杨清,李大光,陈勃,等.血栓闭塞性脉管炎患者血清ET-1、NO和hs-CRP检测及临床意义[J].中国实验诊断学,2015,19(7):1109-1110.
[18]庄丽华,胡家才,吴昊.桃红四物汤加赤芍治疗早中期血栓闭塞性脉管炎78例疗效评估[J].中西医结合心脑血管病杂志,2015,13(5):697-698.