中西医结合治疗血栓闭塞性脉管炎疗效及相关指标的研究

目的探讨中西医结合治疗血栓闭塞性脉管炎的疗效及对血液黏稠度、雌激素、血栓素B2、6-酮-前列腺素变化的影响。方法血栓闭塞性脉管炎患者118例分为两组，对照组35例，治疗组83例；血清免疫球蛋白和血清补体C3、C4测定采用免疫比浊法测定；血流变学检测采用KD—N6A自动冲洗旋转式血流变测试仪测定；雌二醇、血栓素B2、6-酮-前列腺素采用放射免疫法测定；治疗前和治疗后3个月各测一次。治疗西药部分是654—2、复方丹参片、刺五加、复方芦丁和左旋咪唑等。中药隔日一剂，疗程3个月。所获数据采用方差分析和￡检验。结果1）对照组治疗前后比较IgG的含量（P〈0．05），IgM、IgA的含量比较无显著性差异（P〉0．05），常规治疗能增加患者血清补体C3的含量（P〈0．01），血清IgM、IgA、C4的含量无明显影响（P〉0．05）。治疗组治疗前后IgA含量比较P〉0．05；血清IgM、IgG、C3、C4的含量有显著性差异沪〈O．05～0．01）。两组治疗后IgA含量比较P〉0．05；血清IgM、IgG、C3、C4的含量有显著性差异沪〈0．05～0．01）。2）两组治疗3个月后全血黏度（低切）、全血黏度（高切）、血浆黏度、红细胞压积、纤维蛋白原测定（P〈0．05～0．01），有显著性差异。治疗组更明显一些。基本接近健康对照纽。3）对照组治疗前后E2、TXB2、6一K—PGFlOt比较，P均〉0．05，无显著性差异。治疗组治疗前后雌激素、血栓素B2、6-酮-前列腺素比较，P均〈0．01，有显著性差异。治疗组与对照组治疗后雌激素、血栓素B2、6-酮-前列腺素比较，P均〈0．0l，有显著性差异。4）对照组治愈8例，占22．86％；截肢者17例，占48．57％；两年内因吸烟再发或加重10例，占28．57％。治疗组治愈82例，占98．79％；无截肢者；两年内因吸烟再发2例，占2．41％。结论中西医结合治疗血栓闭塞性脉管炎对血液黏稠度、雌激素、血栓素B2、6-酮-前列腺素变化的影响较大，基本使其恢复正常。治愈率高，费用低廉，避免截肢。

Combine Traditional Chinese and Western Medicine Treatment of Thromboangiitis Obliterans Effect Research and Related Indicators

Objective To explore the curative effect of combined traditional Chinese and western medicine treatment of thromboangiitis obliterans and blood viscosity, estrogen, thromboxane B2, 6- ketone- prostaglandins. Methods 118 patients with thromboangiitis obliterans was divided into two groups, control group 35 cases, treatment group 83 cases. Se- rum immunoglobulin and the determination of serum complement C3, C4 USES the immune turbidimetric method. Hemor- rheology study testing the KD - N6A automatic flushing rotary hemorrheology tester determination. Estradiol, thromboxane B2, 6 - ketone - prostaglandins by radioimmunity method. Before and 3 months after treatment the test one more time. West- ern medicine treatment part 654-2, compound salvia tablet, acanthopanax, compound rutin, levamisole, etc. Day a dose of Chinese medicine, treatment for 3 months. Data obtained using analysis of variance and t test. Results 1） The control group before and after treatment comparison of IgG levels （P 〈 0.05）, the content of IgM and IgA was no significant dif- ference （P 〉 0.05）. Conventional treatment can increase patients serum C3 levels （P 〈 0.01）, serum IgM and IgA, C4 con- tent had no obvious effect （P 〉 0.05）. IgA levels before and after treatment in treatment group comparison （P 〉 0.05）. Se- rum IgM and IgG, C3, C4 levels had significant difference （P 〈 0.05 - 0.01）. Treatment group and control group after treatment comparing IgA content comparison （P 〉 0.05）; Serum IgM and IgG, C3, C4 levels had significant difference （P 〈 0.05 - 0.01）. 2） The two groups after 3 months treatment, whole blood viscosity （low shear）, whole blood viscosity （high shear）, plasma viscosity, erythrocyte deposited, determination of fibrinogen （P 〈 0.05 - 0.01）. There is significant difference. The treatment group is more obvious. Basic close to healthy controls. 3） The control group before and after treatment of Estrogen, thromboxane B2, 6 - ketone - prostaglandins was compared, P 〉 0.05, no significant difference. Before and after the treatment way Estrogen, thromboxane B2, 6 - ketone - prostaglandins, P 〈 0.01, there are significant differences. Treatment group and control group after treatment of Estrogen, thromboxane B2, 6 - ketone - prostaglandins comparison, P 〈 0.01. There are significant differences. 4） 8 cases were cured in control group, accounting for 22.86%; Amputees 17 cases, accounting for 48.57%; Two years smoking again hair or aggravating 10 cases, accounting for 28.57%. The treatment group cure 82 cases, accounting for 98.79%; Without amputees; Smoking two years recurrence in 2 cases, accounting for 2.41%. Conclusion Combining traditional Chinese and western medicine treatment of thrombo- angiitis obliterans on blood viscosity, estrogen, thromboxane B2, 6 - ketone - prostaglandin changes is larger, the influ- ence of the base so that it is back to normal. High cure rate, low cost, to avoid amputation.