中药内服外用联合法舒地尔治疗老年下肢动脉硬化闭塞症临床研究

目的 探讨中药内服外用联合法舒地尔治疗老年下肢动脉硬化闭塞症(ASO)临床疗效及对患者踝臂指数(ABI)与血清C反应蛋白(CRP)、同型半胱氨酸(Hcy)的影响。 方法 对温州市中医院2016年8月—2018年8月收治的104例老年ASO患者展开研究,采取随机数字表法分为对照组与观察组,每组52例,对照组给予法舒地尔治疗;观察组在对照组的基础上联合中药四妙勇安汤内服外用,2组均治疗1个月。比较2组治疗前后ABI、CRP与Hcy的水平变化及足背动脉指标(血管内径、峰值流速及血流量),观察临床疗效和不良反应情况。 结果 观察组治疗总有效率高于对照组(94.23%vs. 76.92%,χ2=6.310,P=0.012);2组治疗后血流量、血管内径较治疗前显著升高,峰值流速降低(P<0.05);与对照组治疗后比较,观察组治疗后血管内径、血流量水平更高,峰值流速更低(P<0.05);2组治疗前的ABI、CRP及Hcy水平比较差异无统计学意义(P>0.05);2组治疗后的ABI、CRP及Hcy水平相比治疗前均有明显改善,且观察组治疗后ABI水平高于对照组,CRP及Hcy水平低于对照组(P<0.05);2组不良反应发生率(11.54%vs. 13.46%)比较,差异无统计学意义(χ2=0.088,P=0.767)。 结论 中药内服外用联合法舒地尔对老年ASO的疗效确切,有效抑制炎症反应,改善下肢血流量,提高踝臂指数并降低Hcy水平,无明显药物不良反应,属于一种有效的治疗方案。 

Clinical efficacy of oral and external use of traditional Chinese medicine combined with fasudil in treatment of lower extremity arteriosclerosis obliterans in elderly patients

Objective To investigate the Clinical efficacy of oral and external use of traditional Chinese medicine combined with fasudil in the treatment of lower extremity arteriosclerosis obliterans in elderly patients and its effect on ABI, serum CRP and Hcy. Methods One hundred and four elderly patients with lower extremity arteriosclerosis obliterans admitted to Wenzhou Hospital of Traditional Chinese Medicine from August 2016 to August 2018 were studied. They were randomly divided into control group and observation group, 52 cases in each group. The control group was treated with fasudil. The observation group was combined with traditional Chinese medicine Simiao Yongan Decoction on the basis of the control group.The two groups were treated for one month. The levels of ABI, CRP and Hcy before and after treatment were compared and analyzed. The indexes of dorsal pedal artery(vessel diameter, peak velocity and blood flow) were measured. The clinical efficacy and adverse reactions were observed. Results The total effective rate of the observation group was higher than that of the control group(94.23% vs. 76.92%, χ2=6.310, P=0.012). After treatment, the vessel diameter and blood flow of the two groups significantly increased, and the peak flow rate significantly decreased(P<0.05). Compared with the control group, the observation group had a higher level of blood vessel diameter and blood flow and a lower peak flow velocity(P<0.05).The levels of ABI, CRP and Hcy after treatment in the two groups were significantly improved compared with before treatment, and the ABI levels in the observation group were higher than those in the control group, while the levels of CRP and Hcy were lower than those in the control group(P<0.05). There was no significant difference in the incidence of adverse reactions between the two groups(11.54% vs. 13.46%, χ2=0.088, P=0.767). Conclusion The combination of oral and external use of traditional Chinese medicine and fasudil has definite curative effect on elderly ASO. It can effectively inhibit inflammation, improve blood flow of lower limbs, increase ankle-brachial index and reduce the level of Hcy. There is no obvious adverse drug reactions. It is an effective treatment program.