消栓通络胶囊联合氯吡格雷治疗动脉硬化闭塞症的临床研究

目的探讨消栓通络胶囊联合硫酸氢氯吡格雷片治疗动脉硬化闭塞症的临床疗效。方法选取2017年1月—2017年12月在复旦大学附属中山医院青浦分院确诊并接受治疗的112例动脉硬化闭塞症患者为研究对象,将所有患者随机分为对照组和治疗组,每组各56例。对照组患者口服硫酸氢氯吡格雷片,1片/次,1次/d。治疗组在对照组基础上口服消栓通络胶囊,6粒/次,3次/d。两组患者均持续治疗2个月。观察两组的临床疗效,比较两组血流动力学、最大行走距离、血脂指标、炎症因子水平。结果治疗后,对照组和治疗组的总有效率分别为80.36%、94.64%,两组比较差异具有统计学意义(P0.05)。治疗后,两组患者踝肱指数、腘动脉最大血流速度、足背动脉血流量、最大行走距离均明显上升,同组治疗前后比较差异有统计学意义(P0.05);且治疗后治疗组各指标明显高于对照组,两组患者治疗后的差异有统计学意义(P0.05)。治疗后,两组患者低密度脂蛋白胆固醇(LDL-C)、总胆固醇(TC)、低切全血黏度、高切全血黏度、纤维原蛋白水平显著下降,同组治疗前后比较差异有统计学意义(P0.05);且治疗组的血脂指标显著低于对照组,两组比较差异有统计学意义(P0.05)。治疗后,治疗组高敏C反应蛋白(hs-CRP)、白细胞介素-1(IL-1)、白细胞介素-6(IL-6)、细胞间黏附分子-1(ICAM-1)水平均显著降低,同组治疗前后比较差异有统计学意义(P0.05);且治疗组炎症因子水平明显低于对照组,两组比较差异有统计学意义(P0.05)。结论消栓通络胶囊联合硫酸氢氯吡格雷片治疗动脉硬化闭塞症具有较好的临床疗效,可改善血流动力学,调节血脂指标和炎症因子水平,增加最大行走距离,具有一定的临床推广应用价值。

Clinical study on Xiaoshuan Tongluo Capsules combined with clopidogrel in treatment of atherosclerosis obliterans

Objective To investigate the clinical efficacy of Xiaoshuan Tongluo Capsules combined with Clopidogrel Hydrogen Sulphate Tablets in treatment of atherosclerosis obliterans. Methods Patients (112 cases) with atherosclerosis obliterans in Qingpu Branch of Zhongshan Hospital Affiliated to Fudan University from January 2017 to December 2017 were randomly divided into control and treatment groups, and each group had 56 cases. Patients in the control group were po administered with Clopidogrel Hydrogen Sulphate Tablets, 1 tablet/time, once daily. Patients in the treatment group were po administered with Xiaoshuan Tongluo Capsules on the basis of the control group, 6 grains/time, three times daily. Patients in two groups were treated for 2 months. After treatment, the clinical efficacies were evaluated, and hemodynamics, maximum walking distance, blood lipid indexes, and the levels of inflammatory factors in two groups were compared. Results After treatment, the clinical efficacies in the control and treatment groups were 80.36% and 94.64%, respectively, and there was difference between two groups (P<0.05). After treatment, ankle brachial index, popliteal artery maximum blood flow velocity, dorsalis pedis artery blood flow, and maximum walking distance in two groups were significantly increased, and the difference was statistically significant in the same group (P<0.05). And the observational indexes in the treatment group were significantly higher than those in the control group, with significant difference between two groups (P<0.05). After treatment, the levels of LDL-C, TC, low whole blood viscosity, high whole blood viscosity, and fibrinogen in two groups were significantly decreased, and the difference was statistically significant in the same group (P<0.05). And the blood lipid indexes in the treatment group were significantly lower than those in the control group, with significant difference between two groups (P<0.05). After treatment, the levels of hs-CRP, IL-1, IL-6, and ICAM-1 in two groups were significantly decreased, and the difference was statistically significant in the same group (P<0.05). And the levels of inflammatory factors in the treatment group were significantly lower than those in the control group, with significant difference between two groups (P<0.05). Conclusion Xiaoshuan Tongluo Capsules combined with Clopidogrel Hydrogen Sulphate Tablets has clinical curative effect in treatment of atherosclerosis obliterans, can improve hemodynamics, regulate blood lipid index and inflammatory factor level, and increase the maximum walking distance, which a certain clinical application value.