摘要
目的探讨复原通络方治疗下肢动脉疾病支架植入治疗后再狭窄的临床疗效。方法收集2019年4月至2021年4月于上海中医药大学附属曙光医院就诊的90例下肢动脉疾病支架植入治疗后再狭窄患者的临床资料,按照治疗方法的不同将患者分为中药组和对照组,每组45例。对照组患者给予基础治疗和治疗后硫酸氢氯吡格雷片+阿司匹林肠溶片;中药组患者在对照组的基础上服用复原通络方。比较两组患者治疗后6个月的临床疗效,治疗前后的6分钟跛行距离、踝肱指数(ABI)、经皮氧分压(TcPO2)、肝肾功能指标[丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)、肌酐(Cr)、血尿素氮(BUN)]以及下肢动脉的内径、血流量。结果治疗后6个月,中药组患者的总有效率高于对照组患者,差异有统计学意义(P﹤0.05)。治疗前、治疗后1周、治疗后3个月、治疗后6个月,两组患者的6分钟跛行距离比较,差异均无统计学意义(P﹥0.05)。治疗前、治疗后1周,两组患者的ABI比较,差异均无统计学意义(P﹥0.05);治疗后3、6个月,中药组患者的ABI、TcPO2均高于对照组患者,差异均有统计学意义(P﹤0.05)。治疗后1周,两组患者股动脉内径、胫后动脉内径和足背动脉内径比较,差异均无统计学意义(P﹥0.05);治疗后3、6个月,中药组患者的股动脉内径较对照组增宽,差异有统计学意义(P﹤0.05);治疗后3、6个月,两组患者胫后动脉、足背动脉内径比较,差异均无统计学意义(P﹥0.05)。治疗后1周,中药组患者股动脉、胫后动脉、足背动脉的血流量均较对照组无明显增加,差异均无统计学意义(P﹥0.05);治疗后3、6个月,中药组患者股动脉、胫后动脉、足背动脉的血流量均较对照组患者增加,差异均有统计学意义(P﹤0.05)。两组患者治疗前和治疗后6个月的ALT、AST、BUN、Cr水平比较,差异均无统计学意义(P﹥0.05)。结论复原通络方能够缓解下肢动脉疾病支架植入治疗后再狭窄患者的临床症状,改善患者的下肢血管功能,降低再狭窄的发生率。
Objective To investigate the clinical efficacy of fuyuan tongluo prescription in the treatment of restenosis after stent implantation for lower extremity arterial disease.Method The clinical data of 90 patients with restenosis after stent implantation treatment for lower extremity arterial diseases who were treated at Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine from April 2019 to April 2021 were collected.The patients were divided into traditional Chinese medicine group and control group according to different treatment methods after the treatment,with 45 cases in each group.Patients in the control group were given basic treatment and post-treatment clopidogrel bisulfate tablets+aspirin enteric-coated tablets.Patients in the traditional Chinese medicine group took Fuyuan Tongluo prescription based on the control group.The clinical efficacy of the two groups of patients 6 months after treatment was compared.The 6-minute claudication distance,ankle brachial index(ABI),transcutaneous oxygen tension(TcPO2),liver and kidney function indicators[alanine transaminase(ALT),aspartate transaminase(AST),creatinine(Cr),blood urea nitrogen(BUN)],and the inner diameter and blood flow of lower extremity arteries were also compared between the two groups before and after the treatment.Result Six months after the treatment,the total effective rate of patients in the traditional Chinese medicine group was higher than that of patients in the control group,and the difference was statistically significant(P<0.05).There were no statistically significant difference in the 6-minute claudication distance between the two groups of patients before,one week,three months,and six months after the treatment(P>0.05).There was no statistically significant difference in the ABI between the two groups of patients before and one week after the treatment(P>0.05).Three and six months after the treatment,the ABI and TcPO2 of the patients in the traditional Chinese medicine group were higher than those of the patients in the control group,and the differences were statistically significant(P<0.05).There were no statistically significant difference in the inner diameter of the femoral artery,posterior tibial artery,and dorsalis pedis artery between the two groups of patients one week after treatment(P>0.05).Three and six months after the treatment,the inner diameter of the femoral artery of the patients in the traditional Chinese medicine group was wider than that of the control group,and the difference was statistically significant(P<0.05).Three and six months after the treatment,there were no statistically significant difference in the inner diameter of the posterior tibial artery and dorsalis pedis artery between the two groups of patients(P>0.05).After one week of treatment,the blood flow of the femoral artery,posterior tibial artery and dorsalis pedis artery in the traditional Chinese medicine group did not significantly increase compared to the control group,and the difference were not statistically significant(P>0.05).After 3 and 6 months of treatment,the blood flow of the femoral artery,posterior tibial artery,and dorsalis pedis artery in the Chinese medicine group patients increased compared to the control group patients,and the differences were statistically significant(P<0.05).There was no statistically significant difference in the levels of ALT,AST,BUN,and Cr between the two groups of patients before and six months after the treatment(P>0.05).Conclusion Fuyuan tongluo prescription could alleviate the clinical symptoms of patients with restenosis after stent implantation for lower extremity arterial disease,improve their lower extremity vascular function,and reduce the incidence of restenosis.
作者
杜玉青
柳国斌
王宏飞
王徐红
黄仁燕
樊炜静
Du Yuqing;Liu Guobin;Wang Hongfei;Wang Xuhong;Huang Renyan;Fan Weijing(Department of Vascular Surgery,Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 200032,China)
出处
《血管与腔内血管外科杂志》
2023年第12期1420-1425,共6页
Journal of Vascular and Endovascular Surgery
基金
国家自然科学基金面上项目(82274528)。
关键词
复原通络方
下肢动脉疾病
支架植入
再狭窄
临床疗效
fuyuan tongluo prescription
lower extremity arterial disease
stent implantation
restenosis
clinical efficacy
