辨证循经注射自体骨髓单个核细胞联合中药治疗下肢动脉缺血性疾病的临床研究  

Therapeutical effect of autologous bone marrow mononuclear cell injection along the meridians according to syndrome differentiation on ischemia in artery of lower extremity

作　　者：董建勋[1] 冯凯[2] 王伏声[1] 丁毅[1] 牛晓暐[1] 徐旭英[1] 康煜冬[1] 李勇[1] 吴珣[1] 

机构地区：[1]首都医科大学附属北京中医医院,北京100010 [2]中国人民解放军307医院

出　　处：《北京中医药大学学报》2007年第1期64-66,共3页Journal of Beijing University of Traditional Chinese Medicine

基　　金：北京市中医重点学科研究项目

摘　　要：目的观察辨证循经注射自体骨髓单个核细胞（Bone Marrow Mononuclear Cell，BM—MNC）对下肢缺血性疾病的治疗作用。方法选择42例严重下肢缺血患者。术前1周应用益气活血通脉中药，1周后抽取骨髓液，依密度梯度离心法提取单个核细胞；采用辨证循经的方法注射缺血肢体。术后在益气活血通脉方基础上，连服4—6周具有温阳、温经、通络作用的中药。观察手术前后踝肱指数（ankle／brachial index，ABI）、光电容积描记（photoplethysmography，PPG）、经皮氧分压（TcPO2）、经皮二氧化碳分压（TcPCO2）、痛感、冷感、创面生长愈合等情况，进而综合评价其疗效。结果注射1—2周后全部患者的临床症状均得到不同程度的改善，其中以静息痛、冷感改善较明显；2周后下肢膝关节下10cm处有不同程度的TcPO2升高和TcPCO2降低；4周后ABI有增加趋势；PPG波形亦有不同程度的改善；跛行距离延长；疮面愈合周期缩短。结论辨证循经注射自体骨髓单个核细胞联合中药对改善下肢缺血患者的临床症状及体征具有显著的作用。To observe the therapeutical effect of autologous bone marrow mononuclear cell injection along the meridians according to syndrome differentiation on ischemia in artery of lower extremity. Method Forty-two patients with ischemia in artery of lower extremity were given the formula with Chinese medicine of replenishing qi, activating blood and promoting blood circulation for 1 week. Then autologous bone marrow mononuclear cells got from patient by density gradient centrifugation were injected along the meridians in ischemic extremity of patient according to syndrome differentiation. The patients were given Chinese medicine of wanning yang, wanning meridians and unblocking collaterals on the basis of the previous formula for 4 to 6 weeks after injection. Before and after treatment, ankle/brachial index （ABI）, photoplethysmography（PPG）, transcutaneous arterial oxygen tension （TcPO2 ）, transcutaneous carbon dioxide tension（ TcPCO2 ）, and then the curative effect improved to different painful feeling, cold feeling , growth was evaluated synthetically. Results degree obviously. Two weeks after and healing of raw surface were observed The clinical symptoms of all patients were 1 to 2 weeks after injection and rest pain and cold feeling were improved more injection, TcPO2 increased and TcPCO2 decreased to some degree at 10 cm below articular genu. Four weeks after injection, there was tendency of increase in ABI, and the wave form of PPG was improved, and the limping distance was prolonged, and the healing cycle was shortened. Conclusion Autologous bone marrow mononuclear cell injection along the meridian according to syndrome differentiation has significant effect on improving clinical symptoms and signs of patients with ischemia in artery of lower extremity.

关 键 词：辨证 循经注射 骨髓单个核细胞 下肢缺血 

分 类 号：R654.4[医药卫生—外科学]