扶正祛邪通脉法联合西医常规治疗多发性大动脉炎72例临床观察  

Clinical observation of the principle of strengthening body resistance to eliminate pathogenic factors and promote blood circulation combined with western routine therapy on polyarteritis

作　　者：李振刚[1] 魏英杰[1] 李晓波[1] 雷小明[1] 郝占峰[1] 左爱欣[1] 

机构地区：[1]河北省石家庄长城中西医结合医院周围血管科,河北石家庄050035

出　　处：《河北中医》2016年第8期1179-1183,共5页Hebei Journal of Traditional Chinese Medicine

摘　　要：目的观察扶正祛邪通脉法联合西医常规治疗多发性大动脉炎(头臂干动脉为主)的临床疗效。方法选取石家庄长城中西医结合医院周围血管科2013-10—2014-12收治的72例多发性大动脉炎(头臂干动脉病变为主)的患者进行临床观察。以入选的72例患者入院前病情作对照,入院后在原有西医治疗基础上加用扶正祛邪通脉中药口服,入院时及治疗4周后对血管超声、红细胞沉降率(ESR)、C反应蛋白(CRP)、纤维蛋白原(FIB)及治疗前后症状阳性率比较观察分析。结果血管彩超方面,治疗前颈动脉狭窄率为(84.35±4.77)%,治疗后为(50.55±6.04)%,治疗前后比较差异有统计学意义(P<0.05);治疗后残存管腔内径、血管内膜厚度均改善(P<0.05)。免疫指标方面,治疗前ESR为(40.68±22.52)mm/1 h,治疗后ESR为(15.08±9.79)mm/1h;治疗前CRP为(21.38±16.96)mg/L,治疗后CRP为(5.54±4.40)mg/L;治疗前FIB为(4.14±1.26)g/L,治疗后FIB为(2.63±0.70)g/L,治疗前后免疫指标比较差异均有统计学意义(P<0.05)。治疗后患者头晕、视物模糊、乏力、发热及颈部疼痛不适等较前明显缓解(P<0.05),颈动脉杂音、颈动脉搏动、桡动脉搏动情况治疗前后比较差异无统计学意义(P>0.05)。治疗过程中监测肝肾功能未见异常,未曾出现出血、股骨头坏死等不良事件。结论扶正祛邪通脉法联合西医常规治疗多发性大动脉炎可以缓解患者不适症状,改善患者生活质量,控制免疫炎症活动,改善血管狭窄,同时可以减少激素及免疫抑制剂引起的不良反应。Objective To observe the clinical effects of the principle of strengthening body resistance to eliminate pathogenic factors and promote blood circulation combined with western routine therapy on polyarteritis（ mainly to brachiocephalic trunk）. Methods 72 patients with polyarteritis from October 2013 to December 2014 were observed. All patients after admission were treated by decoction of strengthening body resistance to eliminate pathogenic factors and promote blood circulation on the basis of the original western medicine,and then compared with pre- admission conditions. The vascular ultrasound,erythrocyte sedimentation rate（ ESR）,C- reactive protein（ CRP）,fibrinogen（ FIB） before admission and 4 week after treatment were observed,as well as the positive rates of symptoms. Results The carotid artery stenosis rate before and after treatment was（ 84. 35 ± 4. 77） % and（ 50. 55± 6. 04） % respectively,with statistical differences（ P〈0. 05）. The ESR before and after treatment was（ 40. 68 ±22. 52） mm /1 h and（ 15. 08 ± 9. 79） mm /1 h respectively,with statistical differences（ P〈0. 05）. The CRP before and after treatment was（ 21. 38 ± 16. 96） mg / L and（ 5. 54 ± 4. 40） mg / L respectively,and the FIB was（ 4. 14 ±1. 26） g / L and（ 2. 63 ± 0. 70） g / L respectively,with statistical differences（ P〈0. 05）. The symptoms of dizzy,blurred vision,weak,fever and cervical pain after treatment were markedly improved（ P〉0. 05）. There were no statistical differences on carotid murmur,carotid pulsation and arterial pulse wave before and after treatment（ P〈0. 05）. There were no abnormal in liver and kidney function during treatment,and without the adverse events of bleeding and femoral head necrosis,etc. Conclusion The principle of strengthening body resistance to eliminatepathogenic factors and promote blood circulation combined with western routine therapy can relieve the uncomfortable symptom in patients with polyarteritis,improve quality of life,c

关 键 词：TAKAYASU动脉炎 中西医结合疗法 

分 类 号：R543.105.8[医药卫生—心血管疾病]