自拟脉痹方治疗糖尿病下肢动脉硬化闭塞症的临床研究:一项多中心回顾性分析  

Clinical study of Zinimaibi decoction in treatment of diabetic lower limb arteriosclerosis occlusion:a multicenter retrospective analysis

作　　者：关怿[1] 林丽珠 魏青 李萍[1] 王辉 代二庆[4] 樊春英 褚月颉[1] Guan Yi;Lin Lizhu;Wei Qing;Li Ping;Wang Hui;Dai Erqing;Fan Chunying;Chu Yuejie(Department of Diabetes,Tianjin Academy of Traditional Chinese Medicine Affiliated Hospital,Tianjin 300120,China;Nanhai Hospital of Southern Medical University,Foshan City,Guangdong Province,Foshan 528244,Guangdong,China;Second Affiliated Hospital of Tianjin University of Traditional Chinese Medicine(TCM),Tianjin 300150,China;Affiliated Hospital of Armed Police Logistics College,Tianjin 300162,China;Tianjin Heping District Hospital of TCM,Tianjin 300050,China)

机构地区：[1]天津市中医药研究院附属医院糖尿病科,300120 [2]广东省佛山市南方医科大学南海医院,广东佛山528244 [3]天津市中医药大学第二附属医院,300150 [4]武警后勤学院附属医院,天津300162 [5]天津市和平区中医医院,300050

出　　处：《中国中西医结合急救杂志》2019年第6期681-684,共4页Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care

摘　　要：目的观察自拟脉痹方治疗糖尿病下肢动脉硬化闭塞症(LASO)中医辨证为气虚血瘀型消渴合并早期脱疽患者的临床疗效.方法选择2017年1月至12月天津中医药研究院附属医院、天津中医药大学第二附属医院、武警后勤学院附属医院、天津市和平区中医医院收治的糖尿病LASO中医辨证为气虚血瘀型消渴合并早期脱疽患者127例,按随机数宇表法将患者分为中药治疗组(63例)和对照组(64例).最终中药治疗组纳入患者59例,对照组64例.两组患者均接受常规降糖调脂治疗;中药治疗组在常规治疗基础上口服自拟脉痹方(组成:黄蔑40 g、川穹15 g、当归10 g、赤芍15 g、桃仁10 g、红花10 g、地龙12 g、鸡血藤30 g、牛膝10 g、稀苍草30 g、木瓜20 g、玄参20 g、黄苹20 g、桔梗10 g),煎煮至400 mL,每日1剂,早晚餐后温服,连服3个疗程,每个疗程2周,共6周.观察两组治疗前后血脂、中医证候积分、踝肽指数(ABI)、临床疗效和安全性指标的变化;采用双下肢彩色多普勒检查下肢动脉狭窄情况.结果两组患者治疗后三酚甘油(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)均较治疗前明显降低,高密度脂蛋白胆固醇(HDL-C)较治疗前明显升高(均P<0.05);巨治疗后中药治疗组TC明显低于对照组(mmol/L:5.22±0.68比5.55±0.57,P<0.05).随时间延长,两组治疗后中医证候积分均逐渐降低,治疗6周时中药治疗组的中医证候积分明显低于对照组(分:16.68±4.93比19.00±5.79,P<0.05).中药治疗组临床总有效率明显高于对照组[76.27%(45/59)比43.75%(28/64),P<0.05].双下肢彩色多普勒检查显示,股总动脉变化分层为3对照组4例、中药治疗组5例,股总动脉变化分层为4对照组25例、中药治疗组30例,股总动脉变化分层为5对照组30例、中药治疗组18例,股总动脉变化分层为6对照组5例、中药治疗组6例.两组不同股总动脉变化程度患者数比较差异无统计学意义(Z=1.219,P=Objective To observe the clinical effect of Zinimaibi decoction in the treatment of patients with diabetic lower limb arteriosclerotic occlusion(LASO)accompanied by Qi deficiency and Blood stasis syndrome of Xiaoke and early stage gangrene according to the syndrome differentiation of traditional Chinese medicine(TCM).Methods One hundred and twenty-seven patients suffering from diabetic lower LASO accompanied by Qi deficiency and Blood stasis syndrome of Xiaoke with early stage gangrene in the syndrome differentiation of traditional Chinese medicine(TCM).They were all admitted to Tianjin Academy of TCM Affiliated Hospital,Second Affiliated Hospital of Tianjin University of TCM,Affiliated Hospital of Armed Police Logistics College,Tianjin Heping District Hospital of TCM from January to December 2017.According to the method of random number table,the patients were divided into a TCM treatment group(63 cases)and a control group(64 cases).Fifty-nine patients were included in the TCM treatment group and 64 patients were included in the control group,the patients in both groups were all treated with routine hypoglycemic and lipid-modulating treatments.On the basis of routine treatment,additionally the patients in TCM group took Zinimaibi decoction(composition:astragalus membranaceus 40 g,ligusticum chuanxiong 15 g,angelica sinensis 10 g,red peony 15 g,peach kernel 10 g,safflower 10 g,earthworm 12 g,caulis spatholobi 30 g,achyranthes bidentata 10 g,siegesbeckiae 30 g,papaya 20 g,scrophularia 20 g,scutellaria baicalensis 20 g,latycodon grandiflorum 10 g),the above ingredients were boiled in water to form 400 mL warm decoction,1 dose per day,orally taking twice a day,once 200 mL after breakfast and once 200 mL after dinner,taking 3 therapeutic courses,2 weeks constituting each course,and 6 weeks in total.The changes in levels of serum lipids,TCM syndrome scores,ankle brachial indexes(ABI),clinical effects and safety indexes before and after treatment in the two groups were observed;arterial stenosis in lower extremities we

关 键 词：自拟脉痹方 糖尿病 下肢动脉硬化闭塞症 临床研究 

分 类 号：R25[医药卫生—中医内科学]