自拟温肾通脉汤对阳虚寒凝型闭塞性动脉硬化症肢体缺血改善的疗效和护理观察  

Effect and Nursing Observation of Wenshen Tongmai Decoction on Improving Limb Ischemia for Yang deficiency and Cold-coagulation Type ASO

作　　者：廖春梅[1] LIAO Chunmei(Luzhou Municipal Traditional Chinese Medicine Hospital,Luzhou Sichuan 646000,China)

机构地区：[1]泸州市中医医院,四川泸州646000

出　　处：《四川中医》2020年第9期212-216,共5页Journal of Sichuan of Traditional Chinese Medicine

摘　　要：目的:探讨自拟温肾通脉汤对阳虚寒凝型闭塞性动脉硬化症患者肢体缺血改善情况的疗效观察和护理。方法:选择我院收治的57例阳虚寒凝型闭塞性动脉硬化症患者随机分为对照组(n=28)和观察组(n=29)例,对照组采用常规治疗护理措施,治疗组在对照组治疗护理基础上加用自拟温肾通脉汤熏蒸治疗,同时结合中医理论进行辨证护理;观察记录两组患者治疗前及治疗第一周、第二周及第三周患者患肢疼痛评分、跛行评分、皮肤温度评分、麻木评分;并记录两组患者患肢治疗前后行血管彩色多普勒超声检查,观察血管管腔直径的改变及两组患者治疗前后药物不良反应比较。结果:本研究结果显示两组患者治疗方法与时间在静息疼痛VAS评分、跛行距离或跛行时间、皮肤温度及麻木评分上存在交互作用(P≤0.05);治疗方法在静息疼痛VAS评分、跛行距离或跛行时间、皮肤温度及麻木评分上主效应显著(P≤0.05);时间在静息疼痛VAS评分、跛行距离或跛行时间评分、皮肤温度评分及麻木评分上主效应显著(P≤0.05);其中干预第1个疗程后患者静息疼痛VAS评分、跛行距离或跛行时间评分及皮肤温度评分无差异(P>0.05),第二、三疗程后观察组患者静息疼痛VAS评分较对照组明显降低(P≤0.05);干预第一、二疗程后观察组患者麻木评分较对照组无差异(P>0.05),第三疗程后观察组患者麻木评分较对照组明显降低(P≤0.05);观察组患者治疗前后股动脉、腘动脉、胫后动脉管腔直径对比显示股动脉管径治疗前后及组间比较差异不明显,差异无统计学意义(P>0.05);观察组治疗后腘动脉、胫后动脉管径扩张明显(P≤0.05),且观察组改善情况优于对照组(P≤0.05),差异有统计学意义。结论:护理配合自拟温肾通脉汤对阳虚寒凝型闭塞性动脉硬化症患者肢体缺血改善具有较好的作用。Objective: To explore the effect of Self-made Wenshen Tongmai Decoction on improving limb ischemia for patients with Yang deficiency and cold coagulation type of ASO. Methods: 57 patients with Yang-deficiency and cold-coagulation type ASO were randomly divided into a controlled group(n=28) and an observation group(n=29). The controlled group was given routine treatment and nursing measures, while the treatment group was fumigated with Self-made Wenshen Tongmai Decoction on the basis of the treatment and nursing of the controlled group. At the same time, combined with traditional Chinese medicine theory, differential nursing was observed and recorded before treatment and after treatment. The pain score, limp score, skin temperature score and numbness score of the affected limbs in the first week, the second week and the third week of treatment were recorded. The changes of vascular lumen diameter were observed by color Doppler ultrasound before and after treatment. The adverse drug reactions of the two groups were compared before and after treatment. Results: The results showed that there was interaction between treatment methods and time on resting pain VAS score, limping distance or limping time, skin temperature and numbness score(P<0.05). The main effect of treatment methods on resting pain VAS score, limping distance or limping time, skin temperature and numbness score was significant(P<0.05), time on resting pain VAS score, limping distance and numbness score was significant(P<0.05), time on resting pain VAS score, limping distance was significant(P<0.05). There was no significant difference in VAS score, limp distance or limp time score and skin temperature score after the first course of intervention(P>0.05). The VAS score of patients in the observation group was significantly lower than that in the controlled group after the second and third courses of treatment(P<0.05). There was no difference in numbness score between the observation group and the controlled group(P>0.05), but the numbness score of the

关 键 词：温肾通脉汤 熏蒸 阳虚寒凝 闭塞性动脉硬化症 缺血 护理 

分 类 号：R248.1[医药卫生—中医临床基础]