当归四逆汤加味联合西药治疗血栓闭塞性脉管炎临床研究  

Clinical Study on Modified Danggui Sini Tang Combined with Western Medicine for Thromboangiitis Obliterans

作　　者：寿怡 楼柏炀 SHOU Yi;LOU Boyang

机构地区：[1]杭州市拱墅区半山街道社区卫生服务中心,浙江杭州310022 [2]中国人民解放军联勤保障部队第903医院,浙江杭州310013

出　　处：《新中医》2021年第7期16-19,共4页New Chinese Medicine

摘　　要：目的:观察当归四逆汤加味联合西药治疗血栓闭塞性脉管炎(TAO)患者的临床疗效。方法:将90例TAO脉络寒凝证患者按随机数字表法分为观察组和对照组各45例,2组均给予阿司匹林肠溶片、盐酸尼卡地平片、前列地尔注射液治疗,疼痛难以忍受者服用布洛芬片。观察组加予当归四逆汤加味内服。2组疗程均为3个月。治疗前、治疗3个月后评定肢体发凉、肢体麻木、间歇性跛行、肢体颜色和静息痛5项主要症状、体征评分,评价踝肱指数(ABI),记录间歇性跛行距离。比较2组的临床疗效。结果:治疗后,观察组临床疗效优于对照组(P<0.05)。2组间歇性跛行距离均较治疗前增加(P<0.01),ABI均升高(P<0.01)。观察组间歇性跛行距离多于对照组(P<0.01),ABI高于对照组(P<0.01)。2组肢体发凉、肢体麻木、间歇性跛行、肢体颜色及静息痛评分均较治疗前降低(P<0.01),观察组上述5项评分均低于对照组(P<0.01)。结论:在常规西药治疗基础上加予当归四逆汤加味治疗TAO脉络寒凝证患者,可有效减轻临床症状、体征,提高临床治疗效果。Objective:To observe the clinical effect of modified Danggui Sini tang combined with western medicine for patients with thromboangiitis obliterans(TAO). Methods: A total of 90 cases of TAO patients with cold congealing in the collaterals syndrome were divided into the observation group and the control group according to the random number table method,45 cases in each group. Both groups were treated with aspirin enteric-coated tablets,nicardipine hydrochloride tablets and alprostadil injection, and patients with intolerable pain can take ibuprofen tablets. The observation group was additionally given oral administration of modified Danggui Sini tang. Both groups were treated for three months. Before treatment and after three-month treatment,the scores of the five main symptoms and signs including cold extremities,limb numbness,intermittent claudication,limb color and rest pain were evaluated,the ankle brachial index(ABI) was evaluated and intermittent claudication distance was recorded. The clinical effect was evaluated in the two groups. Results: After treatment, the clinical effect in the observation group was better than that in the control group(P<0.05). The intermittent claudication distances in the two groups were increased when compared with those before treatment(P<0.01),ABI were increased(P<0.01). The intermittent claudication distance in the observation group was more than that in the control group(P<0.01),ABI was higher(P<0.01). The scores of cold extremities,limb numbness,intermittent claudication,limb color and rest pain in the two groups were decreased when compared with those before treatment(P<0.01),and the above five scores in the observation group were lower than those in the control group(P<0.01). Conclusion: Based on routine western medicine treatment, the additional therapy of modified Danggui Sini tang for TAO patients with cold congealing in the collaterals syndrome can effectively relieve clinical symptoms and signs and improve clinical effect.

关 键 词：血栓闭塞性脉管炎 脉络寒凝证 当归四逆汤 踝肱指数 间歇性跛行距离 

分 类 号：R654.4[医药卫生—外科学]