基于彩色多普勒超声评价针刺联合曲美他嗪治疗冠状动脉造影相关桡动脉损伤的疗效  

Effect of acupuncture combined with trimetazidine in treatment of radial artery injury related to coronary angiography based on color doppler ultrasound

作　　者：南明花 李爽 焦晓民[1] 白长川 NAN Minghua;LI Shuang;JIAO Xiaomin;BAI Changchuan(The Second Affiliated Hospital of Liaoning University of Traditional Chinese Medicine,Shenyang,Liaoning 110000,China)

机构地区：[1]辽宁中医药大学附属第二医院,辽宁沈阳110000

出　　处：《上海中医药杂志》2022年第12期57-60,共4页Shanghai Journal of Traditional Chinese Medicine

基　　金：辽宁省中医药特色人才培养项目(辽中医药综合字[2021]38号)。

摘　　要：目的基于彩色多普勒超声观察针刺联合曲美他嗪治疗冠状动脉造影相关桡动脉损伤的临床疗效。方法纳入冠状动脉造影相关桡动脉损伤患者86例,随机分为对照组和治疗组,每组各43例。所有纳入患者均行经桡动脉造影术,术后给予曲美他嗪口服;在此基础上,治疗组患者术后给予针刺治疗。两组治疗周期均为15 d。治疗15 d后评价所有患者的临床疗效;治疗前(术后当天)及治疗后(治疗15 d后),运用彩色多普勒超声仪器检测所有患者的桡动脉血管内径、舒张末期血流速度(EDV)、收缩期最大血流速度(PSV)、阻力指数(RI)、搏动指数(PI);于治疗前及治疗后,检测所有患者的凝血酶原时间(PT)及活化部分凝血活酶时间(APTT);研究过程中,观察并记录两组患者的并发症发生情况,计算并发症发生率。结果(1)治疗后,治疗组的总有效率为90.70%,对照组的总有效率为74.42%,治疗组的临床疗效优于对照组(P<0.05)。(2)治疗后,两组患者的桡动脉血管内径较治疗前明显增大(P<0.05),且治疗组患者的桡动脉血管内径较对照组亦明显增大(P<0.05);两组患者的桡动脉EDV、PSV较治疗前均明显加快(P<0.05),桡动脉血流RI、PI较治疗前均明显减小(P<0.05),且治疗组患者的桡动脉EDV、PSV较对照组亦明显加快(P<0.05),桡动脉血流RI、PI较对照组明显减小(P<0.05)。(3)治疗后,两组患者的PT、APTT较治疗前均明显延长(P<0.05),且治疗组患者的PT、APTT较对照组亦明显延长(P<0.05)。(4)治疗组患者的并发症发生率为11.63%,对照组为37.21%,治疗组的并发症发生率明显低于对照组(P<0.05)。结论针刺联合曲美他嗪治疗能够有效提高冠状动脉造影术后桡动脉的血管弹性,加快桡动脉的血流速度,抑制血栓形成,缓解血管痉挛,从而降低桡动脉管腔狭窄及闭塞等并发症的发生率,提高临床疗效。ObjectiveTo observe the efficacy of acupuncture combined with trimetazidine in the treatment of radial artery injury related to coronary angiography based on color doppler ultrasound.MethodsA total of 86 patients with radial artery injury related to coronary angiography were included and randomly divided into the control group and the treatment group,43 cases in each group.All the included patients were treated with transradial artery angiography,and were orally treated with trimetazidine after operation.Based on above,the patients in the treatment group were treated with acupuncture after operation.The treatment course of the two groups was 15 days.The clinical effect was evaluated after 15 days of treatment.Before(on the day after operation)and after treatment(after 15 days of treatment),the radial artery internal diameter,end diastolic velocity(EDV),peak systolic velocity(PSV),resistance index(RI)and pulsatility index(PI)were detected by doppler ultrasound instrument.Before and after treatment,the prothrombin time(PT)and activated partial thromboplastin time(APTT)were detected.In the course of treatment,the complications were observed and recorded,and the incidence of the complications was calculated.Results treatment group and the control group were 90.70%and 74.42%respectively,and the effect of the treatment group was better than that of the control group(P<0.05).(2)After treatment,the radial artery internal diameter in the two groups was significantly increased compared with that before treatment(P<0.05),and the radial artery internal diameter of the treatment group was obviously greater than that of the control group(P<0.05);the EDV and PSV of radial artery in the two groups were significantly accelerated compared with those before treatment(P<0.05),the RI and PI of radial artery blood flow were significantly decreased compared with those before treatment(P<0.05),and the EDV and PSV of radial artery in the treatment group were obviously faster than those in the control group(P<0.05),the RI and PI of radial

关 键 词：冠状动脉造影 桡动脉损伤 针刺 曲美他嗪 彩色多普勒超声 

分 类 号：R541.4[医药卫生—心血管疾病] R445.1[医药卫生—内科学]