甘草附子汤加味治疗脉络寒凝症血栓闭塞性脉管炎患者的临床观察  

Clinical Effect of Modified Gancao Fuzi Decoction on Thromboangiitis Obliterans of Cold Coagulation in Vein

作　　者：徐洪涛 许永城 杨建飞 李骥 曹烨民 XU Hong-tao;XU Yong-cheng;YANG Jian-fei;LI Ji;CAO Ye-min(Vascular Department,Shanghai Integrated Traditional Chinese and Western Medicine Hospital,Shanghai 200082)

机构地区：[1]上海中医药大学附属上海市中西医结合医院脉管科,上海200082

出　　处：《世界中西医结合杂志》2023年第11期2259-2263,共5页World Journal of Integrated Traditional and Western Medicine

基　　金：上海市进一步加快中医药传承创新发展三年行动计划[ZY(2021-2023)-0302];上海市临床重点专科建设项目(中医专业);华东片区及市级中医专科专病联盟建设[ZY(2021-2023)-0303];国家自然科学基金资助项目(82174382)。

摘　　要：目的观察上海市名中医曹烨民教授经验方甘草附子汤加味治疗脉络寒凝症血栓闭塞性脉管炎(Thromboangiitis obliterans,TAO)的临床疗效。方法选取2020年6月—2021年12月期间上海中医药大学附属上海市中西医结合医院脉管科门诊或住院收治的血栓闭塞性脉管炎患者60例,按随机数字表法分为对照组和治疗组,每组各30例。对照组在常规基础治疗上采用贝前列素钠片,治疗组在对照组基础上采用甘草附子汤加味。治疗4周后,观察比较两组患者临床疗效、不良反应,治疗前后中医证候评分、实验室检查指标[C-反应蛋白(C-reactiveprotein,CRP)、雌激素、纤维蛋白原(Fibrinogen,FIB)、踝肱指数(Ankle brachial index,ABI)]。结果治疗后治疗组临床总有效率93.33%(28/30)明显高于对照组76.67%(23/30),差异有统计学意义(P<0.05)。治疗后两组患者中医证候间跛评分、肢体皮肤发凉评分、肢体酸胀评分、皮肤温度评分均较治疗前明显改善,差异有统计学意义(P<0.05);且治疗组中医证候间跛评分、肢体皮肤发凉评分、肢体酸胀评分、皮肤温度评分均明显优于对照组,差异有统计学意义(P<0.05)。治疗后两组患者CRP、FIB指标均较治疗前降低,差异有统计学意义(P<0.05);且治疗组CRP、FIB指标均较对照组明显降低,差异有统计学意义(P<0.05)。治疗期间,两组患者不良反应发生率比较,差异无统计学意义(P>0.05)。结论经验方甘草附子汤加味治疗脉络寒凝症血栓闭塞性脉管炎安全、有效,可显著改善患者临床症状,降低炎症反应及高凝状态,值得临床推广。Objective To study the clinical effect of modified Gancao Fuzi Decoction,an empirical formula developed by famous traditional Chinese medicine professor Cao Yemin from Shanghai for the treatment of thromboangiitis obliterans of cold coagulation in vein.Methods From June 2020 to December 2021,60 patients diagnosed with thromboangiitis obliterans or hospitalized in Vascular Department,Shanghai Integrated Traditional Chinese and Western Medicine Hospital were selected and divided into a control group and a treatment group according to the random number table,30 in each group.The control group received Beprost Sodium Tablets on the conventional basic treatment,while the treatment group was treated with modified Gancao Fuzi Decoction on the basis of the control group.After 4 weeks of treatment,the clinical effects,adverse reactions,and the traditional Chinese medicine symptom scores,and laboratory test indicators[C-reactive protein(CRP),estrogen,fibrinogen(FIB),ankle brachial index(ABI)]before and after treatment were compared between the two groups.Results After treatment,the total effective rate(93.33%,28/30)of the treatment group was higher than that(76.67%,23/30)of the control group(P<0.05),and the improvement effect of the treatment group in intermittent claudication,limb skin coolness,limb soreness,skin temperature,CRP and fibrinogen was better than that of the control group(P<0.05).The two groups had decreased CPR and FIB after treatment compared with the conditions before treatment,with the treatment group having more decrease(P<0.05),while there was no difference in adverse reactions between the two groups during treatment(P>0.05).Conclusion Modified Gancao Fuzi Decoction is safe and effective in the treatment of thromboangiitis obliterans of cold coagulation in vein.It significantly improves the clinical symptoms of patients and reduces inflammatory reaction and hypercoagulability,which is worthy of clinical promotion.

关 键 词：甘草附子汤 血栓闭塞性脉管炎 脉络寒凝症 

分 类 号：R364.15[医药卫生—病理学]