加味黄芪桂枝五物汤治疗糖尿病性下肢动脉硬化闭塞症患者的疗效及对其血管内皮功能的影响  

Efficacy of Modified Huangqi Guizhi Wuwu Decoction on Treatment of Diabetic Ar-teriosclerosis Obliterans of Lower Extremity and Its Effect on Vascular Endothelial Func-tion

作　　者：杨泽慧 解子其 杜蔚青 李茜 高杰[1,2] YANG Zehui;XIE Zi-qi;DU Wei-qing;Li Xi;GAO Jie(Heilongjiang University of Chinese Medicine,Harbin Heilongjiang 150040;First Depatment of Peripheral Vascular Disease,First Afiliated Hospital,Heilongjiang Univesity of Chinese Medicine,Habin Heilongiang 150040;Second De-partment of Periphenl Vascul ar Diseases,First Afiliated Hospital,Heilongjiang Univesity of Chinese Medicine,Harbin Heilongjiang150040)

机构地区：[1]黑龙江中医药大学,黑龙江哈尔滨150040 [2]黑龙江中医药大学附属第一医院周围血管病一科,黑龙江哈尔滨150040 [3]黑龙江中医药大学附属第一医院周围血管病二科,黑龙江哈尔滨150040

出　　处：《世界中西医结合杂志》2024年第7期1371-1376,共6页World Journal of Integrated Traditional and Western Medicine

基　　金：2022年黑龙江省自然科学基金资助项目(LH2022H075);国家中医考试2022年科研课题(TC2022044);2022年黑龙江省中医药科研项目(ZHY2022-184);2023年黑龙江省教育科学规划重点课题(GJB1423477);2022年黑龙江省“双一流”学科协同创新成果建设项目(培育项目A档,LJGXCG2022-102);2022年黑龙江省卓越研究生培养模式改革创新项目(项目序号:36);黑龙江省双一流学科项目(21010);2022年度高等教育本科教育教学改革研究重点委托项目(SJGZ20220102)。

摘　　要：目的探讨加味黄芪桂枝五物汤治疗糖尿病性下肢动脉硬化闭塞症(Diabetes lower extremity arteriosclerosis obliterans,DLASO)患者的疗效及对其血管内皮功能的影响。方法选取2020年2月-2023年2月期间在黑龙江中医药大学附属第一医院就诊的气虚血瘀型DLASO患者102例,按随机数字表法分为对照组和观察组,每组各51例。对照组予以常规西医治疗,观察组在对照组基础上加用中药加味黄芪桂枝五物汤。治疗2个月后,观察比较两组患者临床疗效、不良反应情况,治疗前后的中医证候积分、下肢动脉血管影像学指标、血液流变学指标(全血高切黏度、全血低切黏度、血浆黏度和红细胞压积)、血脂指标[总胆固醇(Totalcholesterol,TC)、甘油三酯(Triglycerides,TG)、低密度脂蛋白胆固醇(Low-density lipoprotein cholesterol,LDL-C)、高密度脂蛋白胆固醇(High-density lipoprotein cholesterol,HDL-C)]。结果治疗后两组患者下肢麻木、皮温降低、间歇性跛行、静息痛评分及总积分均较治疗前明显降低,差异有统计学意义(P<0.05);且观察组中医证候评分及总积分均明显低于对照组,差异有统计学意义(P<0.05)。治疗后两组患者股动脉、腘动脉及胫后动脉内径较治疗前明显增加,股动脉左右两侧的血管内膜厚度较治疗前明显降低,斑块大小较治疗前明显缩小,差异有统计学意义(P<0.05);且观察组股动脉、腘动脉及胫后动脉内径值明显高于对照组,斑块明显小于对照组,差异有统计学意义(P<0.05)。但两组患者股动脉左右两侧的血管内膜厚度比较,差异无统计学意义(P>0.05)。治疗后两组患者TC、TG、LDL-C、全血高切黏度、全血低切黏度及血浆黏度均较治疗前明显降低,HDL-C及红细胞压积水平较治疗前明显升高,差异有统计学意义(P<0.05);且观察组TC、TG、LDL-C、全血高切黏度、全血低切黏度及血浆黏度水平低于对照组,HDL-C及红细胞压积水平�Objective To explore the efficacy of modified Huangqi Guizhi Wuwu Decoction in the treatment of diabetic arteriosclerosis obliterans of the lower extremity and its effect on vascular endothelial function.Methods A total of 102 cases of patients with diabetic arteriosclerosis obliterans of the lower extremity featuring Qi deficiency and blood stasis who visited the First Affiliated Hospital of Heilongjiang University of Chinese Medicine from February 2020 to February 2023 were selected as the research subjects.They were divided into a control group and an observation group using a random number table method,with 51 cases in each group.The control group was treated with conventional Western medicine,while the observation group was treated with Huangqi Guizhi Wuwu Decoction on the basis of the control group.After two-month treatment,the clinical efficacy,adverse reaction,traditional Chinese medicine(TCM)syndrome scores,arterial imaging indicators of the lower extremity,hemorheological indicators[whole blood high shear viscosity,whole blood low shear viscosity,plasma viscosity,and hematocrit],and blood lipid indicators[total cholesterol(TC),triglycerides(TG),low-density lipoprotein cholesterol(LDL-C),and high-density lipoprotein cholesterol(HDL-C)]were observed and compared before and after treatment between two groups.Results After treatment,the lower limb numbness,decreased skin temperature,intermittent claudication,resting pain score,and total score of the two groups of patients were significantly reduced,and the difference was statistically significant(P<0.05).The TCM syndrome score and total score in the observation group were significantly lower than those in the control group(P<0.05).After treatment,the inner diameters of the femoral artery,popliteal artery,and posterior tibial artery in the two groups of patients increased significantly.The thickness of the intima of the left and right femoral arteries decreased significantly,and the size of the plaque decreased significantly(P<0.05).The inner diameter values

关 键 词：糖尿病 下肢动脉硬化闭塞症 加味黄芪桂枝五物汤 气虚血瘀型 

分 类 号：R587.2[医药卫生—内分泌]