脉络舒通丸联合低分子肝素、地塞米松在血栓闭塞性脉管炎中的应用效果  

Application effect of Mailuo Shutong Pills combined with low molecular weight heparin and Dexamethasone in the treatment of thromboangitis obliterans

作　　者：周和成 赵小琴 谢青 吴邓中 刘智华 ZHOU Hecheng;ZHAO Xiaoqin;XIE Qing;WU Dengzhong;LIU Zhihua(General Surgery Ward One,Yingtan People's Hospital,Jiangxi Province,Yingtan 335000,China;Injection Room,Yingtan People's Hospital,Jiangxi Province,Yingtan 335000,Chin)

机构地区：[1]江西省鹰潭市人民医院普外一病区,江西鹰潭335000 [2]江西省鹰潭市人民医院门诊注射室,江西鹰潭335000

出　　处：《中国当代医药》2024年第29期35-40,共6页China Modern Medicine

基　　金：江西省卫生健康委科技计划项目(202410798)。

摘　　要：目的观察脉络舒通丸联合低分子肝素、地塞米松用于治疗血栓闭塞性脉管炎(TAO)的临床疗效及机制研究。方法选取2018年2月至2023年2月就诊于鹰潭市人民医院的80例TAO患者作为研究对象,采用信封法随机分为参照组(40例)和联合组(40例)。参照组采用皮下注射低分子肝素钙注射液(38 U/kg,qd)+静脉滴注地塞米松磷酸钠注射液(10 mg,qd),联合组采用联合口服脉络舒通丸(36.0 g,1瓶/次,tid)。所有患者均连续治疗14 d。比较治疗14 d后两组的Rutherford分级分布和治疗效果,比较治疗7、14 d后凝血酶时间(TT)、凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、纤维蛋白原(FIB),血清血栓素B2(TXB2)、血小板活化因子(PAF)、6-酮-前列腺素F1α(6-k-PGF1α),白细胞介素(IL)-1β、IL-6、IL-17、肿瘤坏死因子-α(TNF-α)水平及内皮素-1(ET-1)、一氧化氮(NO)、血管内皮生长因子(VEGF)水平。结果联合组治疗14 d后Rutherford分级分布情况优于参照组,联合组总有效率高于参照组,差异有统计学意义(P<0.05);两组治疗7、14 d后TT、PT、APTT、6-k-PGF1α、NO均高于本组治疗前,且联合组高于参照组,差异有统计学意义(P<0.05);两组治疗7、14 d后FIB、TXB2、PAF,IL-1β、IL-6、IL-7、TNF-α水平及ET-1、VEGF水平均低于本组治疗前,且联合组低于参照组,差异有统计学意义(P<0.05)。两组的不良反应总发生率比较,差异无统计学意义(P>0.05)。结论脉络舒通丸和低分子肝素、地塞米松可以显著提升TAO治疗效果,调节患者的凝血功能并改善内皮功能,抑制炎症反应,从而保护血管及促进血液循环。Objective To observe the clinical effects and mechanism of Mailuo Shutong Pills combined with low molecular weight heparin and Dexamethasone in the treatment of thromboangitis obliterans(TAO).Methods A total of 80 TAO pa-tients admitted to Yingtan People's Hospital from February 2018 to February 2023 were selected as the study objects,and randomly divided into reference group(40 cases)and combination group(40 cases)by envelope method.The reference group was treated with subcutaneous injection of low molecular weight heparin calcium injection(38 U/kg,qd)and intravenous in-fusion of Dexamethasone Sodium Phosphate Injection(10 mg,qd).On this basis,the combination group was treated with oral Mailuo Shutong Pills(36.0 g,1 bottle/time,tid).All patients received 14 d of continuous treatment.After 14 d of treatment,the distribution of Rutherford grades and therapeutic effects were observed.After 7 and 14 d of treatment,thrombin time(TT),prothrombin time(PT),activated partial thromboplastin time(APTT),the levels of fibrinogen(FIB),serum thromboxane B2(TXB2),platelet activating factor(PAF),6-keto-prostaglandin F1α(6-k-PGF1α),interleukin(IL)-1β,IL-6,IL-17,tumor necrosis factor-α(TNF-α),endothelin-1(ET-1),nitric oxide(NO),and vascular endothelial growth factor(VEGF)were detected.Results After 14 days of treatment,the Rutherford grading distribution in combination group was better than that in reference group,and the total effective rate in com-bination group was higher than that in reference group,the differences were statistically significant(P<0.05).After 7 and 14 days of treatment,TT,PT,APTT,6-k-PGF1αand NO in the two groups were higher than before treatment,and the combination group were higher than those of the reference group,the differences were statistically significant(P<0.05).Af-ter 7 and 14 days of treatment,the levels of FIB,TXB2,PAF,IL-1β,IL-6,IL-7,TNF-α,ET-1 and VEGF in the two groups were lower than before treatment,and the combination group were lower than those of the reference group,with sta-tistica

关 键 词：血栓闭塞性脉管炎 脉络舒通丸 低分子肝素 地塞米松 

分 类 号：R259[医药卫生—中西医结合]