血管腔内治疗相关性胆固醇结晶栓塞的中西医结合分期分型辨治初探  

Preliminary study on classification and treatment of intravascular cholesterol crystallization embolization by integrated traditional Chinese and Western medicine

作　　者：陈明娅 鞠上[2] 张可人 王宁[2] 邓莉娟 周敏 Chen Mingya;Ju Shang;Zhang Keren;Wang Ning;Deng Lijuan;Zhou Min(The First Clinical School of Medicine,Beijing University of Chinese Medicine,Beijing 100020,China;Department of Peripheral Vascular,Dongzhimen Hospital,Beijing University of Chinese Medicine,Beijing 100010,China)

机构地区：[1]北京中医药大学第一临床医学院,北京100020 [2]北京中医药大学东直门医院周围血管科,北京100010

出　　处：《血管与腔内血管外科杂志》2024年第12期1418-1422,共5页Journal of Vascular and Endovascular Surgery

基　　金：国家重点研发计划项目(2019YFC1709302)。

摘　　要：目的探讨血管腔内治疗相关性胆固醇结晶栓塞(CCE)的中西医结合分期分型辨治情况。方法收集2022年6月至2024年11月于北京中医药大学东直门医院收治的15例血管腔内治疗相关性CCE患者的临床资料,均进行西医基础治疗及中医分型辨治,观察中西医结合治疗血管腔内治疗相关性CCE的疗效,提出符合血管腔内治疗相关性CCE的中西医结合分型分期辨治规律。结果治疗后,14例患者肢端皮肤改善,3例愈合,1例趋于愈合,1例于治疗2个月后行左膝下截肢。治疗后,红细胞沉降率、血清肌酐水平、嗜酸性粒细胞百分比、视觉模拟评分法(VAS)评分均低于治疗前,差异均有统计学意义(P﹤0.05)。结论血管腔内治疗相关性CCE是动脉硬化患者血管侵入性操作后的严重并发症,具有高病死率和致残率,通过中西医结合分型分期辨治,能够有效降低病情发展风险并改善预后。Objective To investigate the classification and treatment of intracavitary treatment related cholesterol crystallization embolization(CCE)in integrative Chinese and Western medicine.Method Clinical data of 15 patients with endovascular treatment-related CCE admitted to Dongzhimen Hospital,Beijing University of Chinese Medicine from June 2022 to November 2024 were collected.All patients were treated with basic Western medicine and Chinese medicine classification and treatment,and the efficacy of combined Chinese and Western medicine in the treatment of endovascular treatment-related CCE was observed.The rule of classification and staging of Chinese and Western medicine in accordance with endovascular treatment related CCE was proposed.Result After treatment,the skin of the extremities improved in 14 patients,healed in 3 cases,tended to heal in 1 case,and underwent lower left knee amputation in 1 case 2 months after treatment.After treatment,erythrocyte sedimentation rate,serum creatinine level,eosinophile percentage and visual analogue scale(VAS)score were all lower than those before treatment,with statistical significance(P<0.05).Conclusion Endovascular treatments-related CCE is a serious complication in patients with arteriosclerosis after vascular invasive operation,with a high mortality and disability rate.The classification and staging of integrated traditional Chinese and Western medicine can effectively reduce the risk of disease development and improve the prognosis.

关 键 词：胆固醇结晶栓塞 中医辨证 分期论治 中西医结合 

分 类 号：R543[医药卫生—心血管疾病]