复原通络方防治下肢动脉硬化闭塞症介入术后再狭窄脉络瘀阻证的临床疗效  

Clinical Efficacy of Fuyuan Tongluo Prescription in Prevention and Treatment of Restenosis with Collateral Obstruction Syndrome After Interventional Operation of Lower Limb Arteriosclerosis Obliterans

作　　者：吴芳芳 李晓宇 柳国斌[1] 王宏飞 樊炜静 黄仁燕 WU Fangfang;LI Xiaoyu;LIU Guobin;WANG Hongfei;FAN Weijing;HUANG Renyan(Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 201203,China)

机构地区：[1]上海中医药大学附属曙光医院,上海201203

出　　处：《中国实验方剂学杂志》2025年第7期134-140,共7页Chinese Journal of Experimental Traditional Medical Formulae

基　　金：国家自然科学基金面上项目(82274528);国家自然科学基金青年科学基金项目(82305245)。

摘　　要：目的:观察复原通络方(由黄芪、红花、鸡血藤、路路通、伸筋草、积雪草等中药组成)治疗下肢动脉硬化闭塞症介入术后再狭窄脉络瘀阻证患者的效果及对一期通畅率水平的影响。方法:将88例脉络瘀阻证下肢动脉硬化闭塞症介入术后患者随机分为两组。对照组(n1=44)服用阿司匹林和氯吡格雷双联抗血小板治疗;观察组(n2=44)在阿司匹林和氯吡格雷双联抗血小板治疗的基础上加用复原通络方免煎颗粒治疗。两组皆治疗24周,随访观察36周。比较两组患者治疗前后的一期通畅率、症状量化评分、踝肱指数(ABI)、凝血功能、炎症指标的变化情况。结果:一期通畅率比较,治疗36周后,观察组一期通畅率优于对照组,差异具有统计学意义(χ^(2)=4.14,P<0.05)。治疗24周后,观察组与对照组一期通畅率差异无统计学意义。临床疗效比较,根据症状量化评分结果,治疗24周后观察组整体疗效均优于对照组,差异具有统计学意义(χ^(2)=2.24,P<0.05)。ABI水平比较,观察组治疗24、36周后ABI水平高于对照组,差异具有统计学意义(P<0.05)。凝血功能指标水平比较,治疗24周、36周后观察组D-二聚体、纤维蛋白原低于对照组(P<0.05)。炎症指标水平比较,治疗24周、36周后观察组C反应蛋白(CRP)低于对照组,差异具有统计学意义(P<0.05)。两组患者白细胞计数(WBC)、红细胞沉降率(ESR)治疗前后差异无统计学意义。结论:在双联抗血小板治疗的基础上,加用复原通络方免煎颗粒,可以提高下肢动脉硬化闭塞症介入术后患者患肢血管一期通畅率。服用更长时间的复原通络方可明显改善患者的临床症状,具有临床应用价值。Objective:To observe the effects of the Fuyuan Tongluo prescription(composed of Astragali Radix,Carthami Flos,Spatholobi Caulis,Liquidambaris Fructus,Lycopodii Herba,Centellae Herba,etc.)in the treatment of restenosis with collateral obstruction syndrome after interventional operation of lower limb arteriosclerosis obliterans,and its impact on the primary patency rate.Methods:A total of 88 patients with collateral obstruction syndrome after interventional surgery for lower limb arteriosclerosis obliterans were randomly divided into two groups.The control group(n1=44)received dual antiplatelet therapy with aspirin and clopidogrel.The observation group(n2=44)was treated with Fuyuan Tongluo prescription non-decocted granules in addition to aspirin and clopidogrel.Both groups received treatment for 24 weeks and were followed up for 36 weeks.The changes in primary patency rate,symptom scores,ankle-brachial index(ABI),coagulation function,and inflammatory markers before and after treatment were compared between the two groups.Results:For primary patency rate,after 36 weeks of treatment,the observation group had a significantly better primary patency rate than the control group(χ^(2)=4.14,P<0.05).After 24 weeks of treatment,there was no significant difference in primary patency rate between the two groups.Clinical efficacy comparison:Based on symptom quantification scores,and using the Nimodipine method as a reference,the overall efficacy of the observation group was superior to that of the control group after 24 weeks of treatment(χ^(2)=2.24,P<0.05).ABI levels:The observation group had a higher ABI than the control group after 24 and 36 weeks of treatment(P<0.05).Coagulation function indicators:After 24 and 36 weeks of treatment,D-dimer and fibrinogen levels in both groups were lower than before treatment(P<0.05).Inflammatory markers:After 24 and 36 weeks of treatment,CRP levels in the observation group were lower than those in the control group(P<0.05).There were no significant differences in white blood cell(WBC)an

关 键 词：复原通络方 下肢动脉硬化闭塞症 脉络瘀阻证 临床疗效 一期通畅率 

分 类 号：R259[医药卫生—中西医结合] R856.5[医药卫生—中医内科学] R543.5[医药卫生—中医学]