阿司匹林联合活血祛瘀方治疗下肢动脉硬化闭塞症的临床评价  

Clinical Evaluation of Aspirin Combined with Huoxue Quyu Decoction in the Treatment of Lower Extremity Arteriosclerosis Obliterans

作　　者：尹凌峰 曹烨民[2] 徐磊 倪皓轩 王御震 YIN Lingfeng;CAO Yemin;XU Lei;NI Haoxuan;WANG Yuzhen(Department of Vascular Science,Shanghai Hospital of Integrated Traditional Chinese and Western Medicine,Shanghai University of Traditional Chinese Medicine,Shanghai 200080,China;Vascular Disease Diagnosis and Treatment Center,Shanghai Hospital of Integrated Traditional Chinese and Western Medicine,Shanghai 200082,China;Hospital of Traditional Chinese Medicine Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 200071,China)

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一科,上海200080 [2]上海市中西医结合医院脉管病诊疗中心,上海200082 [3]上海中医药大学附属市中医医院,上海200071

出　　处：《中国药学杂志》2025年第5期539-546,共8页Chinese Pharmaceutical Journal

摘　　要：目的 探讨阿司匹林联合活血祛瘀方治疗下肢动脉硬化闭塞症(ASO)的临床疗效。方法 选择本院收治的下肢ASO患者136例作为研究对象,年龄范围为49~87岁,平均年龄(65.00±6.54)岁。根据不同治疗方法分为2组,常规阿司匹林治疗68例纳入对照组,活血祛瘀方联合阿司匹林治疗68例纳入研究组。比较两组患者治疗前后血小板功能、血流动力学指标、血脂指标、动脉硬化指标、健康状况(SF-36)及临床疗效。采用广义估计方程(GEE)模型分析下肢ASO临床疗效的影响因素以及踝肱指数(ankle-brachial index, ABI)在不同时点、不同组别和不同分期的交互效应。结果 2组患者接受治疗6周后各项血小板功能、血流动力学指标、血脂指标及动脉硬化指标与治疗前相比均具有显著差异(P<0.05),研究组患者血小板聚集率(platelet aggregation rate, PAR)、D二聚体(D-dimer, D-D)、纤维蛋白原(fibrinogen, FIB)、全血高切黏度(high whole blood viscosity, HWBV)、全血低切黏度(low whole blood viscosity, LWBV)、红细胞沉降率(erythrocyte sedimentation rate, ESR)、总胆固醇(total cholesterol, TC)、三酰甘油(triacylglycerol, TG)及低密度脂蛋白胆固醇(low density lipoprotein cholesterol, LDL-C)水平均显著低于对照组(P<0.05),而患者出血时间(bleeding time, BT)、高密度脂蛋白(high density lipoprotein cholesterol, HDL-C)、ABI、趾肱指数(toe-brachial index, TBI)、跛行距离、健康状况评分及临床疗效均显著高于对照组(P<0.05);GEE模型分析结果显示治疗方法、治疗时间及Fontaine分期均显著影响下肢ASO的临床疗效(P<0.05);交互效应分析中治疗2周、4周,研究组和对照组中Ⅲ期、Ⅳ期ASO患者ABI值差异显著(P<0.05),治疗6周时,不同治疗方式对Ⅱ期、Ⅲ期、Ⅳ期ASO患者ABI值的影响具有统计学意义(P<0.05)。结论 阿司匹林联合活血祛瘀方治疗下肢ASO在血小板功能、血流动力学、血脂及动脉硬化等指OBJECTIVE To investigate the clinical efficacy of aspirin combined with Huoxue Quyu decoction in the treatment of lower extremity arteriosclerosis obliterans(ASO).METHODS A total of 136 patients with lower extremity ASO admitted to our hospital were selected as the research objects,aged 49-87 years,with an average age of(65.00±6.54)years.According to treatment methods,68 cases of conventional aspirin treatment were included in the control group,and 68 cases of Huoxue Quyu prescription combined with aspirin were included in the study group.The platelet function,hemodynamic index,blood lipid index,arteriosclerosis index,health status and clinical effect of the two groups were compared before and after treatment.Generalized estimation equation(GEE)model was used to analyze the factors affecting the clinical efficacy of ASO in the lower extremities,and GEE model was used to analyze the interaction effects of ankle-brachial index(ABI)at different time points,different groups and different stages.RESULTS After 6 weeks of treatment,the platelet function,hemodynamic indexes,lipid indexes and arteriosclerosis indexes of the two groups were significantly different compared with those before treatment(P<0.05).PAR,D-D,FIB,HWBV,LWBV,ESR,TC,TG and LDL-C levels in the study group were significantly lower than those in the control group(P<0.05),while BT,HDL-C,ABI,TBI,lameness distance,health status score and clinical efficacy were significantly higher than those in the control group(P<0.05).GEE model analysis showed that treatment method,treatment time and Fontaine stage significantly affected the therapeutic effect of ASO in lower limbs(P<0.05).In the interaction effect analysis,after 2 and 4 weeks of treatment,the ABI values of ASO patients in the study group and the control group were significantly different(P<0.05).After 6 weeks of treatment,different treatment methods had statistically significant effects on ABI values of ASO patients in stageⅡ,ⅢandⅣ(P<0.05).CONCLUSION Aspirin combined with Huoxue Quyu decoction is b

关 键 词：下肢动脉硬化闭塞症 活血祛瘀方 阿司匹林 临床疗效 

分 类 号：R543.5[医药卫生—心血管疾病]