摘要
目的观察芒针联合纤溶酶治疗下肢动脉硬化闭塞症的临床疗效及其对患者血流动力学的影响。方法纳入下肢动脉硬化闭塞症患者100例并随机分为纤溶酶组和联合组,每组50例。纤溶酶组采用纤溶酶进行治疗,联合组在纤溶酶组的治疗基础上联合芒针治疗。治疗前后分别检测患者血清白介素(IL)-6、IL-18、C反应蛋白(CRP)、同型半胱氨酸(Hcy)水平,检测足背动脉和腘动脉血流量、血管内径、血液流变学、血流动力学,比较两组中医证候评分及临床疗效。结果治疗后,联合组血清IL-6、IL-18、CRP和Hcy水平均低于纤溶酶组(P<0.05),联合组足背动脉和腘动脉血流量、血管内径高于纤溶酶组(P<0.05),联合组全血比黏度高切、全血比黏度低切、全血还原黏度高切、全血还原黏度低切、纤维蛋白原均低于纤溶酶组(P<0.05),联合组峰值血流速度、阻力指数、搏动指数均低于纤溶酶组(P<0.05),联合组中医证候评分低于纤溶酶组(P<0.05),联合组总有效率高于纤溶酶组(P<0.05)。结论芒针联合纤溶酶治疗可显著改善下肢动脉硬化闭塞症患者临床症状,抑制IL-6、IL-18、CRP和Hcy的异常表达,改善血液流变学、血流动力学,提高临床疗效。
Objective To investigate the clinical efficacy of elongated needles plus plasmin for arteriosclerosis obliterans of the lower extremity and its effect on hemodynamics in the patients.Methods One hundred patients with arteriosclerosis obliterans of the lower extremity were enrolled and randomized to a plasmin group and a combination group,with 50 cases in each group.The plasmin group was treated with plasmin and the combination group,with elongated needles in addition.Serum interleukin(IL)-6,IL-18,C-reactive protein(CRP)and homocysteine(Hcy)levels were measured and the blood flow volume,internal diameters,hemorheological parameters and hemodynamic parameters of the dorsalis pedis artery and popliteal artery were determined in the patients before and after treatment.The clinical therapeutic effects and TCM syndrome scores were compared between the two groups.Results After treatment,serum IL-6,IL-18,CRP and Hcy levels were lower in the combination group than in the plasmin group(P<0.05);the blood flow volume and internal diameters of the dorsalis pedis artery and popliteal artery were higher in the combination group than in the plasmin group(P<0.05);high-shear whole blood specific viscosity,low-shear whole blood specific viscosity,high-shear whole blood reduced viscosity,low-shear whole blood reduced viscosity and fibrinogen were lower in the combination group than in the plasmin group(P<0.05);peak blood flow velocity,resistance index and pulsatility index were lower in the combination group than in the plasmin group(P<0.05);the TCM syndrome score was lower(P<0.05)and the total efficacy rate was higher(P<0.05)in the combination group than in the plasmin group.Conclusions Elongated needles plus plasmin can markedly relieve the clinical symptoms,inhibit the abnormal expressions of IL-6,IL-18,CRP and Hcy,improve hemorheology and hemodynamics and heighten the clinical therapeutic effect in patients with arteriosclerosis obliterans of the lower extremity.
作者
仝光照
许志会
张青天
吕嘉荣
黄忠利
戴莹
TONG Guang-zhao;XU Zhi-hui;ZHANG Qing-tian;LÜJia-rong;HUANG Zhong-li;DAI Ying(Shijiazhuang Hospital of Traditional Chinese Medicine,Shijiazhuang 050000,China)
出处
《上海针灸杂志》
2021年第6期697-702,共6页
Shanghai Journal of Acupuncture and Moxibustion
基金
河北省中医药管理局科研计划项目(2020336)。
关键词
针刺疗法
长针疗法
芒针
纤溶酶
针药并用
动脉硬化闭塞症
血流动力学
Acupuncture therapy
Long needle therapy
Elongated needle
Plasmin
Acupuncture medication combined
Arteriosclerosis obliterans
Hemodynamics
