目的 探讨脉络舒通丸联合低分子肝素钙注射液治疗下肢动脉硬化闭塞症的临床疗效。方法 选取2020年1月—2023年1月在廊坊市人民医院就诊的130例下肢动脉硬化闭塞症患者，将所有患者按照随机数字表法分为对照组和治疗组，每组各65例。对照组皮下注射低分子肝素钙注射液，1支/次，2次/d。治疗组在对照组基础上饭后口服脉络舒通丸，3次/d，每次12 g/次。两组在治疗7 d后统计疗效。比较两组患者的临床疗效、行走距离、超声参数、血清指标。结果 治疗后，治疗组的总有效率明显高于对照组，差异有显著性（P＜0.05）。治疗后，两组的最长行走距离、无痛行走距离明显增长（P＜0.05）；治疗组的最长行走距离、无痛行走距离明显长于对照组（P＜0.05）。治疗后，两组的踝肱指数（ABI）、股动脉血流速度、足背动脉血流速度显著升高（P＜0.05）；治疗组的ABI、股动脉血流速度、足背动脉血流速度明显高于对照组（P＜0.05）。治疗后，两组的血清CD163、转化生长因子-β1（TGF-β1）、白细胞介素-17（IL-17）水平显著降低（P＜0.05）；治疗组的血清CD163、TGF-β1、IL-17水平明显低于对照组（P＜0.05）。结论 脉络舒通丸联合低分子肝素钙注射液可提高下肢动脉硬化闭塞症的疗效，提高患者行走距离，改善下肢血流速度，降低炎症反应。

Objective To investigate the clinical effect of Mailuo Shutong Pills combined with Low Molecular Weight Heparin Calcium Injection in treatment of lower extremity arteriosclerosis obliterans. Methods Patients (130 cases) with lower extremity arteriosclerosis obliterans in Langfang People's Hospital from January 2020 to January 2023 were divided into control and treatment groups according to the random number table method, and each group had 65 cases. Patients in the control group were sc injected with Low Molecular Weight Heparin Calcium Injection, 1 dose/time, twice daily. Patients in the treatment group were po administered with Mailuo Shutong Pills after a meal on the basis of the control group, 12 g/time, three times daily. Patients in two groups were treated for 7 d. The clinical efficacies, walking distance, ultrasound parameters, and serum indicators in two groups were compared. Results After treatment, the total effective rate of the treatment group was significantly higher than that of the control group, with a significant difference (P < 0.05). After treatment, the longest walking distance and painless walking distance of two groups were significantly increased (P < 0.05), and the longest walking distance and painless walking distance of the treatment group were significantly longer than those of the control group (P < 0.05). After treatment, ABI, femoral artery blood flow velocity, and dorsalis pedis artery blood flow velocity of two groups were significantly increased (P < 0.05), and ABI, femoral artery blood flow velocity, and dorsalis pedis artery blood flow velocity of the treatment group were significantly higher than those of the control group (P < 0.05). After treatment, the serum levels of CD163, TGF-β1, and IL-17 in both groups were significantly reduced (P < 0.05), and the serum levels of CD163, TGF-β1, and IL-17 in the treatment group were significantly lower than those in the control group (P < 0.05). Conclusion Mailuo Shutong Pills combined with Low Molecular Weight Heparin Calcium Injection can improve the efficacy of lower extremity arteriosclerosis obliterans, increase the walking distance, improve lower limb blood flow velocity, and reduce inflammatory reactions.

R973

河北省卫生健康委科研基金项目（20181464）