目的 探讨脉络舒通丸联合贝前列素钠片治疗血栓闭塞性脉管炎的临床疗效。方法 选取2021年10月—2022年10月廊坊市人民医院收治的164例血栓闭塞性脉管炎患者,按照随机数字表法将所有患者分为对照组和治疗组,每组各82例。对照组患者口服贝前列素钠片,2片/次,3次/d。治疗组在对照组基础上饭后口服脉络舒通丸,12 g/次,3次/d。两组患者连续治疗3个月。观察两组的临床疗效,比较两组的踝肱指数(ABI)、最大步行距离、血液流变学指标和血清炎性因子水平。结果 治疗后,治疗组总有效率为90.24%,明显高于对照组总有效率78.05%(P<0.05)。治疗后,两组的ABI、最大步行距离明显高于治疗前(P<0.05);治疗后,治疗组的ABI、最大步行距离明显高于对照组(P<0.05)。治疗后,两组的纤维蛋白原(FIB)、血浆黏度(PV)低于治疗前,红细胞变形指数(DI)高于治疗前(P<0.05);治疗后,治疗组的FIB、PV低于对照组,DI高于对照组(P<0.05)。治疗后,两组的血栓素B2(TXB2)、C反应蛋白(CRP)、内皮素1(ET-1)水平低于治疗前(P<0.05);治疗后,治疗组的TXB2、CRP、ET-1水平低于对照组(P<0.05)。结论 脉络舒通丸联合贝前列素钠片治疗血栓闭塞性脉管炎的疗效确切,可控制病情发展,改善血液流变学,降低炎症反应,药物安全性良好。

Objective To investigate the clinical effect of Mailuo Shutong Pills combined with Beraprost Sodium Tablets in treatment of thromboangiitis obliterans.Methods Patients(164 cases) with thromboangiitis obliterans in Langfang People's Hospital from October 2021 to October 2022 were divided into control and treatment groups according to the random number table method, and each group had 82 cases. Patients in the control group were po administered with Beraprost Sodium Tablets, 2 tablets/time, three times daily. Patients in the treatment group were po administered with Mailuo Shutong Pills after meal on the basis of the control group, 12g/time, three times daily. Patients in two groups were treated for 3 months. After treatment, the clinical efficacies were evaluated, and the ABI, maximum walking distance, hemorheology index, and serum inflammatory factor level in two groups were compared.Results After treatment, the total effective rate in the treatment group was 90.24%, significantly higher than the total effective rate in the control group of 78.05%(P<0.05). After treatment, ABI and maximum walking distance of two groups was significantly increased(P<0.05).After treatment, ABI and maximum walking distance in the treatment group were significantly higher than those in the control group(P<0.05). After treatment, FIB and PV in two groups were lower than before treatment, while DI in two groups was higher than before treatment(P<0.05). After treatment, FIB and PV in the treatment group were lower than those in the control group, while DI was higher than that in the control group(P<0.05). After treatment, the levels of TXB2, CRP, and ET-1 in two groups were decreased(P<0.05).After treatment, the levels of TXB2, CRP, and ET-1 in the treatment group were lower than those in the control group(P<0.05).Conclusion Mailuo Shutong Pills combined with Beraprost Sodium Tablets is effective in treatment of thromboangiitis obliterans,can control the development of disease, improve hemorheology, and reduce inflammatory reactions with good drug safety.

R973

河北省卫生健康委医学科学研究课题(20181464)