目的 探讨脉络舒通丸联合多磺酸粘多糖乳膏治疗血栓性浅静脉炎的临床疗效。方法 选取2021年5月—2023年8月上海中医药大学附属曙光医院收治的骨科病房术后血栓性浅静脉炎患者98例，依据用药情况分为对照组（49例）和治疗组（49例）。对照组患者给予多磺酸粘多糖乳膏，挤出乳膏3～5 cm涂在患处并轻轻按摩，2次/d。在对照组基础上，治疗组口服脉络舒通丸，12 g/次，3次/d。两组治疗15 d。观察两组患者临床疗效，比较治疗前后两组患者症状改善时间，血液流变指标纤维蛋白、血浆黏度、全血高切黏度和全血低切黏度，及血清内皮素-1（ET-1）、血管内皮生成因子（VEGF）、血栓素B₂（TXB₂）和白细胞介素-1β（IL-1β）水平。结果 治疗后，治疗组总有效率（95.92%）明显高于对照组有效率83.67%（P＜0.05）。治疗后，治疗组患者皮肤肿胀、皮肤发热、患肢疼痛、条索状结节等症状改善时间均明显早于对照组（P＜0.05）。治疗后，两组患者纤维蛋白、血浆黏度、全血高切黏度、全血低切黏度指标均明显降低（P＜0.05），且治疗组患者的指标水平明显低于对照组（P＜0.05）。治疗后，两组患者血清ET-1、TXB₂和IL-1β水平均明显降低，而VEGF水平明显升高（P＜0.05），且治疗组ET-1、TXB₂、IL-1β和VEGF水平均明显好于对照组（P＜0.05）。结论 多磺酸粘多糖乳膏与脉络舒通丸协同治疗血栓性浅静脉炎，能有效改善患者症状，并充分降低血液黏稠度，促进机体炎性反应减弱。

Objective To explore the clinical effect of Mailuo Shutong Pills combined with Mucopolysaccharide Polysulfate Cream in treatment of thrombotic superficial phlebitis. Methods Patients (98 cases) with thrombotic superficial phlebitis in Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine from May 2021 to August 2023 were divided into control (49 cases) and treatment (49 cases) group based on different treatments. Patients in the control group were administered with Mucopolysaccharide Polysulfate Cream, squeeze out 3 — 5 cm of cream and apply it to the affected area, gently massage, twice daily. Patients in the treatment group were po administered with Mailuo Shutong Pills on the basis of the control group, 12 g/time, three times daily. Patients in two groups were treated for 15 d. After treatment, the clinical evaluations were evaluated, the symptom relief time, the levels of hemorheology indicators fibrin, plasma viscosity, whole blood high shear viscosity and whole blood low shear viscosity, and the levels of serum ET-1, TXB2, IL-1β and VEGF in two groups before and after treatment were compared. Results After treatment, the clinical effective rate of the treatment group (95.92%) was significantly higher than 83.67% of the control group (P < 0.05). After treatment, the improvement time of symptoms such as skin swelling, skin fever, limb pain, and linear nodules in the treatment group was significantly earlier than that in the control group (P < 0.05). After treatment, the indicators of fibrin, plasma viscosity, whole blood high shear viscosity, and whole blood low shear viscosity in two groups were significantly reduced (P < 0.05), and the levels of indicators in the treatment group were significantly lower than those in the control group (P < 0.05). After treatment, the levels of serum ET-1, TXB₂, and IL-1 β in two groups were significantly reduced, while the level of VEGF was significantly increased (P < 0.05), and the levels of ET-1, TXB₂, IL-1β, and VEGF in the treatment group were significantly better than those in the control group (P < 0.05). Conclusion The synergistic treatment of Mucopolysaccharide Polysulfate Cream and Mailuo Shutong Pills for thrombotic superficial phlebitis can effectively improve patient symptoms, fully reduce blood viscosity, and promote the weakening of inflammatory response.

R973