目的 探讨雷公藤多苷联合贝前列素钠治疗血栓闭塞性脉管炎的临床效果。方法 选取2014年6月-2018年6月天津市第五中心医院收治的82例血栓闭塞性脉管炎患者，随机分为对照组和治疗组，每组各41例。对照组口服贝前列素钠片，1片/次，3次/d。治疗组在对照组基础上口服雷公藤多苷片，1.0 mg/（kg·d），分3次于饭后口服。两组均连续治疗2个月。观察两组的临床疗效，比较两组治疗前后视觉模拟评分法（VAS）评分、患肢皮温、踝肱指数（ABI）、无痛步行距离、最大步行距离、患肢溃疡面积、血清学指标、阻抗血流图参数的变化情况。结果 治疗后，对照组和治疗组的总有效率分别是73.2%、90.2%，两组比较差异具有统计学意义（P<0.05）。治疗后，两组麻木VAS评分、冷感VAS评分、静息痛VAS评分均较治疗前显著下降，同组治疗前后比较差异具有统计学意义（P<0.05）；治疗后，治疗组这些VAS评分显著低于对照组，两组比较差异具有统计学意义（P<0.05）。治疗后，两组患肢皮温、ABI值、无痛步行距离和最大步行距离均较治疗前显著升高，而溃疡面积则均显著减小，同组治疗前后比较差异具有统计学意义（P<0.05）；治疗后，治疗组患肢皮温、ABI值、无痛步行距离和最大步行距离高于对照组，而溃疡面积小于对照组，两组比较差异具有统计学意义（P<0.05）。治疗后，两组血清白介素-6（IL-6）、免疫球蛋白G（IgG）较治疗前显著降低，而血清补体C₃水平均显著上升，同组治疗前后比较差异具有统计学意义（P<0.05）；治疗后，治疗组血清IL-6、IgG水平低于对照组，而补体C₃水平高于对照组，两组比较差异具有统计学意义（P<0.05）。治疗后，两组患者波幅较治疗前均显著增高，而上升时间均显著缩短，同组治疗前后比较差异具有统计学意义（P<0.05）；治疗后，治疗组波幅高于对照组，而上升时间短于对照组，两组比较差异具有统计学意义（P<0.05）。结论 雷公藤多苷联合贝前列素钠治疗血栓闭塞性脉管炎具有较好的临床疗效，减轻肢体缺血的相关症状，促进溃疡愈合，能有效改善患者肢体血流障碍，抑制体内炎症反应，具有一定的临床推广应用价值。

Objective To investigate the clinical effect of tripterygium glycosides combined with beraprost sodium in treatment of thromboangiitis obliterans. Methods Patients (82 cases) with thromboangiitis obliterans in the Fifth Central Hospital of Tianjin from June 2014 to June 2018 were randomly divided into control (41 cases) and treatment (41 cases) groups. Patients in the control group were po administered with Beraprost Sodium Tablets, 1 tablet/time, three times daily. Patients in the treatment group were po administered with Tripterygium Glycosides Tablets on the basis of the control group, 1.0 mg/(kg·d), and took it three times after meals. Patients in two groups were treated for 2 months. After treatment, the clinical efficacy was evaluated, and the changes of VAS scores, skin temperature of the affected limb, ABI, painless walking distance, maximum walking distance, and ulcer area of the affected limb, serological indexes and impedance blood flow diagram parameters in two groups before and after treatment were compared. Results After treatment, the clinical efficacy in the control and treatment groups were 73.2% and 90.2%, respectively, and there were differences between two groups (P < 0.05). After treatment, the numbness VAS, cold sensation VAS and rest pain VAS in both groups were significantly decreased, and there were differences in the same group (P < 0.05). After treatment, the VAS scores in the treatment group were lower than those in the control group, and there were differences between two groups (P < 0.05). After treatment, skin temperature of the affected limb, ABI, painless walking distance, and maximum walking distance in two groups were was significantly increased, but ulcer area of the affected limb in two groups were significantly decreased, and there were differences in the same group (P < 0.05). After treatment, skin temperature of the affected limb, ABI, painless walking distance, and maximum walking distance in the treatment group were higher than those in the control group, but ulcer area of the affected limb was lower than that in the control group, and there were differences between two groups (P < 0.05). After treatment, IL-6 and IgG were significantly decreased, but C₃ in two groups was significantly increased, and there were differences in the same group (P < 0.05). After treatment, IL-6 and IgG in the treatment group were lower than those in the control group, but C₃ was higher than that in the control group, and there were differences between two groups (P < 0.05). After treatment, amplitude was significantly increased, but rise time in two groups was significantly decreased, and there were differences in the same group (P < 0.05). After treatment, amplitude in the treatment group was higher than those in the control group, but rise time was shorter than that in the control group, and there were differences between two groups (P < 0.05). Conclusion Tripterygium glycosides combined with beraprost sodium has significant effect in treatment of thromboangiitis obliterans, and alleviate symptoms related to limb ischemia, and also can promote ulcer healing, effectively improve limb blood flow disorders in patients, and inhibit inflammatory reactions, which has a certain clinical application value.