Clinical Effect of Modified Huangqi Guizhi Wuwu Tang on Patient with Lower-extremity Arterial Disease

Yan CHENG; Kai-di LUAN; Hong-yan DING; Yong TANG; Jun WANG; Wei-gang YU

doi:10.13422/j.cnki.syfjx.20191232

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Clinical Effect of Modified Huangqi Guizhi Wuwu Tang on Patient with Lower-extremity Arterial Disease

Clinic | 更新时间：2021-02-09

- Clinical Effect of Modified Huangqi Guizhi Wuwu Tang on Patient with Lower-extremity Arterial Disease
- Chinese Journal of Experimental Traditional Medical Formulae Vol. 25, Issue 15, Pages: 136-141(2019)
- 作者机构：
  
  1.潍坊市人民医院，山东　潍坊　 261041；
  2.潍坊医学院，山东　潍坊　 261041；
  3.哈尔滨医科大学　第二临床医学院，哈尔滨　 150081
- 作者简介：
- 基金信息：
- DOI：10.13422/j.cnki.syfjx.20191232
  CLC： R25; R58; R587; R587.1
- Received：14 November 2018，
  
  Published Online：22 January 2019，
  
  Published：05 August 2019
- 稿件说明：
移动端阅览
Yan CHENG, Kai-di LUAN, Hong-yan DING, et al. Clinical Effect of Modified Huangqi Guizhi Wuwu Tang on Patient with Lower-extremity Arterial Disease[J]. Chinese journal of experimental traditional medical formulae, 2019, 25(15): 136-141.
DOI：

Yan CHENG, Kai-di LUAN, Hong-yan DING, et al. Clinical Effect of Modified Huangqi Guizhi Wuwu Tang on Patient with Lower-extremity Arterial Disease[J]. Chinese journal of experimental traditional medical formulae, 2019, 25(15): 136-141. DOI： 10.13422/j.cnki.syfjx.20191232.

摘要

目的：

观察加味黄芪桂枝五物汤治疗老年2型糖尿病下肢血管病变(LEAD)气阴两虚兼血瘀症患者的临床疗效及抗炎和抗氧化作用机制。

方法：

将128例患者随机按数字表法分为对照组和观察组各64例。对照组给予生活方式干预和控制血糖、血压、血脂等药物治疗；口服普罗布考片，0.5 g/次，2次/d，早、晚餐时服用；口服拜阿司匹林肠溶片，100 mg·d

－1

，连续治疗3个月；前列地尔注射液，10 μg·d

－1

，加生理盐水10 mL，静注，1次/d。连续注射15 d，休息15 d为1个疗程，共治疗3个疗程。观察组在对照组治疗的基础上内服加味黄芪桂枝五物汤，1剂/d。两组疗程均连续治疗3个月。测量治疗前后踝肱指数(ABI)，趾肱指数(TBI)，以彩色多普勒超声检测治疗前后足背动脉血管内径、峰值流速、血流量，进行治疗前后主要症状和体征评分，检测治疗前后血清白细胞介素-1(IL-1)，同型半胱氨酸(Hcy)，肿瘤坏死因子-

(TNF-

)，高敏C反应蛋白(hs-CRP)，胱抑素-C(CysC)，丙二醛(MDA)，超氧化物歧化酶(SOD)和氧化型低密度脂蛋白(OX-LDL)水平。

结果：

经秩和检验，观察组患者临床疗效优于对照组(

0.05)；观察组ABI和TBI指数均高于对照组(

0.01)；观察组患者足背动脉血管内径、峰值流速、血流量改善均好于对照组(

0.01)；观察组间歇性跋行、下肢疼痛、足背动脉搏动、皮肤色泽、皮肤温度、肢体麻木、肢体酸胀等主要症状、体征评分均低于对照组(

0.01)；治疗后观察组血清IL-1，Hcy，TNF-

，hs-CRP和CysC水平均低于对照组(

0.01)；观察组MDA，Ox-LDL水平均低于对照组，SOD水平高于对照组(

0.01)。

结论：

采用加味黄芪桂枝五物汤结合西医治疗LEAD患者，能减轻临床症状及体征，并改善了下肢血管功能和血流动力情况，具有一定的抗炎症反应和氧化应激效应，减轻血管内皮细胞损伤，对于LEAD进展起到减轻或延缓作用。

Abstract

Objective:

To observe the clinical effect of modified Huangqi Guizhi Wuwu Tang on patient with lower-extremity arterial disease (LEAD) with deficiency of Qi and Yin and blood stasis syndrome

and study the antioxidant mechanism.

Method:

One hundred and twenty-eight patients were randomly divided into control group (64 cases) and observation group (64 cases) by random number table. Patients in control group was treated for controlling blood sugar

blood pressure and blood fat

and got probucol in the morning and evening

0.5 g/time

2 times/days

aspirin enteric-coated tablets for 3 months

100 mg·d

-1

and alprostadil injection diluted with 10 mL normal saline for 15 days

10 μg·d

-1

1 time/day. A course of the treatment in control group was 15 days

and there were 4 courses. In addition to the therapy of control group

patients in observation group were additionally given modified Huangqi Guizhi Wuwu Tang

1 dose/day

for 3 months. Before and after treatment

ankle brachial index (ABI) and toe branch index (TBI) were detected

and internal diameter of dorsal artery of foot

peak velocity and blood flow were detected by color Doppler ultrasound. Main symptoms and sign were scored. And levels of interleukin-1 (IL-1)

Homocysteine (Hcy)

tumor necrosis factor-

(TNF-

)

high sensitive C reactive protein (hs-CRP)

cystatin C (CysC)

malondialdehyde (MDA)

superoxide dismutase (SOD) and oxidized low density lipoprotein (OX-LDL) were detected.

Result:

According to the rank test

clinical effect in observation group was better than that in control group (

0.05). And levels of ABI

TBI and SOD were higher than those in control group (

0.01). The ameliorate of internal diameter of dorsal artery of foot

peak velocity and blood flow were better than those in control group

and scores of intermittent postscript

lower extremity pain

dorsalis pedis artery pulsation

skin color

skin temperature

numbness of limbs

swelling of extremities and the sign and levels of IL-1

Hcy TNF-

hs-CRP

Cys-C and Ox-LDL were lower than those in control group (

0.01).

Conclusion:

Modified Huangqi Guizhi Wuwu Tang can relieve symptoms and signs

lower limb vascular function and hemodynamic

with certain anti-inflammatory effect and oxidative stress. It can also reduce vascular endothelial cell injury

and relieve and postpone the progress of LEAD

关键词

Keywords

references

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