【摘要】 目的 探究消栓止痛胶囊联合脉管复康片治疗肢体动脉硬化闭塞症(arteriosclerosis obliterans,ASO)血脉瘀阻证的临床疗效。方法 选取2021年1月—2024年1月收治的60例下肢ASO患者作为研究对象，使用抽签的方法随机分为常规组和试验组，每组30例。常规组给予西洛他唑治疗，试验组给予消栓止痛胶囊联合脉管复康片治疗。比较2组的临床疗效、中医证候积分、动脉硬化指标、血管内皮细胞功能、凝血功能及不良反应发生情况。结果 试验组的临床总有效率高于常规组(P<0.05)。治疗后，2组的皮肤发凉、酸胀、肢体麻木、疼痛、肤色异常症状积分和总分均降低，且试验组的各症状积分和总分均低于常规组(P<0.05)。治疗后，2组的踝肱指数(ankle brachial index,ABI)、足背动脉血流量和血管内径均上升，且试验组的ABI、足背动脉血流量和血管内径均大于常规组(P<0.05)。治疗后，2组的内皮素-1(endothelin-1,ET-1)和细胞间黏附因子-1(intercellular cell adhesion molecule-1,ICAM-1)水平均降低，一氧化氮(nitric oxide,NO)水平均上升，且试验组的ET-1和ICAM-1水平均低于常规组，NO水平高于常规组(P<0.05)。治疗后，2组的凝血酶时间(prothrombin time,PT)和活化部分凝血酶时间(activeated partial thromboplasting time,APTT)均延长，纤维蛋白原(fibrinogen,FIB)和D-二聚体(D-dimer,D-D)水平均降低，且试验组的PT和APTT均长于常规组，FIB及D-D水平均低于常规组(P<0.05)。2组不良反应发生情况比较差异无统计学意义(P>0.05)。结论 消栓止痛胶囊联合脉管复康片治疗肢体ASO(血脉瘀阻证)的临床疗效较好，可明显改善患者的血管内皮细胞功能及凝血功能，且安全性较好。更多还原

【Abstract】 Objective To investigate the clinical effects of Xiaoshuan Zhitong Capsules combined with Maiguan Fukang Tablets in the treatment of limb arteriosclerosis obliterans(ASO) with blood stasis syndrome. Methods Sixty patients with lower limb ASO admitted to the hospital from January 2021 to January 2024 were selected as the study objects. They were randomly divided into a conventional group and an experimental group by drawing lots, with 30 cases in each group. The conventional group was treated with cilostazol, while the experimental group was treated with Xiaoshuan Zhitong Capsules combined with Maiguan Fukang Tablets. Clinical effects, traditional Chinese medicine syndrome scores, arteriosclerosis indicators, vascular endothelial cell function,coagulation function, and adverse reactions were compared between the 2 groups. Results The total clinical effective rate in the experimental group was higher than that in the conventional group(P<0.05). After treatment, symptom scores for cool skin,soreness and swelling, limb numbness, pain, and abnormal skin color, as well as total scores of both groups decreased. The scores for various symptoms and total score of the experimental group were lower than those of the conventional group(P<0.05). After treatment, ankle-brachial index(ABI), dorsalis pedis artery blood flow,and vascular diameter increased in both groups. Moreover,ABI, dorsalis pedis artery blood flow, and vascular diameter in the experimental group were larger than those in the conventional group(P<0.05). After treatment, the levels of endothelin-1(ET-1) and intercellular cell adhesion molecule-1(ICAM-1) decreased, while nitric oxide(NO) levels increased in both groups. Moreover, the levels of ET-1 and ICAM-1 in the experimental group were lower than those in the conventional group, and NO level was higher than that in the conventional group(P<0.05). After treatment,prothrombin time(PT) and activated partial thromboplastin time(APTT) increased,while fibrinogen(FIB) and D-dimer(D-D) levels decreased in both groups. Moreover, PT and APTT in the experimental group were longer than those in the conventional group,and FIB and D-D levels were lower than those in the conventional group(P<0.05). No statistically significant difference was observed in the incidence of adverse reactions between the 2 groups(P>0.05). Conclusion Applying Xiaoshuan Zhitong Capsules combined with Maiguan Fukang Tablets to treat limb ASO with blood stasis syndrome can achieve relatively good clinical effects, which can significantly improve vascular endothelial cell function and coagulation function in the patients,with good safety.更多还原