98例血栓闭塞性脉管炎Ⅲ期2～3级的治疗探讨

血栓闭塞性脉管炎(简称脉管炎)是常见的外周血管病之一。根据病情,按全国统一诊断标准分为Ⅰ、Ⅱ、Ⅲ期,并将Ⅲ期患者分为1、2、3级。一般认为Ⅲ期2～3级坏死病例属重症,治疗颇为困难,能否保留患肢,减少高位截肢率是本病的治疗关键,亦是判断疗效的标志之一。自1962年～1979年,我们根据中医辩证施治的法则,研制了临床有效的方药,

英文摘要:

This paper reports the results of 98 cases in which the authors have mainly adopted Chinese medicine and herbs combined with western medicine in the treatment of thromboangiitis obliterans at the third-phase 2-3 stage.These cases are divided into four groups and summarized as follows: 1.17 patients were treated by"decoction of improving circulation and warming channels"(活血温经汤).The therapeutic principle is"warming channels and relieving cold"and"improving circulation and relieving stagnation".As a result of the treatment,the percentages,of the good therapeutic effect and the high level amputation of lower limbs are 59.9% and 5% respectively; 2.34 patients were treated by"Si Gu decoction"(四顾汤).It means that the therapeutic principle is "reinforcing vital energy and blood"and"nourishing Yin and eliminating the toxin".The percentages are 91.2% and 2.7% respectively; 3.18 patients were treated by"Ba Wei mixture"(八味合剂),i.e.,it is both"reinforcing vital energy and blood"and"nourishing Yin and cleaning the internal heat".The former percentage is 83.3% and the latter 1.4%; 4.29 patients were treated by"No.Ⅰ Tong Se Mai"(通塞脉Ⅰ号).The therapeutic principle and the composition of herbs are the same as the third group.But the herbs were processed into pills.The percentages are 96.6% and 1% respectively. The therapeutic effects of the four groups.as mentioned above have proved that the therapeutic principles of "reinforcing vital energy and blood"and"nourishing Yin,cleaning the internal heat and eliminating the toxin" are better than the rest.And the effect of No.1 Tong Se Mai is the best.It has been further proved that changing the preparation of Chinese herbs is indeed,one of the ways to raise the therapeutic effects. This paper introduces the experiences dealing with the gangrene of lower limbs.Through the anatomical observation of the specimens of amputations,the authors are the first in our country to propose that the vascular variation of lower limbs is one of the causes leading to the high percentage of high level amputation.

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