中西医结合治疗周围动脉粥样硬化闭塞症疗效观察

目的：观察周围动脉粥样硬化闭塞症（ＡｔｈｅｒｏｓｃｌｅｒｏｓｉｓＯｂｌｉｔｅｒａｎｓ，ＡＳＯ）中西医结合疗效，探讨血浆内皮素－１（ｅｎｄｏｔｈｅｌｉｎｓ－１，ＥＴ－１）、一氧化氮（ｎｉｔｒｉｃｏｘｉｄｅ，ＮＯ）及载脂蛋白与临床治疗的关系。方法：选择９０例ＡＳＯ患者，随机等分为中医、西医和中西医结合治疗３组，分别给予复方丹参注射液、前列腺素Ｅ１和二者组合药物进行治疗，并动态观察治疗过程中的临床表现，同时利用放射免疫测定、亚硝酸盐比色法于治疗前后检测血液ＥＴ－１、ＮＯ和载脂蛋白含量的变化。结果：临床治愈率和显效率中西医结合组分别为４６６７％、４３３３％，疗效优于中医组（２６６７％、２６６７％，Ｐ＜００１）及西医组（３３３３％、４０００％，Ｐ＜００１）。血浆ＥＴ－１、ＮＯ、载脂蛋白的改变同ＡＳＯ１～３期存在正相关关系，且随ＡＳＯ有效治疗后逐渐恢复，并于临床治愈期接近正常水平。结论：中西医结合治疗ＡＳＯ具有较好的临床疗效，动态观察ＡＳＯ治疗前后ＥＴ－１、ＮＯ、载脂蛋白的变化，有助于判断病情轻重并了解疾病进程和治疗效果，具有较大的临床意义。

英文摘要:

Objective: To observe the therapeutic effect of integrated traditional Chinese and western medicine (TCM WM) and its influence on plasma endothelin 1 (ET-1), nitric oxide (NO) and apoproteins. Methods: Ninety patients of peripheral atherosclerosis obliterans (ASO) were divided into three groups randomly and treated with Salvia injection (SI), prostaglandin E 1 (PGE 1) and SI+PGE 1 respectively. The clinical manifestation of patients was observed dynamically, plasma level of ET-1, NO and apoprotein were tested before and after treatment by radioimmunoassay, Griss method, immuno transmission method and enzyme method. Results: The cure rate of the SI, PGE 1 and TCM WM group was 26.67%, 33.33% and 46.67% respectively, the effective rate of them was 26.67%, 40.00% and 43.33% respectively. The therapeutic effect of the TCM WM group was better than that of the SI and PGE 1 group, P<0 01. The plasma level of ET-1, NO and apoprotein was positively correlated with the stage altering of ASO, it was normalized gradually when ASO was alleviating effectively. Conclusion: The TCM WM therapy has good clinical effect in treating ASO. To observe the change of ET-1, NO and apoprotein level before and after treatment dyanamically is helpful to judge the severity, progress of disease and effect of treatment, and has high clinical significance.

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