世界中医药

目的：探讨中西医结合治疗2期以上血栓闭塞性脉管炎的疗效。方法：选取我院血管外科2012年7月至2016年3月54例2期以上血栓闭塞性脉管炎患者采用前列地尔，阿司匹林等扩管，抗血小板治疗及抗感染，并同时根据患者临床表现分为虚寒型，瘀滞型，热毒型，气血两虚型进行中医辨证治疗。局部溃疡给予局部外用中药，清创等对症处理。观察评价所有患者的治疗效果。结果：平均住院治疗37.5 d，9例坏疽患者有2例因缺血症状加重截肢，3例足趾呈干性坏疽而自行脱落；有42例在住院期间疼痛得到不同程度的改善，12例疼痛无明显改善；38例溃疡15例完全愈合，15例溃疡缩小，8例溃疡未见好转。出院时疗效为治愈17例，13例显效，17例进步，7例无效。总有效率87.1%。结论：中西医结合治疗2期以上血栓闭塞性脉管炎具有良好疗效。

English Summary:

To investigate the efficacy of treatment of integrated Chinese medicine and western medicine in thrombosis obliterans of second stage or above.Methods:A total of 54 patients with TO above the second stage during July in 2012 to March in 2016 in our hospital were given antiplatelet drugs (aspirin) as well as vasodilators (alprostadil) and antibiotic treatment.According to different symptoms and signs，all the cases were divided into four TCM types (cold deficiency; sluggish; heat toxicity; deficiency of both qi and blood)，and corresponding treatments were given based on the syndrome differentiation.External Chinese medicine and debriding treatment were also given to local tissue ulceration.Results:The mean hospital duration of all the cases was 37.5 days.Two cases of 9 patients with gangrene received high amputation due to deterioration of ischemic symptom，three cases of digits showed dry gangrene and fall off on their own，42 cases′ pain had been improved at different levels in hospital，12 cases′ pain had no obvious improvement.And 15 cases of 38 ulcer recovered，15 cases had reduced ulcer area，8 cases had no improvement in ulcer.When discharged from hospital,17 cases were cured，13 cases were effective，17 cases showed improvement，7 cases had no effect.The total effective rate was 87.1%.Conclusion:Integrated Chinese medicine and western medicine treatment has good effect in thrombosis obliterans.

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