世界中医药

目的:观察加味四妙勇安汤颗粒剂联合抗血小板及扩血管药物对于间歇性跛行下肢动脉硬化闭塞症(Atherosclerotic Occlusive Disease of the Lower Extremities，ASO-LE)的临床疗效及踝肱指数(Ankle Brachial Index，ABI)、血脂水平及炎性反应因子的影响。方法:将116例间歇性跛行下肢动脉硬化闭塞症患者按照病情等级分层随机抽样分为治疗组58例，对照组58例。2组均给予生理盐水250 mL加入丹参川芎嗪注射液10 mL静脉滴注，1次/d，拜阿司匹林100 mg，1次/d，作为基础治疗。治疗组在此基础上加服加味四妙勇安汤颗粒剂。测定治疗前后总胆固醇(Tch)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-Ch)、低密度脂蛋白胆固醇(LDL-Ch)，肿瘤坏死因子α(TNF-α)、细胞白介素18(Interleukin-18，IL-18)及踝肱指数(Ankle Brachial Index，ABI)水平变化。结果:治疗组总有效率94.83%优于对照组79.31%(P<0.01)，治疗后2组总胆固醇(Tch)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-Ch)，肿瘤坏死因子α(TNF-α)、细胞白介素18(IL-18)水平均较治疗前明显下降(P<0.01)，且治疗组明显优于对照组(P<0.01);治疗后2组高密度脂蛋白胆固醇(HDL-Ch)及踝肱指数(ABI)较治疗前明显升高(P<0.01)，且治疗组明显高于对照组(P<0.01)。结论:加味四妙勇安汤治疗间歇性跛行下肢动脉硬化闭塞症疗效显著，可有效降低患者血脂水平并提高患者的踝肱指数，其作用机制可能与抗炎、降脂、改善血液循环、抗血管内皮损伤有关。

English Summary:

To observe the effect of Jiaweisimiaoyongantang Granules Combined with antiplatelet and vasodilator drugs for atherosclerotic occlusive disease of the lower extremities (ASO-LE) with claudication， and the influence on ankle brachial index(ABI)， blood lipid level and inflammatory factors. Methods:All 116 Patients of ASO-LE with claudication were randomly divided into two groups：a treatment group (58 cases) and a control group (58 cases). They were treated with antiplatelet and vasodilator drugs. Patients in the treatment group were treated with extra Jiaweisimiaoyongantang Granules. Levels of total cholesterol(TCh)， triglyceride(TG)， high density lipoprotein cholesterol(HDL-ch)，low density lipoprotein cholesterol(LDL-ch)， tumor necrosis factor(TNK-α)， Interleukin-18(IL-18) and ABI were measured before and after treatment. Results:The total effective rate of the treatment grouP was 94.83%， compared with 79.31% of the control group(P<0.01). The levels of TCh， TG， LDL-ch， TNK-α and IL-18 were significantly lower than those before the treatment in both of the two groups(P<0.01) and these levels of the treatment group were significantly lower than the control group. The levels of HDL-Ch and ABI were significantly higher than that before the treatment in both of the two groups(P<0.01) and these levels of the treatment group were significantly higher than the control group. Conclusion:Jiaweisimiaoyongantang Granules Combined with antiplatelet and vasodilator drugs has a significant effect in treatment of atherosclerotic occlusive disease of the lower extremities with claudication， and can effectively improve the blood lipid level and ABI of patients and decrease the level of inflammatory factors.

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