2024 年第 8 期 第 0 卷

.阳和汤加减联合针刺辅助治疗糖尿病下肢动脉硬化闭塞症的临床效果

Clinical observation of Yanghe decoction combined with acupuncture in the treatment of diabetic patients with lower extremity arteriosclerosis occlusion

作者：陈智鹏1游元鸿2刘弘毅3

英文作者：Chen Zhipeng1 You Yuanhong2 Liu Hongyi3

单位：1云南中医药大学，昆明650500；2云南省昆明市盘龙区人民医院中医科，昆明650000；3云南中医药大学第一附属医院内分泌科，昆明650000

英文单位：1Yunnan University of Traditional Chinese Medicine Kunming 650500 China; 2Department of Traditional Chinese Medicine Panlong District People′s Hospital in Kunming Yunnan Province Kunming 650000 China; 3Department of Endocrinology First Affiliated Hospital of Yunnan University of Traditional Chinese Medicine Kunming 650000 China

关键词：2型糖尿病；下肢动脉硬化闭塞症；阳和汤；针刺；血液流变学；血管内皮功能

英文关键词：Type2diabetesmellitus;Arteriosclerosisobliteransoflowerextremity;Yanghedecoction; Acupuncture;Hemorheology;Vascularendothelium

• 摘要：

• 目的 探讨阳和汤加减联合针刺辅助治疗糖尿病下肢动脉硬化闭塞症临床效果。方法 选取2022年4月至2023年9月于云南省昆明市盘龙区人民医院及云南中医药大学第一附属医院就诊的糖尿病合并下肢动脉硬化闭塞症患者106例，根据随机数字表法分为观察组与对照组，各53例。对照组给予西医基础治疗，观察组在对照组基础上给予阳和汤加减联合针刺治疗。2组患者均治疗1个月。观察2组患者临床效果、患肢临床症状评分、下肢动脉彩色多普勒超声指标、踝肱指数及跛行距离、血液流变学指标、血管内皮功能。结果 2组各有2例患者主动退出治疗而剔除，最终分别纳入51例患者。治疗后观察组总有效率高于对照组［92.2%（47/51）比76.5%（39/51）］(χ2=6.805，P=0.033)。治疗后2组皮肤温度评分、皮肤色泽评分、疼痛评分、股动脉、腘动脉、足背动脉血流速度峰值均高于治疗前，且观察组高于对照组(均P＜0.05)。治疗后2组全血低切黏度、全血高切黏度、血浆黏度、血清单核细胞趋化蛋白1、内皮素1水平均低于治疗前，且观察组低于对照组（均P＜0.05）。结论 阳和汤加减联合针刺辅助治疗糖尿病下肢动脉硬化闭塞症患者临床效果显著。

• Objective To investigate the clinical effect of Yanghe decoction combined with acupuncture in the treatment of diabetic lower extremity arteriosclerosis obliterans. Methods  A total of 106 patients with diabetes mellitus combined with arteriosclerosis obliterans of lower limbs were selected from April 2022 to September 2023 at Panlong District People′s Hospital in Kunming, Yunnan Province, and First Affiliated Hospital of Yunnan University of Traditional Chinese Medicine were enrolled. Patients were divided into observation group and control group according to the random number table method, with 53 cases in each group. The control group was given basic western medicine treatment, and the observation group was given combined acupuncture treatment with Yanghe decoction on the basis of the control group. Both groups were treated for 1 month. Clinical symptom score of the affected limb, color ultrasound indexes of lower limb arteries, ankle brachial index and claudication distance, hemorheology indexes, Vascular endothelial function and safety status were observed. Results  Two patients in each of the two groups were excluded from treatment, and 51 patients were finally included. After treatment, the total effective rate of observation group was higher than that of control group［92.2%（47/51） vs 76.5%（39/51）］(χ2=6.805，P=0.033). After treatment, scores of lower limb arterial blood flow velocity, brachial ankle index and claudication distance as well as the peak blood flow velocity of femoral artery, popliteal artery and dorsalis pedis artery in both groups were higher than before treatment, and the levels of observation group were higher than those of control group(all P<0.05). After treatment, the levels of whole blood low-cut viscosity, whole blood high-cut viscosity, plasma viscosity, serum mononuclear cell chemotine-1 and endothelin-1 in the two groups were lower than those before treatment, and the observation group was lower than that in the control group (all P＜0.05). Conclusion  Yanghe decoction combined with acupuncture is effective in the treatment of patients with diabetic lower extremity arteriosclerosis occlusion.