中西医结合治疗糖尿病性下肢动脉粥样硬化病变的临床疗效研究

摘要

目的：探讨中西医结合治疗糖尿病性下肢动脉粥样硬化病变( LEAD）的临床疗效。方法选取2012年1月—2014年12月汝州市济仁糖尿病医院收治的2型糖尿病性LEAD患者120例。根据就诊顺序，将其随机分为西医治疗组和中西医结合治疗组各60例。西医治疗组采用常规西医治疗，包括控制血糖和血压、降低血脂及扩张血管治疗；中西医结合治疗组在常规西医治疗基础上，加服活血通络散，3个月为1个疗程。比较并分析两组治疗前和治疗3个月后的糖尿病足症状量表评分、踝臂指数( ABI ）及彩超检查结果。结果两组性别、平均年龄、平均病程及糖化血红蛋白比较，差异无统计学意义( P＞0.05）。治疗前两组疼痛、冷感及麻木3个维度评分比较，差异无统计学意义(P＞0.05）；治疗后两组疼痛、冷感及麻木3个维度评分比较，差异有统计学意义(P＜0.05）；治疗后两组疼痛、冷感及麻木3个维度评分与治疗前比较，差异均有统计学意义( P＜0.05）。治疗前两组ABI比较，差异无统计学意义(P＞0.05）；治疗后两组ABI比较，差异有统计学意义(P＜0.05）；治疗后两组ABI与治疗前比较，差异有统计学意义( P＜0.05）。治疗前两组血管狭窄情况比较，差异无统计学意义( P＞0.05）；治疗后两组血管狭窄情况比较，差异有统计学意义( P＜0.05）。结论中西医结合治疗糖尿病性LEAD的临床效果确切，可有效改善患者的临床症状和下肢血液循环，值得在临床上推广使用。%Objective To investigate the clinical efficacy of the combined therapy of traditional Chinese medicine ( TCM) and western medicine ( WM ) in the treatment of lower extremity atherosclerotic disease ( LEAD ) in diabetic patients.Methods We enrolled 120 patients with type 2 diabetes mellitus and LEAD who were admitted into Jiren Diabetes Hospital of Ruzhou from January 2012 to December 2014.According to the sequence of consultation, the subjects were divided into WM group and TCM+WM group, with 60 patients in each group.The WM group was administrated with conventional WM treatment including blood glucose and blood pressure control, lowering blood lipid and dilating blood vessel; the TCM +WM group was also administrated with Huoxue tongluo power besides conventional therapy with 3 months as a treatment course.Before treatment and 3 months after treatment, diabetic foot symptoms rating scale score, ABI and color ultrasonography results were analyzed and compared between the two groups.Results The two groups were not significantly different in gender, average age, average disease duration and glycosylated hemoglobin ( P >0.05 ) .Before treatment, the two groups were not significantly different in pain, sense of coldness and numbness ( P>0.05); after treatment, the two groups were significantly different in pain, sense of coldness and numbness (P<0.05); the scores of pain, sense of coldness and numbness of the two groups after treatment were significantly different from those before treatment ( P <0.05 ) .Before treatment, the two groups were not significantly different in ABI (P>0.05); after treatment, the two groups were significantly different in ABI (P<0.05); the ABI of the two groups after treatment were significantly different from that before treatment ( P<0.05) .Before treatment, the two groups were not significantly different in the condition of hemadostenosis (P>0.05); after treatment, the two groups were significantly different in the condition of hemadostenosis ( P<0.05) .Conclusion The combined therapy of TCM and WM in the treatment of LEAD in diabetic patients has exact efficacy and is able to improve clinical symptoms and the blood circulation of lower limbs, thus it is worth to be promoted in clinical practice.