四妙勇安方治疗血栓闭塞性脉管炎疗效观察和护理体会

摘要

目的 观察四妙勇安方治疗血栓闭塞性脉管炎的疗效及护理体会.方法 选取2013年6月至2015年3月我院收治的血栓闭塞性脉管炎患者74例为研究对象,采用随机数表法分为观察组和对照组各37例,对照组给予常规西药(前列地尔、己酮可可碱缓释片)、中成药及常规护理,观察组在对照组基础上给予四妙勇安汤及中医护理,两组均治疗2个月,对比其治疗有效率,同时采用酶联免疫吸附试验(ELISA)分析两组血清白介素-6(IL-6)、C-反应蛋白(CRP)、血栓素B2(TXB2)水平,应用全自动血液流变仪测定两组血清低密度脂蛋白(LDL-C)、高密度脂蛋白(HDL-C)、总胆固醇(TC)水平,同时采用疼痛视觉模拟评分法(VAS)、护理满意度评分表评价其疼痛度及护理满意度,并观察不良反应.结果 观察组治疗有效率94.59％明显高于对照组72.97％ (P ＜0.05);观察组治疗后血清IL-6、CRP、TXB2、LDL-C、TC水平低于对照组(P＜0.05),而HDL-C高于对照组(P＜0.05);护理后观察组VAS评分(2.10±0.31)低于对照组,观察组满意度(89.34±1.62)高于对照组(P＜0.05);两组不良反应发生率为13.51％ vs8.11％ (P ＞0.05).结论 四妙勇安方治疗血栓闭塞性脉管炎疗效较单纯西药好,可明显改善患者炎症因子及血脂水平,配合护理可降低患者疼痛,提高其护理满意度.%Objective To observe the effects and nursing experience of Simiaoyong'an drug in treating thromboangiitis obliterans(TAO).Methods Seventy-six patients with TAO treated in our hospital between June 2013 and March 2015 were selected as the study subjects and were randomized into observation group and control group,37 cases in each group.The control group was given conventional western medicine (alprostadil,Pentoxifylline Sustained Release Tablets),Chinese medicine and routine nursing.On the basis,the observation group was given Simiaoyong'an Decoction and traditional Chinese medicine nursing.Both groups were treated for 2 months.The effective rate was compared.The levels of serum interleukin-6(IL-6),C-reactive protein (CRP) and thromboxane B2 (TXB2) were determined by enzyme-linked immunosorbent assay (ELISA) while the levels of serum low density lipoprotein (LDL-C),high density lipoprotein (HDL-C),and total cholesterol(TC)were determined by automatic blood rheometer.Pain degree and nursing satisfaction were evaluated by pain visual analogue scale (VAS)and nursing satisfaction scale,and adverse reactions were observed.Results The effective rate in the observation group (94.59％)was higher than that in the control group(72.97％) (P ＜ 0.05);After treatment,the levels of serum IL-6,CRP,TXB2 [(45.29 ± 1.87) pg/ mL],LDL-C and TC in the observation group were lower than those in the control group (P ＜ 0.05) while HDL-C was higher than that in the control group (P ＜ 0.05);After nursing,VAS score in the observation group(2.10 ± 0.31)was lower than that in the control group,while satisfaction score (89.34 ± 1.62)was higher(P ＜ 0.05);There was no significant difference in the incidence of adverse reactions between the two groups(13.51％ vs 8.11％) (P ＞ 0.05).Conclusion The effect of Simiaoyong'an Decoction is better than that of simple western medicine in treating TAO.It can significantly improve the inflammatory factors and blood lipid levels of patients.Combined with TCM nursing,it can reduce pain,improve nursing satisfaction,without obvious adverse reactions.