【摘要】：目的通過(guò)觀察前列地爾、針刺聯(lián)合前列地爾治療下肢動(dòng)脈斑塊患者的療效差異,從而評(píng)價(jià)針刺聯(lián)合前列地爾治療下肢動(dòng)脈斑塊的臨床療效和安全性。研究方法1.將2013年6月-2014年6月安徽中醫(yī)藥大學(xué)第二附屬醫(yī)院收治的40例符合納入標(biāo)準(zhǔn)的下肢動(dòng)脈斑塊患者,按照隨機(jī)數(shù)字表法分為治療組(針刺聯(lián)合前列地爾組)和對(duì)照組(前列地爾組)各20例。2.針刺聯(lián)合前列地爾治療組:患者取坐位,常規(guī)消毒后,采用單手進(jìn)針法將天協(xié)牌針灸針快速刺入患者以下穴位:足三里、三陰交、懸鐘、豐隆,均為雙側(cè)。進(jìn)針后行手法催氣,以有酸麻脹或有觸電感為佳,得氣后停止行針,留針,中間隔20分鐘行針一次,治療時(shí)間為40分鐘,每日1次,并將前列地爾注射液l0μg(與對(duì)照組藥外包裝完全一致)溶解在10ml生理鹽水中,然后緩慢靜脈推注,每日給藥1次,連續(xù)給藥14d。受試者實(shí)際用藥量80%研究所需用藥量,視為脫落。3.前列地爾對(duì)照組:將前列地爾注射液l0μg(哈藥集團(tuán)生物工程有限公司生產(chǎn),國(guó)藥準(zhǔn)字H20084565)溶解在10ml生理鹽水中,然后緩慢靜脈推注,每日給藥1次,連續(xù)給藥14d。受試者實(shí)際用藥量80%研究所需用藥量,視為脫落。4.兩組均以14次為1個(gè)療程,療程間休息7天再進(jìn)入下一個(gè)療程,治療2個(gè)療程。治療前后均檢查患者雙下肢動(dòng)脈彩超,對(duì)兩組患者進(jìn)行療效評(píng)價(jià);并且6個(gè)月后再次行下肢動(dòng)脈彩超檢查判斷其療效。最后將采集的數(shù)據(jù)用統(tǒng)計(jì)軟件SPSS17.0進(jìn)行分析。結(jié)果共納入40例完成實(shí)驗(yàn)。針刺聯(lián)合前列地爾組治療后觀察指標(biāo)較治療前有顯著差異(P0.01),前列地爾組治療后較前有差異(P0.05)。兩組治療前后下肢動(dòng)脈中內(nèi)膜厚度及斑塊面積的差異有統(tǒng)計(jì)學(xué)意義(P0.05),且治療組優(yōu)于對(duì)照組。6個(gè)月后針刺聯(lián)合前列地爾治療組與前列地爾對(duì)照組比較有顯著差異(P0.01)。結(jié)論針刺足三里、三陰交、懸鐘、豐隆穴聯(lián)合前列地爾注射液和單用前列地爾注射液均能改變下肢動(dòng)脈斑塊的大小,降低下肢動(dòng)脈中內(nèi)膜厚度,但是針刺足三里、三陰交、懸鐘、豐隆穴聯(lián)合前列地爾注射液組的效果明顯優(yōu)于單用前列地爾注射液組,且針刺治療組維持療效優(yōu)于對(duì)照組。所以針刺足三里、三陰交、懸鐘、豐隆穴能減小下肢動(dòng)脈斑塊的大小、降低下肢動(dòng)脈中內(nèi)膜厚度,從而減少梗塞的風(fēng)險(xiǎn)。
[Abstract]:Objective to evaluate the efficacy and safety of alprostadil combined with alprostadil in the treatment of arterial plaque of lower extremity. Method 1. From June 2013 to June 2014, 40 patients with arterial plaques of lower extremity who were admitted to the second affiliated Hospital of Anhui University of traditional Chinese Medicine, According to random number table method, 20 cases in treatment group (acupuncture combined with alprostadil group) and 20 cases in control group (alprostadil group) were divided into treatment group (n = 20) and control group (n = 20). Acupuncture combined with alprostadil treatment group: the patients took the sitting position, after routine disinfection, the Tianxie acupuncture needle was quickly punctured into the following points: Zusanli, Sanyinjiao, suspension bell, Fenglong, both sides. After entering the needle, the best way to promote qi is to have acid swelling or electric shock. After getting qi, stop the needle, keep the needle, once every 20 minutes, treatment time is 40 minutes, once a day, Alprostadil injection 10 渭 g (exactly the same as the control group) was dissolved in 10ml saline, and then was injected intravenously once a day for 14 days. The actual amount of medicine used in the study was 80%, which was regarded as shedding. Alprostadil control group: L0 渭 g of alprostadil injection (produced by Harbin Pharmaceutical Group Bioengineering Co., Ltd., H20084565) was dissolved in normal saline of 10ml, then slowly injected intravenously, once a day, continuously for 14 days. The actual amount of medicine used in the study was 80%, which was regarded as shedding. 4. 4. The two groups were treated with 14 times as a course of treatment, rest 7 days between the courses and then enter the next course of treatment, 2 courses of treatment. Before and after treatment, the two lower extremity arteries were examined by color Doppler ultrasound to evaluate the curative effect of the two groups, and six months later, the lower extremity artery color ultrasound was performed again to judge the curative effect. Finally, the collected data is analyzed by SPSS17.0. Results A total of 40 cases were included in the experiment. Acupuncture combined with alprostadil group after treatment there was a significant difference in the observation index (P0.01), alprostadil group after treatment than before the difference (P0.05). There were significant differences in intimal thickness and plaque area between the two groups before and after treatment (P0.05). After 6 months of acupuncture combined with alprostadil, there was significant difference between the treatment group and the alprostadil control group (P0.01). Conclusion Acupuncture of Zusanli, Sanyinjiao, Xuanzhong, Fenglong acupoint combined with alprostadil injection and alprostadil injection alone can change the size of arterial plaque of lower extremity and decrease the thickness of intima of lower extremity artery, but acupuncture at Zusanli and Sanyinjiao can change the size of arterial plaque of lower extremity. The effect of Xuanzhong, Fenglong acupoint combined with alprostadil injection group was better than that of single alprostadil injection group, and the maintenance effect of acupuncture group was better than that of control group. Therefore, acupuncture at Zusanli, Sanyinjiao, Xuanzhong and Fenglong points can reduce the size of arterial plaques of the lower extremities, reduce the intimal thickness of the arteries of the lower extremities, and thus reduce the risk of infarction.
【學(xué)位授予單位】：安徽中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2015
【分類號(hào)】：R543.5

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