温经通络方外洗治疗糖尿病肢体动脉闭塞症临床研究

【作者】 张清怡；

【导师】 高彦彬；

【作者基本信息】 北京中医药大学 ， 中医内科， 2008， 硕士

【摘要】 本论文主要包括文献综述和临床研究两个部分。文献综述共两部分。第一部分主要从病理、发病机制、诊断及治疗方面探讨了近年来西方医学对糖尿病肢体动脉闭塞症(DLAO)基础及临床研究进展。关于DLAO发病机理,至今尚未完全明确。目前临床治疗方法很多,但总体疗效并不理想。第二部分从中医病名、病因病机、辨证治疗、专方专药治疗、中药外治方面概述了近年来中医关于糖尿病肢体动脉闭塞症的研究进展。临床研究部分观察了温经通络方对糖尿病肢体动脉闭塞症(DLAO)的临床疗效。将符合标准的一期和二期DLAO患者60例,随机分为治疗组(30例)和对照组(30例),在中西医基础治疗的同时,治疗组予温经通络方外洗,对照组予温水外洗。中西医基础治疗包括西药降糖降压调脂治疗,口服阿斯匹林,静点中药血栓通。观察一个疗程后,对患者的循环改善度、动脉血管狭窄度进行观察并对血糖、血脂、血流变指标等进行监测。结果:治疗组的总有效率为86.67%,对照组的总有效率为66.67%。两组病人循环改善度、动脉血管狭窄度皆有改善,经Ridit检验显示治疗组疗效优于对照组(P<0.05)。治疗过程中未见明显不良反应。结论:温经通络方外洗可有效治疗一期和二期糖尿病肢体动脉闭塞症患者;在西药基础治疗同时予以中药血栓通静点配合温经通络方外洗治疗糖尿病肢体动脉闭塞症安全有效,显示了中医药综合疗法的优势,值得临床进一步推广应用。更多还原

【Abstract】 This thesis consists two parts: the literature review and the clinical research.There are 2 sections of the literature review. The first one is about the research progress of western medicine in diabetic limb arterial obstruction( DLAO) in recent years. It includes research of the cause,diagnosis and treatment method.The cause of DLAO has not clearly expounded yet today.There are many ways used in clinical care, but the curative effect is not so good. The second section is about the research progress of TCM in DLAO. It includes the analysis of pathogens and pathogenesis,treatment applying with the pattern identification, special treatment of herbs,herbs immersing.The clinical part is about the research of efficacy for treating DLAO on stage one or two with Wenjingtongluo Decoction .Sixty patients with DLAO conforming to the diagnostic criteria were randomly divided into two groups:the treatment group(30 patients)and the control group(30 patients). Besides the routine therapy,the treatment group was given Wenjingtongluo Decoction immersing lower limbs.The control group is given warm water immersing lower limbs. The clinical effect was observed, and blood sugar, lipid and hemorheological status checked. The results showed that the total effective rate of the herb group was 86.67% and that of control group was 66.67% . The symptoms of circulation and the blood vessel straitness of the treated group were obviously improved. By the Ridit test, significant differences in terms of clinical efficacy between the two groups were noticed (P<0.05). There were no obvious side effects found during the treatment.We can draw the conclusion that Wenjingtongluo decoction shows great effect for patients with DLAO on stage one and two.更多还原