目的 探討脈絡(luò)舒通丸聯(lián)合低分子肝素鈣注射液治療下肢動脈硬化閉塞癥的臨床療效。方法 選取2020年1月—2023年1月在廊坊市人民醫(yī)院就診的130例下肢動脈硬化閉塞癥患者，將所有患者按照隨機數(shù)字表法分為對照組和治療組，每組各65例。對照組皮下注射低分子肝素鈣注射液，1支/次，2次/d。治療組在對照組基礎(chǔ)上飯后口服脈絡(luò)舒通丸，3次/d，每次12 g/次。兩組在治療7 d后統(tǒng)計療效。比較兩組患者的臨床療效、行走距離、超聲參數(shù)、血清指標(biāo)。結(jié)果 治療后，治療組的總有效率明顯高于對照組，差異有顯著性（P＜0.05）。治療后，兩組的最長行走距離、無痛行走距離明顯增長（P＜0.05）；治療組的最長行走距離、無痛行走距離明顯長于對照組（P＜0.05）。治療后，兩組的踝肱指數(shù)（ABI）、股動脈血流速度、足背動脈血流速度顯著升高（P＜0.05）；治療組的ABI、股動脈血流速度、足背動脈血流速度明顯高于對照組（P＜0.05）。治療后，兩組的血清CD163、轉(zhuǎn)化生長因子-β1（TGF-β1）、白細胞介素-17（IL-17）水平顯著降低（P＜0.05）；治療組的血清CD163、TGF-β1、IL-17水平明顯低于對照組（P＜0.05）。結(jié)論 脈絡(luò)舒通丸聯(lián)合低分子肝素鈣注射液可提高下肢動脈硬化閉塞癥的療效，提高患者行走距離，改善下肢血流速度，降低炎癥反應(yīng)。

Objective To investigate the clinical effect of Mailuo Shutong Pills combined with Low Molecular Weight Heparin Calcium Injection in treatment of lower extremity arteriosclerosis obliterans. Methods Patients (130 cases) with lower extremity arteriosclerosis obliterans in Langfang People's Hospital from January 2020 to January 2023 were divided into control and treatment groups according to the random number table method, and each group had 65 cases. Patients in the control group were sc injected with Low Molecular Weight Heparin Calcium Injection, 1 dose/time, twice daily. Patients in the treatment group were po administered with Mailuo Shutong Pills after a meal on the basis of the control group, 12 g/time, three times daily. Patients in two groups were treated for 7 d. The clinical efficacies, walking distance, ultrasound parameters, and serum indicators in two groups were compared. Results After treatment, the total effective rate of the treatment group was significantly higher than that of the control group, with a significant difference (P < 0.05). After treatment, the longest walking distance and painless walking distance of two groups were significantly increased (P < 0.05), and the longest walking distance and painless walking distance of the treatment group were significantly longer than those of the control group (P < 0.05). After treatment, ABI, femoral artery blood flow velocity, and dorsalis pedis artery blood flow velocity of two groups were significantly increased (P < 0.05), and ABI, femoral artery blood flow velocity, and dorsalis pedis artery blood flow velocity of the treatment group were significantly higher than those of the control group (P < 0.05). After treatment, the serum levels of CD163, TGF-β1, and IL-17 in both groups were significantly reduced (P < 0.05), and the serum levels of CD163, TGF-β1, and IL-17 in the treatment group were significantly lower than those in the control group (P < 0.05). Conclusion Mailuo Shutong Pills combined with Low Molecular Weight Heparin Calcium Injection can improve the efficacy of lower extremity arteriosclerosis obliterans, increase the walking distance, improve lower limb blood flow velocity, and reduce inflammatory reactions.

R973

河北省衛(wèi)生健康委科研基金項目（20181464）