Clinical Observation Of Danggui Buxue Decoction In Auxiliary Treatment Of Arteriosclerosis Obliterans Of Lower Extremities

Objective1.To explore the clinical effect of Danggui Buxue decoction(Danggui Buxue decoction)in the treatment of arteriosclerosis obliterans(Atherosclerotic occlusive disease of the lower extremities,ASO-LE).2.To explore the possible mechanism of Danggui Buxue decoction(Danggui Buxue decoction)in treating ASO-LE from the perspective of angiogenesis.Methods The main subjects of this study were stage I ～ II patients with ASO-LE Fontaine stage(age 40 ～ 80 years old).The subjects were randomly assigned to two groups.One group was treated with routine treatment,that is,aspirin enteric-coated tablets.The other group was treated with Danggui Buxue decoction on the basis of the control group(treatment group).The drug use was recorded before treatment and 30 days after treatment.The pain,acid distension,coldness,abnormal skin color,Fuyang pulse movement,dry skin and numbness of limbs were observed,and the ankle brachial index(ankle/)of the affected limbs was measured.The serum concentration of vascular endothelial growth factor(Vascular Endothelial Growth Factor,VEGF)was measured by brachia index,ABI.The data were collected and sorted out,and the improvement of clinical symptoms and signs before and after treatment was evaluated.To explore the possible mechanism of Danggui Buxue decoction in the treatment of ASO-LE from the point of view of vascular neogenesis,and to elucidate the clinical significance of Danggui Buxue decoction in auxiliary treatment of ASO-LE.Results1.General materials: A total of 64 cases were enrolled in this study.There were 32 cases in the control group,1 case in the control group and 31 cases in the control group.In the treatment group,there were 32 cases,2 cases were shedding and 30 cases were completed.There were no significant differences in sex,age,course of disease,Fontaine stage and cardiovascular risk factors between the control group and the treatment group.2.Clinical symptom and sign score: In the control group,0 cases were cured,10 cases(33.33%)were markedly effective,16 cases(51.61%)were effective,5 cases(16.13%)were ineffective,and the total effective rate was 83.87%.In the treatment group,0 cases were cured,18 cases(60.00%)were markedly effective,10 cases(33.33%)were effective,2 cases(6.67%)were ineffective,and the total effective rate was 93.33%.The statistical analysis of rank sum test showed that the curative effect of the treatment group was better than that of the control group in improving the symptoms and signs of ASO-LE patients.3.In the ABI: control group,the ABI of the treatment group was significantly higherthan that of the pre-treatment group(P < 0.01),but there was no significant difference between the two groups(P > 0.05).In the course of 30 days,the two groups had significant effect on improving the blood supply of the affected limbs and dilating the small arteries of the lower extremities,while Danggui Buxue decoction had no effect on the dilatation of the small arteries of the affected limbs in a short period of time.4.Determination of serum VEGF concentration: after treatment,the serum VEGF concentration in the treatment group was higher than that before treatment,the difference was statistically significant(P < 0.05).There was no significant difference in serum VEGF concentration before and after treatment in the control group(P > 0.05).It is suggested that Danggui Buxue decoction can promote the expression of VEGF gene and increase the concentration of serum VEGF in patients with ASO-LE.Conclusions1.Danggui Buxue decoction has therapeutic effect on pain,acid distension,cooling,abnormal complexion,pulse movement of Fuyang and dry skin(P < 0.05),but has no effect on numbness of limbs(P > 0.05)..2.Danggui Buxue decoction may improve the clinical symptoms and signs of affected limbs by increasing the concentration of serum VEGF in patients with ASO-LE and promoting the growth of small blood vessels in ischemic tissue and newborn.3.Through the analysis and discussion of the curative effect,it is shown that the effect of Danggui Buxue decoction combined with western medicine is better than that of western medicine alone,and the curative effect on improving the symptoms and signs of ASO-LE patients is better than that of the control group.