| Objective:To perform clinical observations on the effects of replenishing Qi activating blood resolving stasis method in lower limb ischemia-reperfusion injury using modifications of the basic prescription "Yang-tonifying five-returning decoction". To perform further studies on the traditional Chinese medicine (TCM) mechanism of disease in lower limb ischemia-reperfusion injury, and to reveal replenishing Qi activating blood resolving stasis method as an effective method in prevention and treatment of lower limb ischemia-reperfusion injury.Method:1.TCM patterns for patients with lower limb ischemia-reperfusion injury were diagnossed through observing their TCM symptoms. Patients with patterns of Qi deficiency blood stasis were selected for the study.2.Patients with patterns of Qi deficiency blood stasis were randomly distributed into the control group or treatment group. Control group:Conventional treatments including controlling of blood pressure, blood glucose and blood lipids, platelet inhibition and vasodilation etc. were administered. Treatment group:Yang-tonifying five-returning decoction was given in addition to conventional treatments. The Yang-tonifying five-returning decoction was modified on a case-to-case basis for every patient according to the symptoms displayed.3.Lower limb pain, degree of swelling, abnormal sensations, photoplethysmography (PPG) amplitude, ankle-brachial index (ABI), serum lactate dehydrogenase (LDH) levels and serum creatine (Cr) levels were observed respectively on day1, day3, day7and day14after reperfusion.4.Statistical processing and analysis of the data was performed using SPSS17.0.Results:1.Clinical symptoms:Patients from both groups were scored respectively on their degree of pain, swelling and abnormal sensations. No significant difference (p>0.05) was observed for patients from both groups during day1. On day3, the scores of both groups reached their peak values, and significant difference (p<0.05) was observed between the treatment group and control group. As the treatments progressed, scores of both groups decreased respectively. Significant difference was observed between the two groups on day7and day14.2.PPG amplitude:Peak values for PPG waves of the control group and treatment group before treatment were hcontroi=1-45±0.67and htreatment=1-57±0.60respectively. No statistical significance was observed between h values of both groups (t=0.84; p>0.05). On day14, PPG peak values for both groups reached Hcontrol=2.51±0.60and Htreatment=5.25±1.32. Comparison before and after treatment:Control group:t=7.56, p<0.01; Treatment group:t=13.91, p<0.01. Comparison between both groups after treatment:t=10.34, p<0.01. Statistical significance was observed in both control and treatment group comparisons before and after treatment, as well as comparison between both groups after treatment.3.Biochemical tests:LDH (U/L) for the treatment group and control group were255.7±95.2and398.3±105.2respectively. Cr (μmmol/L) value was59.3±34.7for the treatment group and135.7±38.4for control group. Significant difference (P<0.05) was observed between the treatment group and control group.4.ABI value:Treatment group:ABI before treatment and after treatment were0.4±0.22and0.98±0.21respectively. Control group:ABI before treatment was0.4±0.27and0.88±0.31after treatment. No significant difference (P>0.05) was observed between both groups before treatment. Significant difference (P<0.05) was observed between the treatment group before and after treatment, control group before and after treatment, and treatment group and control group after treatment. Significant difference (P<0.05) was also observed in ABI changes before and after treatment between the treatment group and control group.5.Therapeutic effects:The effective rate for treatment group was100%, while that of the control group was92.30%. Effective rate for the treatment group was higher than control group. P<0.05between both groups.Conclusion:In our study, Qi deficient blood stasis pattern was the main TCM pattern amongst our limb ischemia-reperfusion injury patients. Replenishing Qi activating blood resolving stasis method can improve clinical symptoms such as pain and swelling in patients with limb ischemia-reperfusion injury. Increases in PPG amplitude signifies effective improvement in toe microcirculation. Decreases in serum LDH and Cr values suggest renal function protective effects. ABI value increases indicate an improvement in limb blood flow volume. In conclusion, through its multi-targeting effects, replenishing Qi activating blood resolving stasis method can effectively prevent and treat lower limb ischemia-reperfusion injury. |
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