| Popliteal artery is one of the common lesions in patients with atherosclerosis oblit erans of the lower extremities.Revascularization is the main method of Western medic ine in the treatment of such diseases.With the appearance of drug coated balloon,alt hough it can reduce the incidence of restenosis and improve the patency rate of the t arget blood vessel after endovascular treatment of the lower extremity,the incidence o f restenosis and occlusion of the target blood vessel is higher due to the unique anato mical structure of popliteal artery.At present,traditional Chinese medicine in the treat ment of lower limb ischemic disease has a good effect,but the treatment of popliteal artery disease mainly by the combination of Chinese and Western medicine still needs to be explored.Objective To observe the effect of Xuefu Zhuyu Decoction on symptoms and va scular patency in patients with popliteal artery disease and blood supply reconstruction Through the observation of the curative effect indicators to clarify the role of traditio nal Chinese medicine in the treatment of popliteal artery disease after revascularization,so as to better guide the clinical.Methods 131 cases(131 limbs)of popliteal artery disease,which were admitted from January 2018 to July 2019,According towhether the patients took oral Chinese medicine after operation,they were divided into Chinese medicine group and control g roup.59 cases(59 limbs)in Chinese medicinegroup and 72 cases(72 limbs)in contr ol group.All patients were inquired about the postoperative condition through outpatie nt service and telephone.The traditional Chinese medicine group was treated with Xue fu Zhuyu Decoction on the basis of Western medicine,while the control group was tr eated with western medicine for 3 months,and the basic Western Medicine Group con tinued to take the medicine according to the doctor’s advice.The general condition,ch ronic history,ankle brachial index were observedbefore operation,ABI,Rutherford clas sification,target blood vessels,etc.the clinical efficacy,ABI,Rutherford classification,foot ulcer,target vessel re intervention,TCM symptom score,mortality and cause of death of the two groups were compared before and after operation,3 months and 6 months after operation,and statistical analysis wasconducted.All the 131 patients com pleted the follow-up visit 3 and 6 monthsafter the operation.Results All the 131 patients underwent successful revascularization and the clinica l symptoms were improved.The two groups were comparable in age,gender,smoking history,chronic history,target lesion,ABI,Rutherford classification,TCM syndrome sc ore(P>0.05).After revascularization,the ABI of the two groups was 0.35±0.02 and 084±0.14 respectively;the control group was 0.32±0.02 and 0.81±0.08 respectively;the Rutherford classification of the two groups was mainly at level 3-6 and 0-6 respective 1y;the clinical symptoms of the two groups were improved in 21 cases(35.59%)andr estpain in 11 cases(18.64%)In the control group,26 patients(36.11%)had improvedl imp symptoms,16 patients(22.22%)had disappeared after rest pain,and 30 patients(41.67%)had toe amputation after intracavitary treatment.Although the indexes were s ignificantly improved after operation compared with before operation,there were mores ignificant differences in TCM syndrome score and abi(P<0.05).Three months after th e operation,the ABI,Rutherford classification,foot ulcer and TCM symptom score oft he two groups were significantly improved.However,in ABI,TCM group was 0.79±0.04,control group was 0.66±0.03,TCM group was significantly better than the control group(P<0.05);in TCM syndrome analysis,TCM group had no significant advantage over the control group in skin color,limp distance,ulcer(P>0.05),but in skin temper ature,TCM group score was 2.18±0.07,control group was 3.16±0.11;in pain In TCM group,the score was 2.56±0.08,the control group was 3.58±0.13,the TCM group was better than the control group(P<0.05);in TCM syndrome score,the TCM group was 13.23±0.56,the control group was 16.87±0.64,the TCM group was better than the co ntrol group(P<0.05).There was no significant difference(P>0.05)between the Chines e medicine group(3.51%)and the control group(4.48%).Six months after operation,the observation indexes of the two groups were significantly improved(P<0.05).Howe ver,in ABI,TCM group was 0.75±0.04,control group was 0.59±0.02,TCM group wa s significantly better than the control group(P Group A was better than the control gr oup(P<0.05).In the aspect of TCM syndrome score,the TCM group was 9.12±0.23,the control group was 13.20±0.35,and the TCM group was superior to the control gr oup(P<0.05);in the aspect of target vessel re intervention rate,there was no significa nt difference between the TCM group(7cases)and the control group(7cases)(P>0.05).One case(1.41%)in the control group had major amputation in 3 months,and no ma jor amputation in the traditional Chinese medicine group in 6 months.Six patients die d three months after operation and eight patients died six months after operationConclusion For patients with popliteal artery disease,the use of drug coated bal loon can greatly improve the symptoms.At the same time,oral administration of tradi tional Chinese medicine can improve limb ischemia and relieve clinical symptoms to a certain extent,but the role of traditional Chinese medicine in the prevention of target vessel restenosis and long-term effect of patients with popliteal artery disease still nee ds long-term follow-up data to observe. |
