Zhang Huajun, Liu Tingting, Zhang Yu, Jiang Qian, Su Wei, He Hongying, Xu Haidong
Department of TCM, 263 Clinical Branch, the Army General Hospital of the Chinese People's Liberation Army, Beijing 101100, China.
Zhongguo Zhen Jiu. 2018 Aug 12;38(8):809-13. doi: 10.13703/j.0255-2930.2018.08.004.
To observe the effect difference of warming needling combined with decoction and ciloprost for arteriosclerosis obliterans (ASO) with stasis.
A total of 96 ASO patients with stasis were randomly assigned into a combination group and a western medication group, 48 cases in each group. Anti-hypertension, glucose-lowering and lipid lowering therapies were applied in the two groups. Ciloprost was prescribed orally in the western medication group, twice a day, 100 mg a time. The main acupoints in the combination group were Sanyinjiao (SP 6), Yinlingquan (SP 9), Zusanli (ST 36), Guanyuan (CV 4), and Xuehai (SP 10), matched with Yanglingquan (GB 34) and Weizhong (BL 40). Warming needling was used at Sanyinjiao (SP 6), Zusanli (ST 36), Xuehai (SP 10) and Guanyuan (CV 4), 5 times a week, once a day, 20 min a time. At the same time, self-made decoction was applied in the combination group, 1 dose a day, twice a day. All the treatment was given for continuous 3 courses, 1 month as a course. The indexes were the symptom scores for cool limb skin, sour swelling, numbness, pain, abnormal complexion, ankle brachial index (ABI) and blood biochemical indexes, including fasting blood-glucose (FPG), triacylglycerol (TG), cholesterol total (TC), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), glutamic-pyruvic transaminase (ALT), glutamic-oxalacetic transaminase (AST), serum creatinine (Scr) and blood urea nitrogen (BUN). The adverse reactions were recorded. The clinical effect was evaluated. Two-month follow-up was carried out.
After treatment, the symptom scores for cool limb skin, sour swelling, numbness, pain, abnormal complexion and total score decreased in the two groups (all <0.05), with better results in the combination group (all <0.05). The bilateral ABI were higher than those before treatment in the two groups (all <0.05), with better results in the combination group (both <0.05). The FPG, TG, TC, HDL-C, LDL-C, ALT, AST, Scr, BUN before and after treatment had no statistical significance in the two groups (all >0.05). There was no adverse reaction on acupuncture and moxibustion. The total effective rate of the combination group was 95.8% (46/48), which was better than 91.7% (44/48) of the western medication group (<0.05). The recurrence and aggravation rate in the combination group was 8.7% (4/46), which was lower than 18.2% (8/44) in the western medication group (<0.05).
Warming needling combined with decoction for ASO are better than simple oral ciloprost, with safety.
观察温针结合自拟方与西洛他唑治疗血瘀型动脉硬化闭塞症（ASO）的疗效差异。
将96例血瘀型ASO患者随机分为联合组和西药组，每组48例。两组均给予降压、降糖、降脂治疗。西药组口服西洛他唑，每日2次，每次100 mg。联合组主穴取三阴交（SP 6）、阴陵泉（SP 9）、足三里（ST 36）、关元（CV 4）、血海（SP 10），配穴取阳陵泉（GB 34）、委中（BL 40）。三阴交（SP 6）、足三里（ST 36）、血海（SP 10）、关元（CV 4）行温针治疗，每周5次，每日1次，每次20分钟。同时联合组服用自拟方，每日1剂，分2次服。所有治疗连续进行3个疗程，1个月为1个疗程。观察指标为肢体皮肤发凉、酸胀、麻木、疼痛、面色异常的症状评分，踝肱指数（ABI）及血液生化指标，包括空腹血糖（FPG）、三酰甘油（TG）、总胆固醇（TC）、高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL-C）、谷丙转氨酶（ALT）、谷草转氨酶（AST）、血清肌酐（Scr）和尿素氮（BUN）。记录不良反应，评价临床疗效，并进行2个月的随访。
治疗后，两组肢体皮肤发凉、酸胀、麻木、疼痛、面色异常的症状评分及总分均降低（均P<0.05），联合组改善更明显（均P<0.05）。两组双侧ABI均高于治疗前（均P<0.05），联合组改善更明显（均P<0.05）。两组治疗前后FPG、TG、TC、HDL-C、LDL-C、ALT、AST、Scr、BUN比较，差异均无统计学意义（均P>0.05）。针刺及艾灸未出现不良反应。联合组总有效率为95.8%（46/48），优于西药组的91.7%（44/48）（P<0.05）。联合组复发加重率为8.7%（4/46），低于西药组的18.2%（8/44）（P<0.05）。
温针结合自拟方治疗ASO疗效优于单纯口服西洛他唑，且安全性好。
