CAJ | 학술논문

目的：探讨蛭芪胶囊防治老年糖尿病足介入手术术后再狭窄的临床疗效。方法随机选取2013年2月-2014年2月在该院行糖尿病足介入手术的老年患者120例，按照随机数字表法分为观察组和对照组各60例，其中观察组在应用低分子肝素钙的基础上给予蛭芪胶囊口服，对照组单纯给予低分子肝素钙预防术后再狭窄，两组疗程均为10 d。观察两组患者治疗前后血流动力学的变化，记录再次狭窄发生率及出血倾向。结果两组患者术前的血液流变学指标比较差异无统计学意义(P>0.05)；术后第1天各项指标均较术前差异有统计学意义(P<0.05)，疗程结束后各项指标水平均较术后1 d明显降低，恢复至术前水平，差异有统计学意义(P<0.05)，两组间比较差异无统计学意义(P>0.05)。观察组60例中发生再狭窄3例，发生率为3.33%；对照组发生再狭窄18例，发生率为30%，观察组显著低于对照组，差异有统计学意义(P<0.05)。观察组和对照组出血倾向者分别为4(6.67%)vs 12例(20.0%)，观察组明显低于对照组，差异有统计学意义(χ2=3.905，P<0.05)。未发生严重过敏反应、肝肾功能损害等药物不良反应。结论在常规应用低分子肝素钙的基础上，应用蛭芪胶囊相对于单纯应用低分子肝素钙可以明显降低介入手术术后术后再狭窄的发生。
목적：탐토질기효낭방치노년당뇨병족개입수술술후재협착적림상료효。방법수궤선취2013년2월-2014년2월재해원행당뇨병족개입수술적노년환자120례，안조수궤수자표법분위관찰조화대조조각60례，기중관찰조재응용저분자간소개적기출상급여질기효낭구복，대조조단순급여저분자간소개예방술후재협착，량조료정균위10 d。관찰량조환자치료전후혈류동역학적변화，기록재차협착발생솔급출혈경향。결과량조환자술전적혈액류변학지표비교차이무통계학의의(P>0.05)；술후제1천각항지표균교술전차이유통계학의의(P<0.05)，료정결속후각항지표수평균교술후1 d명현강저，회복지술전수평，차이유통계학의의(P<0.05)，량조간비교차이무통계학의의(P>0.05)。관찰조60례중발생재협착3례，발생솔위3.33%；대조조발생재협착18례，발생솔위30%，관찰조현저저우대조조，차이유통계학의의(P<0.05)。관찰조화대조조출혈경향자분별위4(6.67%)vs 12례(20.0%)，관찰조명현저우대조조，차이유통계학의의(χ2=3.905，P<0.05)。미발생엄중과민반응、간신공능손해등약물불량반응。결론재상규응용저분자간소개적기출상，응용질기효낭상대우단순응용저분자간소개가이명현강저개입수술술후술후재협착적발생。
Objective To explore the clinical effect of Zhi-Qi capsule in treatment of senile diabetic foot restenosis after interven-tional operation. Methods 120 elderly patients with diabetic foot patients from February 2013 - February 2014 by the interven-tional operation in our hospital were randomly divided into observation group and control group with 60 cases in each group, the observation group on the basis of the application of low molecular weight heparin calcium on the granting of Zhi Qi capsule orally, the control group only treated with low molecular weight heparin the prevention of restenosis, two groups were treated for 10d. The changes of hemodynamics before and after treatment in the patients of two groups were observed, the again stenosis and bleeding tendency were recorded. Results The index blood rheology in patients of two groups before treatment had no significant difference (P>0.05);after first days, compared with the preoperative level, all the indexes were statistical differences (P<0.05), after the end of treatment, the level indexes were significantly decreased after 1 days, returned to the preoperative level, with significant difference (P<0.05), there were no statistically significant differences between the two groups (P>0.05). In the observation group, 3 cases of restenosis in 60 cases, the incidence was 3.33%; the control group occurred restenosis in 18 cases, the incidence rate was 30%, the observation group was significantly lower than that of the control group, there were significant differences (P<0.05). The obser-vation group and the control group bleeding were 4 (6.67%) vs 12 (20%), the observation group was significantly lower than that of the control group, with significant difference (χ2=3.905, P<0.05). There were no serious allergic reactions, liver and kidney dys-function adverse drug reaction. Conclusion Based on the conventional application of low molecular heparin calcium on, the appli-cation of Zhi-Qi capsule can significantly reduce the interventional operation postoperative restenosis compared with the simple application of low molecular weight heparin calcium.