火针放血联合康复训练治疗下肢静脉曲张疗效与机制研究

王静丽;王光安;袁宁华;曹秋彩

文章摘要

王静丽;王光安;袁宁华;曹秋彩.火针放血联合康复训练治疗下肢静脉曲张疗效与机制研究[J].中医药信息,2023,40(8):59-64

火针放血联合康复训练治疗下肢静脉曲张疗效与机制研究

Efficacy and Mechanism of Fire Needle Bloodletting Combined with Rehabilitation Training in Treatment of Lower Extremity Varicosity

投稿时间：2022-08-16 录用日期：2022-09-23

DOI：10.19656/j.cnki.1002-2406.20230809

中文关键词: 火针放血康复训练下肢静脉曲张纤溶酶原激活物抑制剂 1 血液高凝状态血管内皮功能血液流变学

英文关键词: Bloodletting with fire needle Rehabilitation training Lower extremity varicosity Plasminogen activator inhibitor－1 Blood hypercoagulable state Vascular endothelial function Hemorheology

基金项目:河南省中医药科学研究专项课题（2022ZY1111）

作者	单位
王静丽;王光安;袁宁华;曹秋彩

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中文摘要:

目的：探究火针放血联合康复训练治疗下肢静脉曲张的疗效及机制。方法：选择河南中医药大学第三附属医院收治的符合纳入标准的下肢静脉曲张患者76例，依据随机数字表随机分为观察组和对照组，每组各38例。观察组给予火针放血联合康复训练治疗，对照组给予手术联合康复训练治疗。于治疗前后检测两组患者肿瘤坏死因子-α(TNF-α)、可溶性血管细胞间黏附因子-1(sVCAM-1)、超敏C反应蛋白（hs-CRP）、纤溶酶原激活物抑制剂1(SERPINE 1)、Kruppel样转录因子2(KLF2)、6-酮-前列腺素F1α(6-Keto-PGF1α)、活化部分凝血活酶时间（APTT）、组织纤溶酶原激活物（tPA）、一氧化氮（NO）、血管性血友病因子（vWF）、纤维蛋白原、红细胞沉降率及血浆黏度水平；采用静脉临床严重程度评分表（VCSS）和静脉功能损害程度评分（VDS）对两组患者静脉情况进行评价；采用慢性静脉功能不全生活质量（CIVIQ）评价患者生活质量；比较两组患者临床疗效和并发症发生情况。结果：治疗后，两组患者观察指标均较治疗前改善明显（P <0.05）；观察组患者治疗后TNF-α、sVCAM-1、hs-CRP、SERPINE 1、6-Keto-PGF1α、vWF、纤维蛋白原、红细胞沉降率、血浆黏度水平低于对照组（P <0.05）,KLF2、APTT、t-PA、NO水平高于对照组（P <0.05）；观察组患者治疗后VDS、CIVIQ、VCSS评分低于对照组（P <0.05）；观察组患者总有效率（97.37%,37/38）高于对照组（94.74%,36/38），但两组比较，差异无统计学意义（P> 0.05）；两组并发症发生情况比较，差异无统计学意义（P> 0.05）。结论：火针放血联合康复训练治疗下肢静脉曲张患者，可抑制患者炎症，降低SERPINE 1水平，提升KLF2、APTT、t-PA水平，改善患者血液高凝状态，减少血管内皮功能损伤，改善患者血液流变学，缓解临床症状，提高临床疗效与生活质量。

英文摘要:

Objective: To explore the efficacy and mechanism of fire needle bloodletting combined with rehabilitation training in treatment of lower extremity varicosity. Methods: A total of 76 patients with varicosity of lower extremities were randomly divided into the observation group and the control group, with 38 patients in each group. The observation group was treated with fire needle bloodletting combined with rehabilitation, whereas the control group was treated with surgery combined with rehabilitation training. The levels of tumor necrosis factor α(TNF-α), soluble vascular cell adhesion molecule-1(sVCAM-1), high-sensitivity C-reactive protein(hs-CRP), plasminogen activator inhibitor 1(SERPINE 1), Kruppel-like transcription factor 2(KLF2), 6-keto-prostaglandin F1α(6-Keto-PGF1α), activated partial thromboplastin time(APTT), tissue plasminogen activator(t-PA), nitric oxide(NO), von Willebrand factor(vWF), fibrinogen, erythrocyte sedimentation rate(ESR) and plasma viscosity were detected before and after the treatment in the two groups. The scores of venous clinical severity scale(VCSS) and venous damage scale(VDS) were assessed in the patients. Chronic venous insufficiency questionnaire(CIVIQ) was used to evaluate life quality of the patients, and the clinical efficacy was compared between the two groups. Results: The observing indexes were all improved after the treatment in the two groups(P < 0. 05). The levels of TNF-α, sVCAM-1, hs-CRP, SERPINE 1, 6-Keto-PGF1α, vWF, fibrinogen, ESR and plasma viscosity were lower(P < 0. 05), and the levels of KLF2, APTT, t-PA and NO were higher in the observation group than those in the control group after the treatment(P < 0. 05). The scores of VDS, CIVIQ and VCSS were lower in the observation group than those in the control group after the treatment(P < 0. 05).The total effective rate was 97. 37%(37/38) in the observation group, which was higher than 94. 74%(36/38) in the control group, but in which there was no statistical difference between the two groups(P > 0. 05). There was also no statistical difference in the occurrence of complications between the two groups(P > 0. 05).Conclusion: Fire needle bloodletting combined with rehabilitation training can inhibit the inflammation, reduce the level of SERPINE 1, increase the levels of KLF2, APTT and t-PA, improve the hypercoagulable state of blood, reduce the damage of vascular endothelial function, improve the rheology, relieve the clinical symptoms, and improve the life quality of the patients in treatment of lower extremity varicosity.

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