迈之灵对下肢慢性静脉功能不全患者微循环的改善效果

Effects of Aescuven forte on microcirculation for the treatment of chronic venous insufficiency

摘要:

目的 分析迈之灵对下肢慢性静脉功能不全(CVI)患者微循环指标的改善情况。方法 入选2016年3月至2017年8月中国医学科学院北京协和医院和赤峰市医院血管外科门诊就诊的CVI患者40例,根据治疗方式分为迈之灵组23例和对照组17例。迈之灵组给予迈之灵及弹力袜治疗,对照组仅采用弹力袜治疗,疗程为4周。观察主要疗效指标[流行病学和经济研究(VEINES)/生活质量(QOL)/症状(Sym)问卷评分、经皮氧分压(TcPO₂)、皮肤温度]、次要疗效指标(温控血流及阻断后反应性充血) 和不良反应, 并对疗效和安全性进行评估。采用SPSS 20.0统计软件进行数据处理及分析。组间比较采用t检验、Mann-Whitney U检验或χ²检验。结果 完成病例36例,迈之灵组22例,对照组14例。迈之灵组治疗前相比治疗后VEINES-QOL[(69.3±13.5) vs(76.7±11.9)分]、VEINES-Sym[(31.9±7.9) vs(36.0±7.4)分]、TcPO₂[(45.2±22.3) vs(56.3±16.5)mmHg]、皮肤温度[32.6(31.5,3.9)℃ vs 31.8(31.0,2.9)℃]和温控血流[(151.4±123.0)% vs(418.0±179.5)%]差异均有统计学意义(P＜0.05)。对照组治疗前相比治疗后VEINES-QOL[(64.0±16.1) vs(69.0±16.7)分]、VEINES-Sym[(29.3± 7.7) vs(32.6±7.9)分]和TcPO₂[(39.6±16.8) vs(51.4±9.9)mmHg]差异有统计学意义(P＜0.05)。迈之灵组相比对照组治疗前后的温控血流差值[(266.6±170.1)% vs(-110.1±160.5)%]差异有统计学意义(P＜0.05)。结论 迈之灵在一定程度上可改善CVI患者生活质量及临床症状,其疗效可能与其对下肢微循环的改善作用有关。微循环指标中TcPO₂、皮肤温度、温控血流可能在一定程度上反映CVI患者下肢微循环的变化。CVI的发病机制可能与下肢微循环改变有密切关联。

Abstract:

Objective To investigate the effects of Aescuven forte on microcirculation for the treatment of chronic venous insufficiency (CVI). Methods A total of 40 outpatients were enrolled in this study from Vascular Surgery Department of Peking Union Hospital and Chifeng Municipal Hospital from March 2016 to August 2017. They were divided into Aescuven forte group (n=23) and control group (n=17). In a course of 4 weeks, the former were treated with Aescuven forte and pressure (elastic stockings), while the latter only with pressure. Observation focused on the primary efficacy indicators [Venous Insufficiency Epidemiological and Economic Studies-quality of life/symptom score (VEINES-QOL/Sym), transcutaneous oxygen pressure (TcPO₂) and skin temperature],secondary efficacy indicators [temperature-controlled blood blow and post-occlusion reactive hyperaemia (PORH)] and adverse reactions, and efficacy and safety were evaluated. SPSS statistics 20.0 was used to perform the statistical analysis. Student＇s t test, Mann-Whitney U test or Chi-square test was employed for comparison between two groups. Results Totally 36 patients (22 in the Aescuven forte group and 14 in the control group) finished the course of the treatment. The readings before vs. after treatment in the Aescuven forte group were VEINES-QOL [(69.3±13.5) vs(76.7±11.9) scores], VEINES-Sym [(31.9±7.9)vs(36.0±7.4)scores], TcPO₂[(45.2±22.3) vs(56.3±16.5)mmHg], skin temperature [32.6(31.5,33.9)℃ vs 31.8(31.0,2.9)℃] and the temperature-controlled blood flow [(151.4±123.0)% vs(418.0±179.5)%], and the differences were statistically significant (P<0.05). The readings before vs. after treatment in the control group were VEINES-QOL [(64.0±16.1) vs(69.0±16.7)scores], VEINES-Sym [(29.3±7.7) vs(32.6±7.9)scores], and TcPO₂ [(39.6±16.8) vs(51.4±9.9)mmHg], and the differences were statistically significant (P<0.05). Significant difference was observed in temperature-controlled blood flow between two groups[(266.6±170.1)% vs(-110.1±160.5)%, P<0.05]. Conclusion Our findings indicated that Aescuven forte may improve the quality of life and relieve the symptoms of the patients with CVI, and that a correlation could be established between curative effects and the improved microcirculation. Parameters such as TcPO₂, skin temperature, temperature-controlled blood flow may indicate the changes of microcirculation, implying a relation between the pathogenesis of CVI and the alteration of microcirculation.