Clinical Research Of Traditional Chinese Medicine Combined With Endovascular Recanalization In Thromboangiitis Obliteranse

Objective To observe the clinical efficacy of percutaneous transluminal angioplasty(PTA)plus debulking combined with Chinese herbal medicine in the treatment of thromboangiitis obliterans.and to compare the clinical effects of percutaneous transluminal angioplasty vs percutaneous transluminal angioplasty plus debulking(PTAD)in the treatment of thromboangiitis obliteransMethods To collect and summarize the clinical data of 62 patients with Rutherford grade 4-6 thromboangiitis obliterans treated by endovascular therapy from January 2014 to April 201 8.aged 26-62 years.all males.Among them,36 cases(36 limbs)were treated by PTADand 26 cases(26 limbs)by PTA.Among 62 patients.5 were severe intermittent claudication,18 were resting pain,39 were limb ulcer and gangrene Among them,PTA group:1 case of severe intermittent claudication,11 cases of resting pain,14 cases of limb ulcer and gangrene.PTAD group:4 patients with severe intermittent claudication.7 patients with resting pain?25 patients with limb ulcer and gangrene.To observe and compared clinical data of both groups by 3 and 6 months after operation.Subgroup analysis:According to syndrome type of Traditional Chinese medicine.18 patients in PTAD group had accepted oral decoction(1 patients with syndrome of cold-dampness blocking collaterals.7 patients with blood stasis syndrome.10 patients with dampness-heat toxic pattern),for 12 weeks,The other 18 patients of PTAD group without oral decoction(1 patients with syndrome of cold-dampness blocking collaterals,8 patients with blood stasis syndrome,9 patients with dampness-heat toxic pattern).We compared two subgroup's scores of TCM syndromes at 3 months after operation,in addition,target lesion revascularization rate and limb salvage rate at 6 months after operation were also analyzed.Results There was no significant difference in age,course of disease,Rutherford grade and ankle brachial index(ABI)between the two groups(P>0.05),and the two groups were comparable.Subgroup comparison:18 patients(18 limbs)in PTAD combined with traditional Chinese medicine group had no significant difference in age,course of disease,Rutherford classification and ABI results between the two groups before treatment(P>0.05).PTAD group was superior to PTA group in clinical symptom improvement grade and ABI detection index,and the difference was statistically significant(P<0.05).In terms of target vessel patency rate and limb salvage rate,PTAD group had better effect,and the difference was statistically significant(P<0.05).Subgroup:There was no significant difference in age,course of disease,Rutherford grade and ankle brachial index(ABI)between the PTAD combined with TCM group and PTAD group.The target vessel re-intervention rates of combined TCM group and non-TCM group were 0.0%(0 cases)and 2.78%(1 case),respectively,with no statistical difference between the two groups.The limb salvage rate was 100%(18 cases and 18 cases)6 month after operation.Conclusion In short term,for thromboangiitis obliterans,traditional Chinese medicine combined with endovascular recanalization has a better therapeutic effect.However,the role of traditional Chinese medicine in preventing target vessel restenosis and long-term efficacy in patients with TAO after operation still needs a large sample size and long-term follow-up data to explore and summarize.