The pathogenesis and treatment of arteriosclerosis obliterans

Arteriosclerosis is a common clinical disease, and occlusive arteriosclerosis is a type of lumen occlusion caused by atherosclerotic lesions. This is a non-inflammatory vascular disease. There are many causes of occlusive arteriosclerosis, and we should also pay attention to early detection and early treatment.

1. Occlusive arteriosclerosis mainly refers to a non-inflammatory vascular disease in which peripheral arteries are narrowed or occluded due to atherosclerotic lesions, and various symptoms and signs are produced based on insufficient blood supply. Peripheral vascular occlusive arteriosclerosis is a part of systemic arteriosclerosis. Its etiology and risk factors are similar to those of arteriosclerosis in other parts of the body. Aging, hypertension, dyslipidemia and diabetes are the main causes. During the aging process, the arterial intima is damaged and endothelial cells are damaged and peeled off under the action of damaging factors. On this basis, thrombosis is repeatedly formed, accompanied by a large amount of lipoprotein and other infiltration and congestion, as well as endothelial cell proliferation and fibrosis, which cause arteriosclerosis.

2. Elderly people, especially those with hypertension, diabetes and hyperlipidemia, who have symptoms of chronic ischemia in the lower limbs and weakened or disappeared arterial pulsation should be suspected of this disease. Limb volume scanning and Doppler ultrasound examination can be used to comprehensively judge the degree of lower limb arterial occlusion and the plane of blockage based on ankle pressure and ankle pressure index, segmental blood pressure and waveform analysis. The above two methods and non-invasive examinations such as radionuclide scanning and infrared imaging technology are particularly suitable for the elderly. Although arterial angiography is painful, it is still the most reliable diagnostic method. It can understand the site of blockage, the degree of blockage and the establishment of collateral circulation, and provide a basis for surgical treatment. In the elderly, it is necessary to pay attention to distinguish it from arterial embolism. Thromboangiitis obliterans and Takayasu arteritis are common in young people and the distinction is usually not difficult.

3. Traditional Chinese medicine believes that occlusive arteriosclerosis is caused by dampness, arthralgia and blood stasis blocking the meridians, and the treatment should be to remove dampness, relieve arthralgia, and promote blood circulation and remove blood stasis. Medicinal herbs include Polygonum cuspidatum, Artemisia capillaris, Alisma orientale, Sophora japonica flower, Thistle, Weed grass, Angelica sinensis, Safflower, Salvia miltiorrhiza, and Shixiaosan. It can be supplemented with antihypertensive drugs such as ilex, polygonatum, raw hawthorn, and thorny aconite. It can also be treated with "Xifeng Tongluo Decoction" (cicada shell, earthworm, Achyranthes bidentata, raw oyster, angelica, and dead worm). For those with deficiency of vital energy and accumulation of phlegm and blood stasis: use the method of invigorating qi, activating blood circulation, extinguishing wind, resolving phlegm and unblocking meridians. Original soup such as astragalus, cinnamon twig, aconite, white mustard seed, Morinda officinalis, epimedium, and Chuanxiong.