Simiao Yong'an Decoction is derived from the New Compilation of Proved Prescriptions(Yan Fang Xin Bian). This formula has the effects of clearing heat and detoxifying as well as activating blood and relieving pain. It is mainly used to treat gangrene caused by excessive heat toxin and with the clinical manifestations including dark red and slightly swollen limbs, scorching skin, ulceration and odor, severe pain, occasional fever, thirst, red tongue, and rapid pulse. Nowadays, Simiao Yong'an Decoction is mostly used in the treatment of thromboangitis obliterans, ulcers in arteriosclerosis obliterans of lower limbs, stent restenosis after angioplasty of lower limbs, ecthyma, deep venous thrombosis, diabetic arteriosclerosis obliterans of lower limbs, diabetic foot ulcer, acute knee arthritis, varicose veins of lower limbs, coronary heart disease, post percutaneous coronary intervention(PCI), sepsis, gout, tumor, chronic tonsillitis in children, and other diseases. It has been identified that diabetic foot with infection, sepsis, arteriosclerosis obliterans, and thromboangitis obliterans belong to the category of gangrene in traditional Chinese medicine(TCM), and Simiao Yong'an Decoction is an ancient specialized prescription for treating this disease. The diseases that can be treated by Simiao Yong'an Decoction include arteriosclerosis obliterans, thromboangitis obliterans, diabetic foot, and ecthyma. The symptoms that can be treated by Simiao Yong'an Decoction include dark red, blackened, slightly swollen, burning, ulceration, and odor in the fingers and toes, and toes falling off, hands and feet decaying and collapsing, severe and unbearable pain in some cases. Furthermore, this formula is effective for skin ulceration spreading, pus dripping, swollen and proliferating lymph nodes. These symptoms are always accompanied by dry mouth, thirst, irritability, yellow urine, and dry stool. The TCM symptoms include red tongue, thin and white tongue coating, and wiry and rapid pulse. In the case with the complication of refractory hypotension, large dosage of Astragali Radix is used to replenish Qi, reinforce healthy Qi, and expressing toxin, which can often achieve blood pressure-elevating and anti-inflammatory effects. Simiao Yong'an Decoction is often combined with Simiao Pills and Guizhi Fuling Pills. High-dose medication is the key to the effectiveness of this formula. Integrated traditional Chinese and western medicine plays an important role in the treatment of diabetic foot with infection, sepsis, septic shock, arteriosclerosis obliterans, and thromboangitis obliterans.
Humans ; Diabetic Foot/physiopathology* ; Drugs, Chinese Herbal/administration & dosage* ; Arteriosclerosis Obliterans/physiopathology* ; Sepsis/physiopathology* ; Critical Care ; Male ; Infections/physiopathology*

OBJECTIVETo observe the effects of refined Xuefu Capsule (RXC) in patients with arteriosclerosis obliterans (ASO) after femoral-popliteal bypass (FPB).

METHODSThirty-eight ASO patients with 41 limbs underwent FPB were randomly assigned to two groups: the control group (18 cases with 20 operated limbs) and the RXC group (20 cases with 21 operated limbs). All patients received long-term anticoagulant treatment with Warfarin, and RXC was given to the RXC group additionally for 3 months. Changes of clinical symptoms, blood coagulating function, as well as the condition of vascular patency and ankle arm index (AAI) were assessed 6 and 12 months after operation.

RESULTSClinical symptoms were improved in all the patients after operation. One year after operation, incidence of intermittent claudication and amputation rate in the RXC group was 20% and 5 %, being lower than the respective rate (56% and 17%) in the control group (P < 0.05); the patency rate was 86% in the RXC group, being higher than that in the control group (65%, P<0.05). Six and 12 months after operation, AAI was 0.73 +/- 0.24 and 0.69 +/- 0.19 respectively in the RXC group, being significantly higher than that in the control group (0.45 +/- 0.17 and 0.41 +/- 0.23, P < 0.05) at the corresponding time points.

CONCLUSIONRXC could obviously increase the patency rate 12 months after FPB, improve the clinical symptoms and alleviate the symptom of limb ischemia in ASO patients.

Aged ; Aged, 80 and over ; Arteriosclerosis Obliterans ; drug therapy ; physiopathology ; surgery ; Blood Vessel Prosthesis Implantation ; Capsules ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Femoral Artery ; surgery ; Graft Occlusion, Vascular ; prevention & control ; Humans ; Male ; Middle Aged ; Phytotherapy ; Popliteal Artery ; surgery ; Vascular Patency ; drug effects