Patient: I am a 76 year old male. primary hypertension was detected at the age of 30 and I have been taking antihypertensive medication since the age of 47. type 2 diabetes was detected at the age of 68 and I have been taking medication since then. Last month, I had an ultrasound of my lower extremities, which revealed that my feet were cold and my eyes were sclerotic. He was seen at Chengdu Community Hospital. In the past two years, he has been taking Lotensin, Bactrim, Lipitor, pancreatic kininogenase, enteral bactrim, aspirin, and insulin. Blood pressure and blood sugar control is very good. In August, the lower limbs were reexamined by ultrasound. Wen-Sheng Lou, Department of Interventional Medicine, Nanjing First Hospital: From your ultrasound report, the degree of progression of atherosclerosis is not too serious for the time being, but the plaque has already formed, and drug treatment is necessary. On the other hand, your blood pressure, glucose and lipid-lowering medications have been well-treated over the years, and your blood pressure and glucose have been effectively controlled, so that the progression of your atherosclerosis has been effectively controlled. I would like to give you three suggestions: 1. Since you have symptoms of coldness in the lower extremities, in addition to ultrasound, you should also go to the hospital regularly to measure the blood pressure of the lower extremities and compare it with the blood pressure of the upper extremities, that is, the ankle-brachial index (ABI), once it is found to be lower than 0.9 or even lower than 0.7, it is possible that the arterial lesions in the lower extremities are aggravated, and then it is necessary to decide whether or not treatment is needed on the basis of arteriography of the lower extremities. It is necessary to decide whether treatment is needed on the basis of lower extremity arteriography. At the same time, it is also important to note that symptoms such as intervertebral disc disease, sciatic neuropathy and diabetic nerve damage can cause coldness in the lower extremities and need to be identified. 2, pay attention to whether you have the fear of cold at the same time appear after walking calf or the whole leg soreness and weakness, calf tightness or even pain and other symptoms, which is what we call intermittent claudication, if there is also need to even lower limb vascular examination. 3, you are recommended to re-eat up the Bay aspirin enteric tablets, cilostazol can effectively relieve the blood supply of the calves of diabetic patients, but he can not replace the role of aspirin, so we generally for diabetic patients are two at the same time to take more effective. Unless there are serious side effects, such as gastrointestinal reactions, heartburn or bleeding, etc. Patient: ABI done twice: normal in September last year, rechecked after ultrasound of lower extremities on May 18 this year greater than 1 and 3 for calcification of the middle layer of the artery (cast uploaded). The first reason is that the aspirin is too much and I want to use as little as possible; the second is that the [precautions] in the instructions for cilostazol says “use with caution if you are using aspirin” and the [pharmacology and toxicology] pharmacology has the same effect. According to your R-bed experience, you will recover tonight. Patient: Add one sentence: Cilostazol is now taken twice a day at 50mg each time, and in the past half month, Halt and barley left arsenic captivation Qu donkey pod strider look at 100mg. do you think it is okay? The dose of 0.1g of aspirin per day is generally very small, and it is fine to take both at the same time in most cases. If you feel that you are taking too many kinds of medications, I suggest that you can stop taking pancreatic kininogenase, because there is enough aspirin and cilostazol. Patient: Should I take all of aspirin, methylcobalamin and pancreatic kininogenase? Or do you use one or two or three of them, I don’t know clearly. Wensheng Lou, Department of Interventional Medicine, Nanjing First Hospital: Hello, methylcobalamin is a nerve-nourishing drug, which is not the same as aspirin, cilostazol and pancreatic kininogenase, so you can continue to take them. Aspirin is an anti-platelet aggregation drug and is the basic drug for this treatment, pancreatic kininogenase is a vasodilator drug that improves microcirculation, while cilostazol has both anti-platelet and vasodilator effects and is unanimously recognized as effective. Therefore, my personal recommendation (for reference only) is to discontinue pancreatic kininogenase and take aspirin and cilostazol. Also, you need to be closely monitored for adverse effects while taking them. Patient: Clarified, thank you.