1.What does atherosclerosis obliterans mean?
We know that the human body depends on the operation of the arterial and venous circulation system to ensure the nutrition and metabolism of the whole body through blood circulation. If we describe a person as a car, then blood is equivalent to gasoline and blood vessels are the pipeline. Atherosclerosis is a series of symptoms caused by the narrowing of arteries in the limbs due to hardening and plaque formation, which reduces blood flow and blood supply to the limbs. It is like the rusting of water pipes. It can be said that the formation mechanism of atherosclerosis and cerebral infarction has some similarity, for example, if atherosclerosis occurs in the cerebral vessels, it is called cerebral infarction, if it occurs in the heart, it is called myocardial infarction, if it occurs in the blood vessels of the limbs, it is called atherosclerosis occlusive disease, which is a very common disease, there are about 20 million patients in China, and due to the change of diet and other structures, every year there will be Incremental increase of about 600,000 people, of which the incidence of people over 70 years of age is 10%, the incidence of people over 75 years of age is 25%.
2, the cause of atherosclerosis?
As the cause of atherosclerosis occlusive disease is not yet very clear, but it is likely to be related to the following factors, which of course also include bad habits.
1, related to advanced age: most of them occur above 50 years old, and the higher the age, the higher the proportion.
2, related to hypertension: increased blood pressure can cause hemodynamic changes, damage to the arterial lining, arterial elasticity is reduced, etc.
3.Related to hyperlipidemia: Increased blood lipids can be deposited on the arteries and eventually form sclerotic plaques to block the lumen.
4.Related to diabetes: abnormal blood sugar and lipid metabolism in diabetic patients accelerates the formation of atherosclerosis.
5, in the habits of life is related to smoking: smoking can aggravate atherosclerosis from various aspects, can destroy the endothelial cells of blood vessels, platelet cohesion enhanced, so that vascular constriction and so on. So a famous foreign doctor once said this: you want to smoke, or legs.
3, the clinical manifestations of atherosclerosis occlusive disease?
The earliest symptom of this disease is the coldness of the affected limbs, mostly cold, numbness and intermittent claudication of the lower limbs. The so-called intermittent claudication is the patient walking a short distance after the end of the limb forgiveness, numbness, pain and other sensations, rest a few moments in the folding feeling disappeared, and then walk.
If the lower abdominal aorta or iliac artery is occluded, there is soreness, weakness and pain in the whole hip and lower limb after walking, and if the symptoms occur in the lower leg, it suggests that the femoral artery may be occluded. As the disease progresses, the ischemia of the affected limb worsens, and persistent resting pain may occur in the toes, foot or lower leg in a quiet state, more intense at night, and the patient often sits with his feet in his arms and stays awake all night.
The affected toes, feet or calves have pale complexion, decreased temperature, decreased sensation, thinning skin, muscle atrophy, thickened and deformed toenails, and sparse bone.
Severe ischemia produces ulcers and gangrene in the toes, feet, or lower legs. Especially patients with combined diabetes are more likely to produce, and easy to evolve into wet gangrene and secondary infection, can occur at the same time the symptoms of systemic toxicity.
4.What are the tests needed for atherosclerosis occlusive disease?
The following tests are usually done in hospitals.
A. Color Doppler ultrasonography, this test is a non-invasive vascular examination, not only can clearly diagnose the extent of sclerotic plaque in the arteries, the degree of stenosis, it is recommended that middle-aged and elderly people who find themselves walking after leg pain or cold limbs should go to the hospital for examination, and should do color Doppler ultrasonography of lower limb arteries for early detection and early treatment
Second, vascular CTA MRA, which is the use of computer systems to depict the vascular travel map, you can see at a glance the degree of narrowing of the lower extremity arteries and the degree of blood flow.
Angiography is a kind of invasive interventional examination method, which can clearly understand the site, scope and degree of arterial stenosis and occlusion in the lower extremities by injecting contrast into the arteries, which is somewhat invasive.
Generally, color Doppler ultrasonography can confirm the diagnosis of lower extremity atherosclerosis occlusive disease.
5.What diseases should be distinguished from atherosclerosis-occlusive disease?
Thrombo-occlusive vasculitis: It usually occurs in young adults under 45 years old who smoke and have no cardiovascular or cerebrovascular pathology, and it is directly related to trauma, frostbite, and smoking.
The lumbar disk herniation: can also appear similar symptoms, here I also want to remind the elderly friends, there are many patients with arteriosclerosis occlusive disease is mistreated, lumbar disk disease generally have numbness, pain but no ischemic cold feeling, you can use your hand in the back of your foot to touch the central beating artery, if the artery is not reachable then there may be ischemic performance.
Phlebitis: Many patients with phlebitis think it is vasculitis or arteriosclerosis occlusive disease, phlebitis is mainly swelling, or pigmentation, generally the limbs are not cold.
Gout: increased blood uric acid, toe joint redness, swelling and pain, obvious at night.
6.What are the treatment methods for atherosclerosis-occlusive disease?
There are many different treatments for atherosclerosis obliterans.
Patients can choose different treatment methods according to different conditions.
(1) Surgical treatment: also known as bypass, the indications are strict.
(2) Interventional therapy: including thrombolysis, dilation, stenting, etc.
(3) Drug therapy: Combination of Chinese and Western medicine drug therapy.
(4) Other therapies: such as stem cell transplantation, hyperbaric oxygen therapy, Chinese medicine ionization, etc.
7.How to choose the treatment method?
In treatment, various means have their own advantages and disadvantages, if the indications are not chosen well, it will be treated more and more heavily. Mr. Wang Jiagang, one of the founders of vascular surgery, a famous vascular expert in China, summed up his lifetime experience and pointed out that 78G-85% of patients with atherosclerosis are not suitable for surgery and interventional treatment, but only for drug treatment. Often patients are older and have ischemia in their heart and brain vessels, while their blood vessels are extensively sclerotic, so it makes sense to choose a combination of Chinese and Western medicine treatment.
At home and abroad, the efficacy of Chinese herbal medicine based treatment is more certain, according to the dialectical treatment, the classification of cold and damp, blood stasis, heat toxicity, qi and blood deficiency, kidney deficiency, etc.. For cold-damp type, we can use herbs to warm the Yang and open the veins such as Yang He Tang, for blood stasis, we can use Tao Hong Si Wu Tang, for heat toxicity, we can use Si Miao Yong An Tang, for Qi and Blood deficiency, we can use Ba Zhen Tang, for kidney deficiency, we can use Zuo or Right Gui Wan.
8, prevention?
As the ancient Chinese medical text Nei Jing says: not to treat the disease to cure the disease before it is indeed prevention is both the treatment of disease
For the prevention of arteriosclerosis occlusive disease is the main prevention or treatment of predisposing diseases.
(1) Prevention of hyperlipidemia.
To develop good dietary habits, control the intake of animal fat, minimize the consumption of animal offal, cream, egg yolk and other high cholesterol foods, eat more vegetables and fruits, and take long-term lipid-lowering drugs if found to be suffering from hyperlipidemia.
(2) Prevention of hypertension.
People over 40 years old should measure blood pressure frequently, control weight, reduce the burden on the heart, self-regulate nerve function, maintain a stable mood, and avoid emotional excitement. Control salt intake, engage in appropriate physical activities, and ensure the duration and quality of sleep.
(3) Prevention of diabetes mellitus.
Control the intake of sugar, should not consume too much sweet food every day, frequently test blood sugar, and find out that you have diabetes should be treated in time, the treatment includes scientific control of the amount of diet and the type of diet, the food is mainly vegetables and soy products, supplemented by pasta and rice.
In addition lifestyle habits should also be noted
1, first of all, should completely quit smoking. Smoking has many harmful effects on the human body. Smoking can make the human peripheral small arteries, micro-arteries continue to spasm, prompting the occurrence of atherosclerosis, so that the intima damage, lumen narrowing, and eventually occlusion of small and medium-sized arteries, producing symptoms of limb ischemia.
2.Secondly, participate in more outdoor activities to promote blood circulation in the limbs. It is beneficial to prevent the occurrence of lower limb atherosclerosis occlusive disease. Outdoor activities should be carried out frequently, and the amount of activity should be moderate. Should not participate in excessive heart burden of strenuous activities. Walking, taijiquan, old age gateball, elderly fitness dance, etc. are suitable for limb blood circulation, but not excessively increase the burden on the heart, is worth advocating physical activities.