摘要
目的评价复脉逐瘀汤对骨科术后下肢深静脉栓塞(deep venous thrombosis,DVT)的疗效。方法将符合纳入标准的2018年1月-2020年12月本院骨科手术后DVT患者90例采用简单随机分组法分为2组,每组45例。2组均采用DVT置管溶栓治疗,在此基础上对照组皮下注射低分子量肝素钙,观察组在对照组基础上加服复脉逐瘀汤,2组均连续治疗14 d。分别于治疗前后进行中医证候评分,采用全自动血栓弹力图分析仪检测血栓弹力图(TEG),包括凝血反应时间(reaction time,R)、凝血块形成时间(clot time formation,K)、凝血块形成速率(alpha-angle,α)、最大振幅(maximal amplitude,MA);采用ELISA法检测血清IL-6、CRP水平;根据全血高度计算红细胞比容(Hct)。记录不良反应,评价临床疗效。结果观察组总有效率为82.2%(37/45)、对照组为62.2%(28/45),2组比较差异有统计学意义(χ^(2)=4.49,P=0.034)。观察组治疗后患肢疼痛、肌肤甲错色黯、患肢肿胀评分低于对照组(t值分别为7.26、7.14、6.88,P值均<0.001)。治疗后,观察组R[(6.12±0.86)min比(5.45±0.56)min,t=3.58]、K[(2.24±0.45)min比(1.72±0.42)min,t=4.63]长于对照组(P<0.01);α[(51.69±2.23)°比(54.23±2.42)°,t=4.23]、MA[(51.58±3.62)min比(54.58±3.53)min,t=3.25]小于对照组(P<0.01),血清IL-6、CRP水平及Hct低于对照组(t值分别为2.66、2.96、7.58,P值均<0.01)。治疗期间,观察组不良反应发生率为6.7%(3/45)、对照组为22.2%(10/45),2组比较差异有统计学意义(χ^(2)=4.41,P=0.036)。结论复脉逐瘀汤可有效降低骨科术后DVT患者的血液黏度,预防血栓形成,提高临床疗效。
Objective To evaluate the curative effect of Fumai Zhuyu Decoction on deep vein thrombosis(DVT)after orthopedic surgery.Methods According to random method,90 patients with DVT after orthopedic surgery who met inclusion criteria in the hospital were divided into two groups between January 2018 and December 2020,45 cases in each group.Both groups were given DVT catheterization for thrombolysis.After that,control group was given subcutaneous injection of low molecular weight heparin calcium,while observation group was additionally treated with Fumai Zhuyu Decoction.All were continuously treated for 14d.Before and after treatment,scores of TCM syndromes were evaluated.The coagulation response time(R),clotting time(K),clotting angle(α)and maximum strength of blood clotting(MA)were detected by full-automatic thromboelastometry analyzer.The levels of serum IL-6 and CRP were detected by ELISA.The hematocrit(Hct)was calculated according to red cell casts and whole blood height.The adverse reactions were recorded.And the clinical curative effect was evaluated.Results The differences in total response rate between observation group and control group were statistically significant[82.2%(37/45)vs.62.2%(38/45);χ^(2)=4.49,P=0.034].After treatment,scores of affected limb pain,dark encrusted skin and affected limb swelling in observation group were significantly lower than those in control group(t values were 7.26,7.14,6.88,respectively,all Ps<0.001).After treatment,R[(6.12±0.86)min vs.(5.45±0.56)min,t=3.58]and K[(2.24±0.45)min vs.(1.72±0.42)min,t=4.63]in observation group were significantly longer than those in control group(P<0.01),α[(51.69±2.23)°vs.(54.23±2.42)°,t=4.23]and MA[(51.58±3.62)min vs.(54.58±3.53)min,t=3.25]were significantly lower than those in control group(P<0.01),and levels of serum IL-6,CRP and Hct were significantly lower than those in control group(t values were 2.66,2.96,7.58,respectively,all Ps<0.01).During treatment,differences in incidence of adverse reactions between observation group and control group were statistically significant[6.7%(3/45)vs.22.2%(10/45);χ^(2)=4.41,P=0.036].Conclusion The Fumai Zhuyu Decoction can reduce blood viscosity,prevent thrombosis and improve clinical curative effect in patients with DVT after orthopedic surgery.
作者
卢雄
张欢
张宝华
Lu Xiong;Zhang Huan;Zhang Baohua(Department of Peripheral Vascular and Tumor Interventional,Hezhou People's Hospital,Hezhou 542899,China;Department of Quality Control,Hezhou People's Hospital,Hezhou 542899,China;Department of Traditional Chinese Medicine,Hezhou People's Hospital,Hezhou 542899,China)
出处
《国际中医中药杂志》
2022年第5期516-520,共5页
International Journal of Traditional Chinese Medicine
基金
广西壮族自治区卫生健康委员会自筹经费科研项目(Z20190110)。
关键词
静脉血栓栓塞
手术后并发症
血栓弹力图试验
复脉逐瘀汤
Venous thromboembolism
Postoperative complications
Thromboelastography
Fumai Zhuyu Decoction
