摘要
目的观察抵当通脉汤对骨科大手术后深静脉血栓形成(DVT)患者凝血指标及血栓弹力图(TEG)参数的影响,探讨其临床疗效和作用机制。方法筛选骨科大手术后DVT患者(湿热下注型)70例,随机分为2组,均给予常规治疗,试验组另给予中药抵当通脉汤。对比治疗前和治疗后14d的总疗效、凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、凝血酶时间(TT)、纤维蛋白原(FIB)、D-二聚体、TEG参数(R值、K值、α角、MA值、CI)的变化情况以及静脉通畅率。结果两组各脱落1例。试验组的总疗效优于对照组(P<0.05),且试验组的显愈率(73.53%)明显高于对照组(50.00%)(P<0.05)。与治疗前相比,治疗后14天两组患者的PT、APTT、TT明显延长(P<0.05,P<0.01),FIB、D-二聚体水平以及α角、MA值、CI明显降低(P<0.05,P<0.01),R值、K值明显升高(P<0.01)。与对照组相比,治疗后14d试验组的APTT、TT延长更明显(P<0.05,P<0.01),FIB、D-二聚体水平以及α角、CI更低(P<0.05,P<0.01),R值和K值更高(P<0.01),静脉通畅率更高(P<0.05)。两组均未出现不良事件。结论抵当通脉汤可以安全有效地降低骨科大手术后DVT患者的FIB和凝血因子水平、抑制血小板聚集、改善血液高凝状态,从而改善患者的症状、体征,起到治疗DVT的作用。
Objective To observe the effects of Didang Tongmai Decoction on coagulation indexes and TEG parameters of patients with deep venous thrombosis(DVT)after major orthopedic surgery,and to explore its clinical efficacy and mechanism of action.Methods 70 patients with DVT(damp-heat type)after major orthopedic surgery were screened and randomly divided into 2 groups.All patients were given conventional treatment,and the experimental group was also given Didang Tongmai Decoction.Total efficacy,PT,APTT,TT,FIB,D-dimer,TEG parameters(R value,K value,Angle,MA value and CI)and venous patency rate were compared before and 14 days after treatment.Results One case dropped out in both two groups.The total curative effect of the experimental group was better than that of the control group(P<0.05),and the obvious healing rate of the experimental group(73.53%)was significantly higher than that of the control group(50.00%)(P<0.05).Compared with before treatment,PT,APTT and TT in 2 groups were significantly prolonged(P<0.05,P<0.01),FIB,D-dimer,Angle,MA value and CI were significantly decreased(P<0.05,P<0.01),R value and K value were significantly increased(P<0.01).Compared with the control group,the extension of APTT and TT in the experimental group was more obvious(P<0.05,P<0.01),FIB,D-dimer,Angle and CI were lower(P<0.05,P<0.01),the R and K values were higher(P<0.01),and the venous patency rate was higher(P<0.05)after 14 days of treatment.There were no adverse events in both groups.Conclusion Didang Tongmai Decoction can safely and effectively reduce the levels of FIB and coagulation factors,inhibit platelet aggregation,improve blood hypercoagulability,thereby improving the symptoms and signs of patients,and playing a role in the treatment of DVT.
作者
张军
张玥
刘湘
刘效敏
王思婷
Zhang Jun;Zhang Yue;Liu Xiang;Liu Xiaomin;Wang Siting(First Clinical Medicine School,Shandong University of Traditional Chinese Medicine,Jinan 250014,China;Affiliated Hospital of Shandong University of Traditional Chinese Medicine,Jinan 250014,China;College of Traditional Chinese Medicine,Shandong University of Traditional Chinese Medicine,Jinan 250014,China)
出处
《世界科学技术-中医药现代化》
CSCD
北大核心
2023年第2期702-708,共7页
Modernization of Traditional Chinese Medicine and Materia Medica-World Science and Technology
基金
国家自然科学基金委员会面上项目(81774311):基于HMGB1/TLR4/NF-κB信号通路研究抵当汤及其拆方干预深静脉血栓形成的作用机制,负责人:张玥
山东省青少年教育科学规划项目大学生学术课题(22BSH013):抵当通脉汤对深静脉血栓形成患者血栓弹力图影响的临床研究,负责人:张军
关键词
抵当通脉汤
骨科大手术
深静脉血栓形成
凝血指标
血栓弹力图
Didang Tongmai Decoction
Major orthopedic surgery
Deep venous thrombosis
Coagulation indexes
Thromboelastography
作者简介
通讯作者:张玥,主任医师,主要研究方向:中西医结合治疗周围血管疾病
