针灸联合中药熏蒸改善老年深静脉血栓的临床疗效观察

Clinical effect of acupuncture and moxibustion plus TCM medicine fumigation on senile deep vein thrombosis

目的:观察针灸联合中药熏蒸治疗老年下肢深静脉血栓(Deep Vein Thrombosis,DVT)的临床疗效及其对相关血清指标的影响。方法:将符合纳入标准的60例老年DVT患者随机分为对照组和治疗组,每组30例。对照组注射低分子肝素钙,连续用药时间不得超过10 d,7 d为一个疗程,治疗2个疗程;治疗组在对照组治疗的基础上加针灸联合中药熏蒸治疗,每周3次,共治疗2周。比较两组患者治疗前后临床症状、双下肢血流速度、双下肢周径差值、纤维蛋白原(Fibrinogen,FIB)、D-二聚体(D-Dimer,D-D)、血小板计数和凝血酶原时间,采用SPSS 24.0统计软件进行统计学分析。结果:在治疗过程中脱落、中止8例,最终治疗组完成治疗者25例,对照组完成治疗者27例。治疗后,两组患者皮肤温度、皮肤色泽和疼痛评分均降低,但治疗组较对照组改善更为明显,组间差异有统计学意义(P<0.05);两组患者左股静脉和右股静脉的血流速度均提高,但治疗组较对照组改善更为明显,组间差异有统计学意义(P<0.05);两组患者治疗后双下肢周径差值、FIB、D-D、血小板计数和凝血酶原时间均有改善,但治疗组症状改善明显优于对照组,差异具有统计学意义(P<0.05)。结论:中医治疗DVT以活血化瘀为治疗大法,疏其血气、令其调达;针刺、艾灸、中药熏蒸作为中医特色外治法,能加速血液循环,化瘀通络止痛等,可通过降低血液黏稠度抑制血小板聚集,促进血栓溶解,改善老年DVT患者的血液循环,且安全有效,无不良反应,值得临床推广。

Objective:To observe the clinical efficacy of acupuncture and moxibustion plus TCM medicine fumigation in the treatment of elderly patients with DVT and its effect on related serum indexes.Methods:Sixty elderly patients with DVT who met the inclusion criteria were selected as the research subjects,and were randomly divided into the control group and the treatment group,with 30 cases in each group.The control group was injected with low molecular weight heparin calcium,the continuous medication time should not exceed 10 days,a treatment course was of 7 days,and the treatment was of two courses.On the basis of the treatment in the control group,the treatment group was treated by acupuncture and moxibustion plus TCM medicine fumigation treatment,the frequency of treatment was three times a week,and the treatment cycle was 2 weeks.The clinical symptoms,blood flow velocity,FIB,D-D,platelet count and prothrombin time were compared between the two groups before and after treatment.SPSS 24.0 statistical software was used for a statistical analysis.Results:In the course of treatment,8 cases fell off and dropped,25 cases in the treatment group and 27 cases in the control group finished treatment.After treatment,the skin temperature,skin color and pain score in the two groups were decreased,but the improvement in the treatment group was more obvious than the control group,and the difference between the two groups was statistically significant(P<0.05).The blood flow velocity of left femoral vein and right femoral vein in both groups was improved,but the improvement was more obvious in the treatment group than that in the control group,and the difference between the two groups was statistically significant(P<0.05).After treatment,the peripheral diameter difference of lower limbs,FIB,D-D,platelet count and prothrombin time in the two groups were improved,but the improvement of symptoms in the treatment group was significantly better than that in the control group,and the difference was statistically significant(P<0.05).Conclusion:The treatment of DVT is based on the treatment principle of promoting blood circulation and removing blood stasis,so it can be adjusted.Acupuncture,moxibustion and TCM medicine fumigation,as characteristic TCM external treatment methods,can accelerate blood circulation,has the function of removing blood stasis,dredging collaterals and relieving pain,can inhibit platelet aggregation by reducing blood viscosity,can promote thrombus dissolution,and can improve blood circulation in elderly patients with DVT.They are safe and effective,without adverse reactions,and worthy of clinical promotion.