血府逐瘀汤对肋骨骨折伴血胸患者凝血功能的影响及疗效观察

Treatment of hemothorax supplemented by Xuefu Zhuyu Decoction:Its curative effect and influence on coagulation state

目的观察血府逐瘀汤对肋骨骨折伴血胸患者凝血功能的影响及对血胸的治疗效果。方法肋骨骨折伴血胸患者随机、对照分组后,分别治疗。常规治疗组30例给予西药常规疗法,血府逐瘀汤组31例在此基础上加用血府逐瘀汤内服。两组均于入院后1、7、14 d进行D-二聚体(D-Di)、凝血4项检查以观察患者凝血功能改变;同时行CT检查,评估其对血胸的疗效。结果骨折后两组患者血液第14天的D-Di水平与入院第1天比较,明显降低(P<0.05)。而且,血府逐瘀汤组显著低于常规治疗组(P<0.05)。入院14 d后,两组凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、凝血酶时间(TT)较入院时均有所延长,纤维蛋白原(FIB)随之减低。胸部CT检查评估血胸疗效,两组总有效率无显著性差异(100%、96.67%,P>0.05)。但是血府逐瘀汤组患者的平均住院天数显著缩短[(13.25±1.48)d、(18.79±1.69)d,P<0.05]。结论血府逐瘀汤可改善血胸患者出现的血液高凝状态;同时,常规疗法辅以血府逐瘀汤既确保临床疗效,又显著缩短血胸患者的住院时间,对临床工作有一定的指导意义。

Objective To observe the curative effect of Xuefu Zhuyu Decoction（XZD） on rib fracture and concomitant hemothorax and explore its influence on coagulation status in these patients.Methods Totally 61 patients were enrolled in this study.In addition to routine treatment（RT group,30 cases）,the other 31 cases（XZD group） were treated by complementary XZD.CT scans were taken to compare the curative effects in the two groups.Prothrombin time（PT）,activated partial thromboplastin time（APTT）,thrombin time（TT）,fibrinogen（FIB）,and plasma D-dimer（D-Di） levels were measured on days 1,7 and 14 after the patients were hospitalized.Results Compared with the test results on day 1,D-Di level decreased significantly on day 14 in both groups.Moreover,its level was remarkably lower in XZD group than in RT group（P〈0.05）.After 14-day treatment,PT,APTT and TT of all the patients increased and FIB decreased.There was no significant difference in total effective rate between the two groups（100% vs.96.67%,P〉0.05）.However the mean hospitalization duration was significantly shorter in XZD group than in RT group [（13.25±1.48）d vs.（18.79±1.69）d,P〈0.05].Conclusion Applying XZD to rib fracture and concomitant hemothorax patients can improve their coagulation status,better their curative effects and shorten hospitalization duration,which is of clinical significance.