消肿止痛汤调控骨科大手术后炎症反应及预防深静脉血栓形成临床观察

Clinical Observation of Xiaozhong Zhitong Decoction on Regulating Inflammatory Reaction and Preventing Deep Venous Thrombosis after Major Orthopedic Operation

目的:观察中药消肿止痛汤调控骨科大手术后炎症因子水平的作用及预防深静脉血栓形成(DVT)的机制。方法:选择行骨科大手术患者53例,随机分为对照组(常规治疗)与治疗组(常规治疗结合消肿止痛汤)进行术后DVT防治。比较2组患者DVT发生率以及炎症因子水平变化。结果:治疗组4例DVT,发生率14.81%;对照组5例,发生率19.23%。2组DVT发生率比较,差异有显著性意义(P<0.05)。术后2天2组患者血清肿瘤坏死因子(TNF)-α、白细胞介素(IL)-1、IL-6的表达水平均高于术前,差异有显著性意义(P<0.05)。术后7天,治疗组上述炎症因子水平较术后2天时明显下降,差异有显著性意义(P<0.05);对照组则未见明显下降(P>0.05);2组比较,差异有显著性意义(P<0.05)。结论:骨科大手术后患者血清炎症因子水平与DVT发生率相关,中药消肿止痛汤可显著的降低骨科术后炎症因子水平,有效预防骨科大手术DVT的发生。

Objective： To observe the effect of Xiaozhong Zhitong decoction on regulating inflammatory cytokines levels and preventing deep venous thrombosis（DVT） after major orthopedic operation. Methods： Fifty-three patients which have received major orthopedic operations were randomized into two groups. Twenty-six cases in the control group were given routine treatment, and twenty-seven cases in the treatment group were given routine treatment and Xiaozhong Zhitong decoction. DVT incidence and the changes of inflammatory cytokines levels were observed. Results： DVT incidence was 14.81% （4 cases） in the treatment group, and was 19.23% （5 cases） in the control group, the difference being significant （P 〈 0.05）. Tumor necrosis factor-α （TNF- α）and interleukin-1 （IL-1）, interleukin-6（IL-6）levels in both groups two days after operation were higher than those before operation （P 〈 0.05）. Seven days after operation, TNF-α and IL-1, IL-6 in the treatment group were lower than those two days after operation （P 〈 0.05）, but those in the control group were not decreased obviously （P 〉 0.05）, the differences between the two groups being insignificant（P 〉 0.05）. Conclusion： Inflammatory cytokines levels are correlated with DVT incidence after major orthopedic operation. Xiaozhong Zhitong decoction is effective on decreasing inflammatory cytokines levels and preventing DVT incidence after major orthopedic operation.