补阳还五汤联合低分子肝素钙注射液治疗剖宫产术后下肢深静脉血栓形成临床研究

Clinical Study of Buyang Huanwu Decoction Combined with Low Molecular Weight Heparin Calcium in Treating Deep Venous Thrombosis in Lower Limb after Cesarean Section

目的观察补阳还五汤联合低分子肝素钙注射液治疗剖宫产术后下肢深静脉血栓(DVT)形成患者的效果。方法选取剖宫产术后DVT形成患者76例,随机分为2组。对照组36例,予低分子肝素钙注射液,100 AXaIU/kg,皮下注射,每日2次;治疗组40例,在对照组治疗基础上予补阳还五汤。观察治疗前后临床症状、体征及全血高切黏度(HBV)、全血低切黏度(LBV)、血浆黏度(PV)、纤维蛋白原(FIB)、血小板(PLT)、部分凝血活酶时间(APTT)、凝血酶时间(TT)、凝血酶原时间(PT)及阻抗容积波图指标、彩色多普勒血流显像(CDFI)。结果治疗后治疗组总有效率为97.5%(39/40),对照组为77.8%(28/36),差异有统计学意义(P<0.05)。治疗组血液流变学(HBV、LBV、PV、FIB)及阻抗容积波图指标治疗前后比较,差异有统计学意义(P<0.05),治疗组凝血功能指标(APTT、TT、PT)治疗前后差异无统计学意义(P>0.05)。治疗期间未发生不良反应。结论补阳还五汤联合低分子肝素钙注射液治疗剖宫产术后DVT形成安全有效。

Objective To observe the treatment effect of Buyang Huanwu Decoction combined with low molecular weight heparin calcium injection in treating deep venous thrombosis （DVT） in lower limb after cesarean section. Methods Seventy-six cases of DVT after cesarean were randomly divided into 2 groups. Thirty-six cases of control group were injected low molecular weight heparin calcium subcutaneously 100 AXaIU/kg twice daily, and forty cases of treatment group were treated with Buyang Huanwu Decoction additionally. After analysing the clinical symptoms and sign before and after treatment, HBV, LBV, PV, FIB, PLT, APTT, TT, PT and indexes of impedance plethysmography, CDFI were observed to evaluate the efficacy. Results After treatment, the total effective rate of treatment group was 97.5%（39/40）, and the control group was 77.8%（28/36）, the difference was statistically significant （P〈0.05）. The differences of hemorheological indexes （HBV, LBV, PV, FIB） and impedance plethysmography indexes between before and after treatment in treatment group were statistically significant （P〈0.05）, while the differences of blood coagulation indexes （APTT, TT, PT） were not significant （P〉0.05）. No adverse reaction was found during treatment. Conclusion The treatment of DVT after cesarean section with Buyang Huanwu Decoction combined with low molecular weight heparin calcium injection is safe and effective.