补气活血方预防人工膝关节置换术后下肢深静脉血栓的临床研究

Clinical Research on Prevent the Lower Limbs'DVT after TKA with BuQiHuoXue Decoction

目的:探讨补气活血方预防人工膝关节置换(TKA)术后下肢深静脉血栓(DVT)的临床疗效及其作用机制。方法:选取广州中医药大学附属骨伤科医院2015年2月-2016年2月符合纳入标准病例共60例,随机分成治疗组及对照组各30例。术后第1天至第10天治疗组予补气活血方治疗,对照组予利伐沙班片治疗。比较两组患者术前、术后第1天,第4天,第7天,第10天D-二聚体、C反应蛋白水平及术前、术后第11天患肢深静脉彩超结果,同时记录有无不良反应或事件。结果:与术后第1天比较,两组术后第10天D-二聚体、C反应蛋白水平均明显降低(P<0.01)。术后第11天患肢深静脉彩超结果提示,治疗组DVT发生率为16.67%,与对照组13.33%相当(P>0.05)。研究全程两组均无不良反应或事件发生。结论:补气活血方能在术后10 d内有效降低D-二聚体、C反应蛋白水平,有效预防TKA术后DVT,临床有效率和利伐沙班片相当,使用安全,其机制可能与降低D-二聚体、C反应蛋白水平有关。

Objective To discuss the clinic curative effect and the action mechanism of prevent the lower limbs＇DVT after TKA by BuQiHuoXue Decoction. Methods Between 2015.2-2016.2, 60 patients that accord with the inclusive criteria were randomly divided into the treatment group and the control group. The treatment group was demanded to take BuQiHuoXue Decoction while the control group take Rivaroxaban between the Day 1 and Day 10 after operation. The D-dipolymer and CRP index beforeTKA and the Day 1,4,7,10 after TKA were observed. And we also recorded the untoward effect and the results of CDUS of deep vein before and Day 11 after the TKA. Results Compare to Day 1 after the TKA, the D-dipolymer and CRP index decreased obviously on Day 10 after the TKA（P 〈 0.01）.On day 11 after TKA, the CDUS of deep vein showed that the treatment group＇s DVT occurrence rate was 16.67 % while the control was 13.33 %（P 〉 0.05）.There is no untoward effect occurred in the whole study. Conclusion BuQiHuoXue Decoction can reduce the D-dipolymer and CRP index effectively within 10 days after the TKA.BuQiHuoXue Decoction can prevent DVT effective after the TKA with safety clinic use and have the same result of Rivaroxaban. The mechanism maybe due to the decrease of the D-dipolymer and CRP index.