活血化瘀法对下肢骨折患者围手术期血栓前状态分子标志物指标的影响

Effect of Blood-activating and Stasis-resolving on Molecular Marker Indexes in Prethrombotic State in Patients with Fracture of Lower Limb in Perioperative Period

目的评价活血化瘀法对下肢骨折患者围手术期血栓前状态分子标志物指标的临床疗效。方法将患者60例采用随机数字表法分为观察组和对照组,各30例。观察组采用基础预防加物理预防加红桃消肿颗粒颗治疗,对照组采用基础预防加物理预防加安慰剂,两组疗程均为7 d,比较两组患者血栓前状态分子标志物指标。结果观察组与对照组不同时间点凝血酶原时间(PT)差异无统计学意义(P>0.05),两组间差异无统计学意义(P>0.05),观察方法与时间因素之间不存在交互作用(P>0.05);不同时间点活化部分凝血活酶时间(APTT)差异有统计学意义(P<0.01);两组间差异无统计学意义(P>0.984);观察方法与时间因素之间不存在交互作用(P>0.05);不同时间点纤维蛋白原明差异有统计学意义(P<0.01);两组间差异无统计学意义(P>0.05);观察方法与时间因素之间不存在交互作用(P>0.05);不同时间点D-二聚体明显差异(P<0.01);组间差异有统计学意义(P<0.05);观察方法与时间因素之间存在交互作用(P<0.01);不同时间点VWF明显差异(P<0.01);组间差异有统计学意义(P<0.05);观察方法与时间因素之间不存在交互作用(P<0.01)。结论红桃消肿颗粒具有降低下肢骨折患者围手术期部分血栓前状态分子标志物(D-二聚体、血友病因子)作用。

Objective： To observed the clinical effect of blood-activating and stasis-resolving on molecular marker indexes in prethrombotic state in patients with fracture of lower limb in perioperative period. Methods： 60 patients were randomly divided into observation group and control group with 30 cases in each group. The observation group was treated with primordial prevention,physical prophylaxis and Hongtao Xiaozhong granule. The control group was treated with primordial prevention,physical prophylaxis and placebo. The treatment course was7 days. Then the molecular marker indexes in prethrombotic state in patients of the two groups were compared.Results： There was no statistical difference on PT at different time points in both groups（P〈0.05） and there was no statistical difference between the two groups（P〈0.05）;there was no interaction effect between observation method and time factor（P〈0.05）. There was significant difference on APTT at different time points（F=33.414,P =0.000）;but there was no significant difference between the two groups（P〈0.05）;there was no interaction effect between observation method and time factor（P〈0.05）. There was statistical difference on fibrinogen at different time points in both groups（P〈0.01） and there was no statistical difference between the two groups（P〈0.05）;there was no interaction effect between observation method and time factor（P〈0.05）. There was statistical difference on d--dimer at different time points in both groups（P〈0.01） and there was statistical difference between the two groups（P〈0.05）;there was interaction effect between observation method and time factor（P〈0.01）.There was statistical difference on VWF at different time points in both groups（P〈0.01） and there was statistical difference between the two groups（P〈0.05）;there was no interaction effect between observation method and time factor（P〈0.01）. Conclusion： Hongtao Xiaozhong granule plays a role in lowering parts of the molecular marker indexes in prethrombotic state（D-dimer,von Willbrand factor） in patients with fracture of lower limb in perioperative period.