复元活血汤合桃红四物汤对髋关节置换术后患者凝血功能及DVT发生的影响

The effects of the Fuyuan Huoxue decoction plus Taohong Siwu decoction on coagulation function and DVT in patients after hip replacement

目的:探讨复元活血汤合桃红四物汤对髋关节置换术后患者凝血功能及DVT发生的影响。方法:将2014年9月-2016年11月在我院行髋关节置换术的104例患者作为研究对象,采用随机数字表法将其随机分为对照组52例和联合组52例,其中前者术后给予低分子肝素钙皮下注射,后者同时给予复元活血汤合桃红四物汤加减口服治疗。比较两组患者术后深静脉血栓)发生情况及术后1d、术后8d凝血功能相关指标变化情况。结果:术后1d两组患者血浆D-二聚体水平比较无显著性差异(P>0.05),术后8d均明显降低,且联合组明显低于对照组(P<0.05);术后1d两组患者凝血四项指标[凝血酶原时间(PT)、部分凝血酶原时间(APPT)、凝血酶时间(TT)、纤维蛋白原(FIB)]比较均无显著性差异(P>0.05),术后8d两组均明显改善,且联合组PT、FIB和TT均明显优于对照组(P<0.05);联合组术后DVT发生率为3.8%,明显低于对照组的17.3%(P<0.05)。结论:复元活血汤合桃红四物汤联合低分子肝素钙在髋关节置换术后患者凝血功能改善方面具有协同作用,其可有效预防术后DVT的发生,安全性高,值得临床推广应用。

Objective： To investigate the effects of the Fuyuan Huoxue decoction（复元活血汤） and Taohong Siwu decoction（桃红四物汤） on coagulation function and DVT of hip arthroplasty patients. Methods： 104 patients were randomly divided into the control group and combined group. The control group was given low molecular hepacarin; the combined group was given the Fuyuan Huoxue decoction and Taohong Siwu decoction more. The incidence of DVT after operation and the changes of related indexes of coagulation function at 1 day and 8 days after operation were compared between two groups. Results： There was no significant difference in plasma D-dimer level between groups on the 1 st postoperative day（P〈0.05）. The plasma D-dimer levels on the 8 th day postoperatively were significantly lower, and that in the combined group was significantly lower than the control group（P〈0.05）. There were no significant differences in the four parameters of coagulation（PT, APPT, TT, FIB） between groups（P〈0.05）. Improvement was observed. PT, FIB, and TT in the combination group were significantly better than those in the control group（P〈0.05）. The incidence of DVT in the combined group was 3.8%, which was significantly lower than 17.3% in the control group（P〈0.05）. Conclusion： The Fuyuan Huoxue decoction and Taohong Siwu decoction plus low molecular weight heparin calcium show a synergistic effect in the improvement of coagulation function after hip joint replacement. It can effectively prevent from postoperative DVT, with high safety, and is worthy of clinical application.