补阳还五汤对股骨干骨折内固定术后血液高凝状态的影响

Effect of Buyang Huanwu Decoction on blood Hypercoagulable State in Patients with Femoral Shaft Fractures after Internal Fixation

目的探究补阳还五汤对股骨干骨折患者内固定术后血液高凝状态的影响。方法用计算机随机数字法将120例股骨干骨折患者分为观察组和对照组各60例。两组患者均进行手术内固定治疗,术后对照组患者予以低分子肝素钙治疗,观察组患者在此基础上加用补阳还五汤。观察两组患者治疗前、治疗6d后中医证候积分、凝血指标[凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、纤维蛋白原(FIB)、D-二聚体(D-D)]和血液流变学指标(全血黏度、血浆黏度)变化情况。结果两组患者PT、APTT水平治疗前后及组间比较,差异均无统计学意义(P>0.05);治疗6d后,两组患者中医证候积分、血浆FIB、D-D、全血黏度、血浆黏度等指标均较治疗前降低,且观察组低于对照组(P<0.05)。结论股骨干骨折患者内固定术后口服补阳还五汤,可促进纤溶功能,降低血液黏度,对血液高凝状态有显著改善作用。

Objective：To explore the effect of Buyang Huanwu decoction on blood hypercoagulable state in patients with femoral shaft fractures after internal fixation.Methods：One hundred and twenty patients with femoral shaft fractures were randomly divided into the observation group and the control group with 60 cases in each group.Both groups were treated with internal fixation.Patients in the control group were treated with low-molecular-weight heparin calcium,while patients in the observation group were additionally treated with Buyang Huanwu decoction after operation.Changes of TCM syndrome scores,coagulation parameters [Prothrombin time（PT）,Activated partial thromboplastin time（APTT）,Fibrinogen（FIB）,D-dimer（D-D）] and hemorheological indicators（whole blood viscosity,plasma viscosity）in both groups before treatment and after 6 days of treatment were observed.Results：There was no significant difference in PT or APTT within groups before and after treatment and between the two groups（P〉0.05）.After 6 days of treatment,TCM syndrome scores,plasma FIB,DD,whole blood viscosity and plasma viscosity in both groups decreased,and they were lower in the observation group than the control group（P〈0.05）.Conclusion：After the internal fixation of femoral shaft fractures,the use of Buyang Huanwu decoction can promote the fibrinolysis function,reduce the blood viscosity,and significantly improve the blood hypercoagulable state.