低分子肝素联合血栓通治疗下肢深静脉血栓形成疗效分析

Curative Effect Observation of Low Molecular Weight Heparin Combined with Xueshuantong for Lower Extremity Deep Venous Thrombosis

目的:观察低分子肝素联合血栓通治疗下肢深静脉血栓的临床疗效。方法:将6 8例下肢深静脉血栓患者按简单随机法分为联合组和对照组各3 4例,对照组采用尿激酶、低分子肝素治疗,联合组在对照组的基础加用血栓通治疗;观察比较2组治疗前后腿围差值、疼痛视觉模拟评分法(VAS)评分、凝血功能[包括D二聚体(DD)、纤维蛋白原(FIB)、凝血酶原时间(PT)、活化部分凝血酶时间(APTT)]、中医证候疗效以及血液流变学等项目。结果:证候疗效总有效率联合组为9 1.18%,对照组为7 9.41%,2组比较,差异有统计学意义(P<0.05);治疗后联合组髌骨腿围差值、胫骨腿围差值、VAS评分均显著低于对照组(P<0.05);治疗后联合组DD、FIB、PT、APTT及全血低切黏度、全血高切黏度、血浆黏度、红细胞压积等指标改善均优于对照组(P<0.05)。结论:低分子肝素与血栓通联合应用于下肢深静脉血栓的治疗,可有效改善患者血液流变学指标,改善凝血,缓解疼痛,效果优于单用低分子肝素。

Objective： To observe the clinical effect of low molecular weight heparin combined with Xueshuantong for lower extremity deep venous thrombosis. Methods： Divided 68 cases of patients with lower extremity deep venous thrombosis into the combination group and the control group randomly by simple random method, 34 cases in each group. The control group was given urokinase low molecular weight heparin for treatment,while the combination group was additionally given Chinese medicine preparation of Xueshuantong. Observed and compared the indexes such as the differences of muscle circumference before and after treatment,scores of visual analogue scale（VAS）,coagulation function,including d-dimer（DD）,fibrinogen（FIB）,prothrombin time（PT）,activated and partial thromboplastin time（APTT）,curative effect of Chinese medicine syndrome and hemorheology. Results：The total effective rate of curative effect of syndrome was 91.18% in the combination group and 79.41% in the control group, difference being significant（P〈0.05）. After treatment, the muscle circumference difference of patella and tibia and VAS score in the combination group were significantly lower than those in the control group（P〈0.05）. After treatment, the imprvement of indexes such as DD, FIB, PT and APTT as well as whole low blood viscosity, whole high blood viscosity, plasma viscosity and hematocrit in the combination group were all better than those in the control group（P〈0.05）. Conclusion：The application of low molecular weight heparin combined with Xueshuantong for lower extremity deep venous thrombosis can effectively improve the hemorheological indexes of patients, improve blood coagulation and relieve pain. Its effect is better than that of single low molecular heparin.