桃红四物汤合四妙散加减治疗急性下肢DVT的临床观察

Clinical Observation on Treatment of Acute Lower Limb DVT with Taohong Siwu Decoction and Si Miao San Addition and Subtraction

目的观察桃红四物汤合四妙散加减治疗急性下肢深静脉血栓的临床疗效。方法将我院确诊为急性下肢深静脉血栓且中医辨证为湿热下注型的150例患者,随机分成研究组和对照组,每组75例;对照组单用西药治疗,研究组在西药治疗的基础上加用桃红四物汤合四妙散加减汤口服;比较两组凝血指标、患肢肿痛减轻及肿胀消退时间、治疗后血管再通情况、两组治愈率。结果研究组PT、APTT、TT时间长于对照组,显示改善凝血作用优于对照组,差异有统计学意义(P<0.05)。两组FbgC.均在正常范围内,差异无统计学意义(P>0.05),研究组肿痛减轻时间为(3.35±0.83)d,少于对照组的(4.65±0.79)d,差异有统计学意义(P<0.05);研究组肿胀消退时间为(4.25±0.14)d,少于对照组的(6.55±1.61)d,差异有统计学意义(P<0.05);研究组血管完全再通比例(46.67%)高于对照组(33.33%),差异有统计学意义(P<0.05);研究组(46.67%)治愈率明显高于对照组(33.33%),差异有统计学意义(P<0.05);两组治疗过程中均未出现皮肤黏膜瘀斑、牙龈出血、排黑便、头痛、胸痛、呼吸困难等情况。结论对湿热下注型急性下肢DVT的患者,治疗上采用西药联合桃红四物汤合四妙散加减汤治疗急性下肢DVT的临床疗效明显优于单用西药,且未增加用药风险。

Objective To observe the clinical efficacy of Taohong Siwu Decoction and Si Miao San in the treatment of acute deep venous thrombosis of lower extremities. Methods 150 patients with acute lower extremity deep venous thrombosis and TCM syndrome differentiation as hot and humid type were randomly divided into study group and control group, 75 cases in each group. The control group was treated with western medicine alone, and the research group was treated with western medicine. On the basis of adding Taohong Siwu Decoction and Si Miao San addition and subtraction;comparing the two groups of coagulation parameters, the swelling and pain of the affected limbs and the swelling subsided time, the revascularization after treatment, the cure rate of the two groups. Results The PT, APTT and TT of the study group were longer than the control group, indicating that the improvement of blood coagulation was better than that of the control group,the difference was statistically significant (P<0.05). The FbgC. of the two groups were in the normal range, the difference was not statistically significant (P>0.05). The time of swelling and pain reduction in the study group was (3.35±0.83)d, which was less than that of the control group (4.65±0.79)d,the difference was statistically significant (P<0.05). The swelling time of the study group was (4.25±1.14)d, which was less than that of the control group(6.55±1.61)d,the difference was statistically significant (P<0.05). The proportion of complete recanalization (46.67%) was higher than that of the control group (33.33%), the difference was statistically significant (P<0.05). The cure rate of the study group (46.67%) was significantly higher than that of the control group (33.33%),the difference was statistically significant(P<0.05);no skin mucosal ecchymosis, bleeding gums, black stools, headache, chest pain, difficulty breathing, etc. occurred during the treatment.Conclusion For patients with damp-heated lower extremity DVT, the clinical efficacy of Western medicine combined with Taohong Siwu Decoction and Si Miao San addition and subtraction in the treatment of acute lower extremity DVT is significantly better than Western medicine alone, and the risk of medication is not increased.