探讨益气活血方加减辨治对预防急诊骨折术后下肢深静脉血栓形成的临床效果

Explore the Clinical Effect of Yiqihuoxue Prescription on the Prevention and Treatment of Deep Vein Thrombosis of Lower Limbs

目的探讨益气活血方加减辨治对预防急诊骨折术后下肢深静脉血栓形成(DVT)的临床效果。方法便利选取2018年4月—2019年11月84例该院收治的急诊骨折术患者,按照简单随机化分为观察组、对照组,每组42例。对照组采用常规低分子肝素钙治疗,对照组基础上,观察组加用益气活血方加减辨治。比较两组DVT发生率、治疗前后中医证候积分、血液流变学指标(血浆黏度、红细胞聚集指数、红细胞压积)、凝血功能指标[活化部分凝血活酶时间(APTT)、血浆凝血酶原时间(PT)、D-二聚体(D-Dimer)、纤维蛋白原(FIB)]水平、生活质量(QLQ-C30评分)。结果两组DVT发生率对比,观察组2.38%(1/42)低于对照组19.05%(8/42)(χ^2=4.201,P<0.05);治疗后观察组中医证候积分低于对照组,QLQ-C30评分高于对照组(P<0.05);治疗后观察组血浆黏度、红细胞聚集指数、红细胞压积低于对照组(P<0.05);治疗后观察组APTT、PT高于对照组,D-Dimer、FIB低于对照组(P<0.05)。结论益气活血方加减辨治急诊骨折术患者,可缓解中医证候,改善血液流变学、抑制血液凝聚、提高生命质量、预防术后下肢深静脉血栓形成。

Objective To explore the clinical effect of Yiqihuoxue prescription on the prevention and treatment of deep vein thrombosis(DVT)of lower limbs after emergency fractures.Methods 84 patients with emergency fractures admitted in the hospital from April 2018 to November 2019 were convenienty selected and divided into observation group and control group according to simple randomization,42 cases in each group.The control group was treated with conventional low-molecular-weight heparin calcium.On the basis of the control group,the observation group was supplemented with Yiqihuoxue prescription for differentiation.Compare the incidence of DVT,TCM syndrome scores before and after treatment,hemorheology indexes(plasma viscosity,red blood cell aggregation index,hematocrit),blood coagulation function indexes[activated partial thromboplastin time(APTT),plasma prothrombin Time(PT),D-dimer(D-Dimer),fibrinogen(FIB)]level,quality of life(QLQ-C30 score).Results The incidence of DVT in the two groups was compared.The observation group was 2.38%(1/42)lower than the control group 19.05%(8/42)(χ^2=4.201,P<0.05);the observation group TCM syndrome score was lower than the control group after treatment,QLQ-C30 score was higher than the control group(P<0.05);plasma viscosity,erythrocyte aggregation index,hematocrit in the observation group after treatment were lower than the control group(P<0.05);APTT and PT in the observation group after treatment were higher than the control,D-Dimer and FIB were lower than the control group(P<0.05).Conclusion The addition and subtraction of Yiqihuoxue prescription in the treatment of emergency fracture patients can relieve TCM syndromes,improve blood rheology,inhibit blood aggregation,improve quality of life,and prevent postoperative deep vein thrombosis.