桃红四物汤拆方对高龄股骨粗隆间骨折术后隐性失血的影响

Efficacy observation of Taohong Siwu decoction's disassembled recipes on postoperative hidden hemorrhage of senile femoral intertrochanteric fracture

目的:观察桃红四物汤拆方与高龄股骨粗隆间骨折患者术后隐性失血之间的相关性。方法:将符合纳入标准的高龄股骨粗隆间骨折患者随机分为3组,分别为桃红四物汤原方组、桃仁加红花组、四物汤组,各组均采用手术内固定治疗,术后予补液、镇痛、抗生素预防感染、低分子肝素钠皮下注射等常规治疗,术后第1天开始服用相应中药,疗程1周。术前1天采集血样检查血常规,术后复查血常规,记录HCT和HGB值,比较各组隐性失血量。结果:各组患者术前1天HGB值比较无明显差异(P﹥0.05),术后3、5、7天HGB值均较术前明显降低(P﹤0.05),且桃红四物汤原方组术后3、5、7天HGB值高于桃仁加红花组及四物汤组(P﹤0.05);各组患者术后3、5、7天HCT值均较术前明显降低(P﹤0.05);桃红四物汤原方组隐性失血量(653.32±24.50)mL低于四物汤组(721.19±30.60)mL及桃仁加红花组(776.56±35.60)mL,差异有统计学意义(P﹤0.05)。结论:桃红四物汤原方治疗高龄股骨粗隆间骨折患者术后隐性失血疗效较桃仁加红花、四物汤效果更好。

Objective:To observe the clinical effect of Taohong Siwu decoction's disassembled recipes on postoperative hidden hemorrhage of senile femoral intertrochanteric fracture.Methods:The patients with senile femoral intertrochanteric fracture,who met including criteria,were randomly divided into three groups,respectively Taohong Siwu decoction's original recipe group,Taoren Honghua recipe group and Siwu decoction group.Each group was treated by surgical internal fixation and postoperative conventional therapy such as postoperative fluid infusion,analgesia,antibiotics to prevent infection and low-molecular-weight heparin sodium subcutaneous injection,etc.,and took the corresponding Chinese herbal medicine from the first day after surgery,the course of treatment was 1 week.In 1 day before surgery,blood samples were collected to check blood routine.After surgery,blood routine was countercheck,values of HCT and HGB were recorded,and volume of hidden hemorrhage was compared between groups.Results:In 1 day before surgery,compared HGB values of patients between groups,there was no significant difference(P﹥0.05);in 3,5 and 7 days after surgery:HGB values were significantly lower than those before surgery(P﹤0.05),and HGB value of Taohong Siwu decoction's original recipe group was higher than that of Taoren Honghua recipe group and Siwu decoction group(P﹤0.05).In 3,5 and 7 days after surgery,HCT values of patients in each group were significantly lower than those before surgery(P﹤0.05);and hidden hemorrhage volume of Taohong Siwu decoction's original recipe group was(653.32±24.50)mL,which was lower than(721.19±30.60)mL of Siwu decoction group and(776.56±35.60)mL of Taoren Honghua recipe group,and the difference was statistically significant(P﹤0.05).Conclusion:The clinical effect of Taohong Siwu decoction's original recipe on postoperative hidden hemorrhage of senile femoral intertrochanteric fracture is better than that of Taoren Honghua recipe and Siwu decoction.