温针配合药物治疗脊髓损伤后深静脉血栓形成的疗效观察

Observations on the Efficacy of Warm Needling Plus Medication for Deep Venous Thrombosis After Spinal Cord Injury

目的观察温针配合药物治疗脊髓损伤(SCI)后深静脉血栓形成(DVT)的临床疗效。方法将120例SCI后DVT患者随机分为治疗组和对照组,每组60例。对照组采用皮下注射肝素治疗,治疗组在对照组基础上采用温针治疗。观察两组治疗前后各项临床症状(患肢肿胀、疼痛、皮肤温度、皮肤颜色)评分、患肢平面周径(大腿、小腿)、凝血相关指标[血小板计数(PLT)、D-二聚体(D-D)、纤维蛋白原(FIB)、凝血酶原时间(PT)]及影像学指标[股总静脉、股深静脉及腘静脉最大血液流速(Vmax)]的变化情况,并比较两组临床疗效。结果两组治疗后各项临床症状评分、患肢平面周径(大腿、小腿)、凝血相关指标及影像学指标与同组治疗前比较,差异均具有统计学意义(P<0.05)。治疗组治疗后各项临床症状评分、患肢平面周径(大腿、小腿)、凝血相关指标及影像学指标与对照组比较,差异均具有统计学意义(P<0.05)。治疗组总有效率为95.0%,对照组为83.3%,两组比较差异具有统计学意义(P<0.05)。结论温针配合药物是一种治疗SCI后DVT的有效方法,其机制或与其改善凝血相关指标及血流速度有关。

Objective To investigate the clinical efficacy of warm needling plus medication for deep venous thrombosis(DVT)after spinal cord injury(SCI).Method One hundred-twenty patients with DVT following SCI were randomized to treatment and control groups,with 60 cases in each group.The control group received subcutaneous injection of heparin and the treatment group,warm needling in addition.The clinical symptom(affected limb swelling,pain,skin temperature and skin color)scores were recorded and the plane circumference of the affected limb(thigh and shank),coagulation-related indicators(platelet count(PLT),D-dimer(D-D),fibrinogen(FIB)and prothrombin time(PT))and imaging indicators(maximum blood flow velocity(Vmax)in the common femoral vein,deep femoral vein and popliteal vein)were measured in the two groups before and after treatment.The clinical therapeutic effects were compared between the two groups.Result There were statistically significant pre-/post-treatment differences in TCM symptom item scores,the plane circumference of the affected limb(thigh and shank),coagulation-related indicators and imaging indicators in the two groups(P<0.05).There were statistically significant post-treatment differences in TCM symptom item scores,the plane circumference of the affected limb(thigh and shank),coagulation-related indicators and imaging indicators between the treatment and control groups(P<0.05).The total efficacy rate was 95.0%in the treatment group and 83.3%in the control group with a significant difference between the two groups(P<0.05).Conclusion Warm needling plus medication is an effective way to treat DVT following SCI.Its mechanism may be related to improving coagulation-related indicators and blood flow velocity.