桃红四物汤加味对尿毒症血液透析患者高凝状态及vWF、TXB2、Hcy水平的影响

Effect of Modified Taohong Siwu Tang on Hypercoagulabale State and Levels of vWF, TXB2, and Hcy in Patients with Uremic Undergoing Hemodialysis

目的:观察桃红四物汤加味对尿毒症血液透析患者高凝状态及血浆血管性血友病因子(vWF)、血栓烷B2(TXB2)、同型半胱氨酸(Hcy)水平的影响。方法:选取50例行维持性血液透析的尿毒症患者,按随机数字表法分为桃红四物汤组和阿司匹林组,每组25例。2组均行血液透析治疗,每周3次。阿司匹林组给予阿司匹林肠溶片治疗,桃红四物汤组在此基础上给予桃红四物汤加味治疗。2组均治疗4周。比较2组治疗前后血液流变学指标、凝血功能指标、vWF、TXB2、Hcy水平及中医证候积分,评价2组临床疗效。结果:治疗后,2组全血高切黏度(HBV)、血浆黏度(PV)、红细胞压积(HCT)及血小板聚集率(PAR)水平均较治疗前降低(P<0.05),桃红四物汤组HBV、PV、HCT及PAR水平均低于阿司匹林组(P<0.05)。治疗后,2组vWF、TXB2、Hcy水平均较治疗前降低(P<0.05),桃红四物汤组vWF、TXB2、Hcy水平均低于阿司匹林组(P<0.05)。治疗后,2组纤维蛋白原(FIB)、D-二聚体(D-D)水平均较治疗前降低(P<0.05),桃红四物汤组FIB、D-D水平均低于阿司匹林组(P<0.05)。治疗后,2组肢体瘀点瘀斑、面色晦暗、局部感觉异常、肢体麻木及肌肤甲错积分均较治疗前降低(P<0.05),桃红四物汤组上述5项中医证候积分均低于阿司匹林组(P<0.05)。桃红四物汤组总有效率为96.00%,高于阿司匹林组的68.00%(P<0.05)。结论:桃红四物汤加味能改善尿毒症血液透析患者的高凝状态,保护其血管内皮功能,提高临床疗效。

Objective: To observe the effect of modified Taohong Siwu tang on hypercoagulabale state and levels of plasma von willebrand factor(vWF), thromboxane B2(TXB2), and homocysteine(Hcy) in patients with uremic undergoing hemodialysis. Methods:A total of 50 cases of patients with uremia who underwent maintenance hemodialysis were selected and divided into the Taohong Siwu tang group and the aspirin group according to the random number table method,25 cases in each group. Both groups were treated with hemodialysis,three times a week. The aspirin group was given aspirin entericcoated tablets,and the Taohong Siwu tang group was additionally given Taohong Siwu tang based on the treatment of the aspirin group. Both groups were treated for four weeks. Hemorrheology indexes, coagulation function indexes, levels of vWF,TXB2,and Hcy,as well as Chinese medicine syndrome scores before and after treatment were compared in the two groups. The clinical effect was evaluated in the two groups. Results:After treatment,levels of whole blood viscosity at high shear(HBV),plasma viscosity(PV),hematocrit(HCT),and platelet aggregation rate(PAR) in the two groups were decreased when compared with those before treatment(P<0.05). After treatment,levels of HBV,PV,HCT and PAR in the Taohong Siwu tang group were lower than those in the aspirin group(P<0.05). After treatment,levels of vWF,TXB2,and Hcy in the two groups were decreased when compared with those before treatment(P<0.05),and the levels in the Taohong Siwu tang group were lower than those in the aspirin group(P<0.05). After treatment,levels of fibrinogen(FIB) and D-dimer(D-D) in the two groups were decreased when compared with those before treatment(P<0.05),and the two levels in the Taohong Siwu tang group were lower than those in the aspirin group(P<0.05). After treatment, scores of petechia and ecchymosis of limbs,dim complexion,localized paresthesia,limb numbness,as well as squamous and dry skin in the two groups were decreased when compared with those before treatment(P<0.05),and the five Chinese medicine syndrome scores above in the Taohong Siwu tang group were lower than those in the aspirin group(P<0.05). The total effective rate was 96.00% in the Taohong Siwu tang group,higher than that of 68.00% in the aspirin group(P<0.05). Conclusion:For patients with uremic undergoing hemodialysis, modified Taohong Siwu tang can improve their hypercoagulabale state, protect vascular endothelial function,and enhance the clinical effect.