谷红注射液联合利伐沙班预防脊柱骨折术后下肢深静脉血栓形成

Clinical effect of Guhong injection combine with rivaroxaban in the prevention of deep venous thrombosis after spine fracture surgical treatment

目的探讨谷红注射液联合利伐沙班预防脊柱骨折术后下肢深静脉血栓形成的疗效及机制。方法本研究为随机、双盲对照设计,将胸椎和腰椎骨折术后12 h患者随机分为对照组(利伐沙班治疗,n=34)和联合组(谷红注射液联合利伐沙治疗,n=34),比较两组使用药物前(基线水平)和治疗后20 d凝血指标、血流变学指标、促炎性因子指标及发生静脉血栓和出血等并发症发生率。结果治疗前两组检测指标水平无明显统计学差异(P>0.05)。治疗20 d后,联合组中凝血指标、血流变学指标和促炎性因子指标的水平不同程度低于对照组,血小板计数、血管内皮素和红细胞变性指数高于对照组,水平差异具有统计学意义(P<0.05,P<0.01),联合组发生血栓2例,对照组6例,两组各有2例发生出血,但停药后均自愈。结论谷红注射液联合利伐沙班可通过凝血功能、血流变学和血小板功能加强改善脊柱骨折术后患者下肢循环功能作用,谷红注射液还能降低炎性因子生成及静脉血栓形成风险因素。联合使用能有效增加利伐沙班发挥抗凝作用,优于利伐沙班单纯用药。

Objective The purpose of the study was to investigate whether Guhong Injection combine with Rivaroxaban provided significantly better outcomes than a single drug treatment in the prevention of deep venous thrombosis after spinal fracture operative intervention and explore therapeutic mechanism.Methods This was a randomized,double blind controlled trial.Patients after spinal fracture operative intervention were randomly divided into two groups,conventional treatment(CG group n=34)and Guhong Iniection treatment(GH group n=34).Blood coagulation indexes,blood rheology,blood biochemical indexes were measured on the basehne and at day 20 following treatment,at the same time,Serum tumor necrosis factor-a(TNF-a),interleukin-6(IL-6)and interleukin-8(IL-8)were measured too.Results Blood coagulation indexes,blood rheology,blood biochemical indexes,TNF-α,IL-6,IL-8 in the GH group had no statistically significant difference than in the CG group on the basehne(P>0.05).The level of Blood coagulation indexes,blood rheology,blood biochemical indexes,TNF-α,IL-6,IL-8 in the GH group were lower than those in the CG group,while the level of platelet count,vascular endothelial gene and red blood cell deformation index in the GH group were higher than that in the CG group at day 20,and the differences were statistically significant(P<0.05,P<0.01).8 patients developed VTE(2 in the GH group,6 in the GC group,P<0.01).2 patients developed bleeding complications both in two group.Conclusion Guhong injection combined with rivaroxaban can improve the circulation function of lower limbs in patients after spinal fracture surgery through coagulation function,hemorheology and platelet function,and safflower extract of Guhong injection can also reduce the production of inflammatory factors and inhibit the risk factors of venous thrombosis.Combined use can effectively assist rivaroxaban to play an anticoagulant role,which is better than rivaroxaban alone.