通痹胶囊对人工全膝关节置换术后凝血功能的影响

Effect of Tongbi capsule on blood coagulation function in patients with total knee arthroplasty

目的 观察通痹胶囊对人工全膝关节置换术(TKA)后凝血功能的影响。方法 将70例接受TKA患者按照随机数字表法分为2组。对照组35例予术后第1天予常规治疗,治疗组35例在对照组治疗基础上加通痹胶囊。2组均连续治疗14天。比较2组治疗前后凝血指标D-二聚体(D-D)、凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、纤维蛋白原(FIB)、血小板(PLT)、红细胞沉降率(ESR)及超敏C反应蛋白(hs-CRP)变化;比较2组深静脉血栓形成(DVT)发生率;比较2组不良反应发生率。结果 2组治疗后D-D、PT、APTT、PLT、ESR、hs-CRP均较本组治疗前升高(P<0.05),FIB较本组治疗前降低(P<0.05);治疗后治疗组D-D、FIB、PLT、ESR、hs-CRP均低于对照组(P<0.05);治疗后治疗组PT、APTT均高于对照组(P<0.05)。治疗组35例,DVT发生1例(2.86%);对照组35例,DVT发生5例(14.29%)。治疗组DVT发生率低于对照组,但比较差异无统计学意义(P>0.05)。治疗组不良反应发生率5.71%(2/35),对照组不良反应发生率17.14%(6/35),治疗组不良反应发生率低于对照组,但比较差异无统计学意义(P>0.05)。结论 通痹胶囊对TKA后患者有良好的治疗效果及安全性,能降低患者凝血指标,一定程度上降低DVT。

Objective To observe the effect of Tongbi capsule on blood coagulation function in patients with total knee arthroplasty(TKA).Methods A total of 70 TKA patients were randomly allocated to treatment group(35 cases)and control group(35 cases).All patients were managed with routine treatment form day 1 of postoperative,and patients in the treatment group were additionally treated with Tongbi capsule,and the treatment continued for 14 days.The coagulation indexes including D-dimer(D-D),prothrombin time(PT),activated partial thromboplastin time(APTT),fibrinogen(FIB),platelet(PLT),erythrocyte sedimentation rate(ESR)and high-sensitivity C-reactive protein(hs-CRP)were included as comparisons between groups before and after treatment.The incidence of deep vein thrombosis(DVT)and adverse reactions was assessed.Results After treatment,the levels of D-D,PT,APTT,PLT,ESR and hs-CRP in the two groups were significantly higher than those before treatment(P<0.05),FIB was significantly lower than before treatment(P<0.05).After treatment,significantly lower D-D,FIB,PLT,ESR and hs-CRP,and significantly higher PT and APTT were detected in the treatment group compared with the control group(P<0.05).The incidence of DVT in the treatment group was lower than that in the control group,but the difference was not statistically significant(2.86%[1/35]vs 14.29%[5/35],P>0.05).The incidence of adverse reactions in the treatment group was similar to the control group(5.71%[2/35]vs 17.14%[6/35],P>0.05).Conclusion For TKA patients,Tongbi capsule has a good therapeutic effect and safety,which can reduce patients’coagulation index,and significantly reduce incidence of DVT.