活血祛瘀方在PICC相关血栓性浅静脉炎患者中的应用

Application of Huoxue Quyu Formula in Patients with PICC-Associated Thrombotic Superficial Phlebitis

目的 评价发生经外周中心静脉置管(PICC)相关的血栓性浅静脉炎患者应用活血祛瘀方湿敷治疗的临床效果。方法 选取2019年1月1日至2022年12月31日在河南省人民医院因乳腺癌入院采用PICC进行化疗后发生血栓性浅静脉炎的86例患者作为研究对象,随机分为对照组42例、试验组44例,对照组接受常规干预,试验组在对照组的基础上接受活血祛瘀方湿敷治疗。比较治疗前后视觉模拟评分(VAS)、上臂臂围变化情况、临床症状消失时间(包括血栓性浅静脉炎痊愈时间、红肿消退时间、疼痛好转时间)、静脉炎治疗情况、生化指标(白细胞计数、血清C反应蛋白)变化情况,同时记录治疗期间不良反应情况。结果 通过干预治疗,两组患者VAS评分均逐渐下降,且对照组低于试验组(P<0.05);两组患者上臂的臂围变化情况差异无统计学意义(P>0.05);试验组患者血栓性浅静脉炎痊愈用时、皮肤红肿消退时间、疼痛好转时间均比对照组短(P<0.05);试验组患者治疗7 d后总有效率之间比较差异无统计学意义(P>0.05);治疗后,白细胞计数和血清C反应蛋白均有所降低,且试验组更低(P<0.05)。两组不良反应发生情况差异无统计学意义(P>0.05)。结论 乳腺癌切除术后采用PICC输液时发生浅静脉炎的患者在基础治疗的同时应用活血祛瘀方湿敷治疗的临床效果明确,可以减轻炎症反应,促进患者恢复,且安全性高。

Objective To evaluate the clinical effect of Huoxue Quyu formula wet compress on patients with peripheral central venous catheterization(PICC)related thrombotic superficial phlebitis.Methods A total of 86 patients with superficial thrombophlebitis who developed thrombophlebitis after chemotherapy for breast cancer in Henan Provincial People’s Hospital from January 1,2019 to December 31,2022 were randomly divided into 42 cases in the control group and 44 cases in the experimental group.The control group received routine intervention,and the experimental group received wet compress treatment with Huoxue Quyu formula on the basis of the control group.The visual analogue score(VAS),changes in upper arm circumference,disappearance time of clinical symptoms(including healing time of superficial thrombophlebitis,time to resolution of redness and swelling,and time to the improvement of pain),treatment of phlebitis and changes in biochemical indexes(white blood cell count,serum C-reactive protein)were compared before and after treatment,and adverse reactions were recorded during treatment.Results Through intervention,the VAS score of both groups gradually decreased,and the control group was lower than that of the experimental group(P<0.05).There was no significant difference in the changes in the circumference of the upper arm in the two groups.The time for the recovery of thrombophlebitis,the time for the skin redness and swelling to subside,and the time for the pain to improve,in the experimental group were shorter than those of the control group(P<0.05).There was no significant difference in the total effective rate of the experimental group after 7 days of treatment(P>0.05).After treatment,white blood cell and serum C-reactive protein were reduced,and the experimental group was lower(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion Patients with superficial phlebitis when using PICC infusion after breast cancer resection have an apparent clinical effect of using wet compress with Huoxue Quyu formula at the same time as essential treatment,which can reduce the inflammatory response and promote recovery,and have high safety.