益气活血通络汤联合低剂量低分子量肝素预防深静脉血栓形成的疗效分析

Efficacy analysis of Yiqi Huoxue Tongluo Decoction combined with low-dose low molecular weight heparin in preventing deep vein thrombosis

目的:分析益气活血通络汤联合低剂量低分子量肝素预防深静脉血栓(DVT)形成的疗效。方法:收集90例老年股骨转子间骨折患者,预防DVT分为常规剂量低分子量肝素组(常规组)和益气活血通络汤联合低剂量低分子量肝素组(联合组),每组45例。比较DVT形成情况、血栓弹力图R值、血红蛋白(HGB)、红细胞压积(HCT)、伤口渗血情况、中医证候积分及不良反应发生情况等。结果:两组术后3 d、术后2周血栓形成情况比较,差异无统计学意义。术后1周与术后2周联合组R值显著短于常规组(P<0.01),提示随着时间延长常规组抗凝强度大于联合组。联合组术后3 d HGB、HCT均显著高于常规组(P<0.05),术后3 d伤口渗血联合组5例显著少于常规组13例(P<0.05)。术后中医证候积分比较,差异有统计学意义(P<0.05),提示联合组抗凝同时可改善气虚症状。两组不良反应发生情况比较差异无统计学意义(P=0.833)。结论:益气活血通络汤联合低剂量低分子肝素预防DVT形成疗效确切,相比常规剂量低分子肝素出血风险更小,可降低术后伤口感染风险并改善全身情况。

Objective:To analyze the efficacy of Yiqi Huoxue Tongluo Decoction combined with low-dose low molecular weight heparin in preventing the formation of deep vein thrombosis(DVT).Methods:Ninety elderly patients with intertrochanteric femur fractures were collected and divided into two groups for DVT prevention:the conventional low-dose low molecular weight heparin group(conventional group)and the Yiqi Huoxue Tongluo Decoction combined with low-dose low molecular weight heparin group(combined group),with 45 cases in each group.The incidence of DVT,thromboelastography R value,hemoglobin(HGB),hematocrit(HCT),wound bleeding,traditional Chinese medicine(TCM)syndrome scores,and adverse effects were compared.Results:There was no statistically significant difference in the incidence of thrombosis between the two groups at 3 days and 2 weeks postoperatively.The R value in the combined group was significantly shorter than that in the conventional group at 1 week and 2 weeks postoperatively(P<0.01),indicating that the anticoagulation strength of the conventional group was greater over time.The combined group had significantly higher HGB and HCT levels at 3 days postoperatively compared to the conventional group(P<0.05).Wound bleeding at 3 days postoperatively was significantly less in the combined group(5 cases)than in the conventional group(13 cases)(P<0.05).There were significant differences in TCM syndrome scores postoperatively(P<0.05),suggesting that the combined group could improve qi deficiency symptoms while providing anticoagulation.The occurence of adverse effects between the two groups was statistically significant(P=0.833).Conclusion:Yiqi Huoxue Tongluo Decoction combined with low-dose low molecular weight heparin is effective in preventing DVT formation.Compared to conventional low molecular weight heparin,it has a lower risk of bleeding,reduces the risk of postoperative wound infection,and improves the overall condition of the patient.