血府逐瘀汤治疗下肢深静脉血栓的临床疗效及对患者凝血功能和炎症因子的影响

Clinical Efficacy of Blood Mansion Stasis-Expelling Decoction in the Treatment of Deep Venous Thrombosis and its Effects on Patients′ Coagulation Function and Inflammatory Factors

目的:观察血府逐瘀汤治疗下肢深静脉血栓的临床疗效及对患者凝血功能和炎症因子的影响。方法:选取2021年8月至2023年3月江阴市中医院周围血管外科治疗的下肢深静脉血栓患者40例,按照随机数字表法分为试验组与对照组,每组各20例。对照组行下腔静脉滤器植入术、导管接触性溶栓术,并控制其他危险因素,试验组在对照组治疗的基础上给予血府逐瘀汤治疗。观察两组患者皮肤温度、色泽以及疼痛评分,血清中D-二聚体、血浆抗凝血酶Ⅲ活性测定(antithrombinⅢactivity,AT-ⅢA)、血浆纤维蛋白原(fibrinogen,FIB)、白细胞介素(interleukin,IL)-1、IL-6的水平,静脉通畅率,消肿率及临床疗效。结果:治疗1 d、3 d后,试验组皮肤温度、皮肤色泽积分优于对照组,差异有统计学意义(P<0.05),治疗1 d、3 d、5 d后,试验组疼痛积分优于对照组,差异有统计学意义(P<0.05)。治疗5 d、7 d后,试验组IL-1、IL-6、D-二聚体水平优于对照组,差异有统计学意义(P<0.05)。治疗7 d后,试验组静脉通畅率优于对照组,差异有统计学意义(P<0.05),两组消肿率比较,差异无统计学意义(P>0.05)。治疗7 d后,两组有效率比较,差异无统计学意义(P>0.05),试验组痊愈率优于对照组,差异有统计学意义(P<0.05)。结论:血府逐瘀汤能改善血脉瘀阻型下肢深静脉血栓患者皮温、色泽、疼痛等症状体征,降低IL-1、IL-6等炎症指标及血栓负荷率,提高静脉通畅率。

Objective:To observe the clinical efficacy of Blood Mansion Stasis-Expelling Decoction on deep venous thrombosis(DVT) and its effects on patients′ coagulation function and inflammatory factors.Methods:A total of 40 patients with DVT treated in the peripheral vascular surgery department of Jiangyin Hospital of between August 2021 and March 2023 were selected and randomly divided into the experimental group and the control group,with 20 cases in each group.The control group underwent inferior vena cava filter implantation and catheter-directed thrombolysis,along with control of other risk factors,while the experimental group received Blood Mansion Stasis-Expelling Decoction in addition to the control group′s treatment.The skin temperature,color,pain scores,serum D-dimer levels,plasma antithrombin Ⅲ activity(AT-ⅢA),plasma fibrinogen(FIB),levels of interleukin(IL)-1,IL-6,venous patency rate,edema reduction rate,and clinical efficacy in both groups were observed.Results:After one day and 3 days of treatment,the skin temperature and color scores of the experimental group were better than those of the control group,with statistically significant differences(P<0.05).After one,3,and 5 days of treatment,the pain scores in the experimental group were superior to those in the control group,with statistically significant differences(P<0.05).After 5 and 7 days of treatment,the levels of IL-1,IL-6,and D-dimer in the experimental group were better than those in the control group,with statistically significant differences(P<0.05).After 7 days of treatment,the venous patency rate in the experimental group was higher than that in the control group,with a statistically significant difference(P<0.05).There was no statistically significant difference in the edema reduction rate between the two groups(P>0.05).After 7 days of treatment,there was no statistically significant difference in the overall efficacy rate between the two groups(P>0.05),but the cure rate in the experimental group was higher than that in the control group,with a statistically significant difference(P<0.05).Conclusion:Blood Mansion Stasis-Expelling Decoction can improve symptoms and signs such as skin temperature,color,and pain in DVT patients with syndrome of static blood obstructing the vessels.It has the ability to reduce inflammatory markers such as IL-1 and IL-6,decrease thrombus burden,and increase venous patency rate.