摘要
目的探讨中医定向透药疗法对下肢骨折术后患者血液高凝状态及下肢深静脉血栓形成的影响。方法选取2020年9月至2021年6月于本院骨伤科行手术治疗的90例下肢骨折患者作为研究对象,采用随机数字表法分为对照组、物理干预组及中医干预组,每组30例。对照组采用低分子肝素钠防治,物理干预组采用间歇性充气压力泵+低分子肝素钠防治,中医干预组采用血府逐瘀汤定向透药治疗+间歇性充气压力泵+低分子肝素钠防治。比较3组凝血指标[活化部分凝血活酶时间(APTT)、凝血酶原时间(PT)、纤维蛋白原(FIB)、D-二聚体(D-D)水平及血小板计数(PLT)]、深静脉血栓形成情况及并发症发生率。结果3组APTT、PT及D-D水平组间、时间比较差异有统计学意义(P<0.05);3组FIB水平时间比较差异有统计学意义(P<0.05);3组PLT组间、时间、交互比较差异有统计学意义(P<0.05);3组APTT、PT、FIB水平、D-D水平交互比较差异无统计学意义,3组FIB水平组间比较差异无统计学意义。T_(0)时,3组APTT、PT、D-D水平、FIB水平、PLT比较差异无统计学意义;T_(1)时,物理干预组、中医干预组APTT、PT均长于对照组,中医干预组PLT低于对照组(P<0.05);T_(2)时,物理干预组、中医干预组APTT、PT均长于对照组,PLT低于对照组(P<0.05);T_(3)时,中医干预组APTT长于对照组,物理干预组、中医干预组PT均长于对照组,D-D水平、PLT均低于对照组,中医干预组PLT低于物理干预组(P<0.05);各指标其他组间比较差异无统计学意义。术后,3组深静脉血栓阳性率比较差异有统计学意义(P<0.05),其中中医干预组深静脉血栓阳性率低于对照组(P<0.05),中医干预组与物理干预组、物理干预组与对照组深静脉血栓阳性率比较差异无统计学意义。术后,3组并发症发生率比较差异有统计学意义(P<0.05),其中中医干预组、物理干预组均低于对照组(P<0.05),中医干预组与物理干预组并发症发生率比较差异无统计学意义。结论中医定向透药疗法可有效降低下肢骨折术后患者的深静脉血栓及并发症发生率,促进凝血指标恢复正常,值得临床推广应用。
Objective To explore the effects of Traditional Chinese Medicine directional drug penetration therapy on hypercoagulable state and deep venous thrombosis in patients after lower limb fracture surgery.Methods 90 patients with lower limb fractures who underwent surgical treatment in department of Orthopedics and Traumatology in our hospital from September 2020 to June 2021 were selected as the research subjects,and they were divided into the control group,the physical intervention group and the Traditional Chinese Medicine intervention group by the random number table method,with 30 cases in each group.The control group was treated with low molecular weight heparin sodium,and the physical intervention group was given intermittent pneumatic pressure pump+low molecular weight heparin sodium,and the Traditional Chinese Medicine intervention group was given directional drug penetration therapy with Xuefu Zhuyu decoction+intermittent pneumatic pressure pump+low molecular weight heparin sodium.Coagulation indicators(activated partial thromboplastin time[APTT],prothrombin time[PT],fibrinogen[FIB],D-dimer[D-D],platelet count[PLT]),deep venous thrombosis and incidence of complications were compared among the three groups.Results There were significant differences in APTT,PT and D-D levels among the three groups of group,time points(P<0.05);there was significant difference in FIB level among the three groups of time points(P<0.05);there were significant differences in PLT among the three groups of group,time points and interaction(P<0.05);there were no significant difference in APTT,PT,FIB level and D-D level among the three groups of interaction,and there was no significant difference in FIB level among the three groups of group.At T_(0),there were no statistically significant differences in APTT,PT,DD,FIB and PLT among the three groups;at T_(1),the APTT and PT in the physical intervention group and Traditional Chinese Medicine intervention group were longer than those in the control group,and PLT in the Traditional Chinese Medicine intervention group was lower than that in control group(P<0.05);at T_(2),the APTT and PT in the physical intervention group and Traditional Chinese Medicine intervention group were longer than those in the control group,and the PLT was lower than that in control group(P<0.05);at T_(3),the APTT in the Traditional Chinese Medicine intervention group was longer than that in the control group,and PT in the physical intervention group and Traditional Chinese Medicine intervention group was longer than that in the control group,and D-D and PLT were lower than those in the control group,and PLT in the Traditional Chinese Medicine intervention group was lower than that in the physical intervention group(P<0.05);there were no statistically significant differences in the above indicators between any two groups.After surgery,the positive rate of deep venous thrombosis was significantly different among the three groups(P<0.05),and the positive rate of deep venous thrombosis in the Traditional Chinese Medicine intervention group was lower than that in the control group(P<0.05),there was no statistical significance in the positive rate of deep venous thrombosis between Traditional Chinese Medicine intervention group and physical intervention group and between the physical intervention group and the control group.After surgery,there were statistically significant differences in the incidence rates of complications among the three groups(P<0.05),and the incidence rates of complication in the Traditional Chinese Medicine intervention group and the physical intervention group were lower than those in the control group(P<0.05),there were no statistical differences in the incidence rates of complications between Traditional Chinese Medicine intervention group and physical intervention group.Conclusion Traditional Chinese Medicine directional drug penetration therapy can effectively reduce the incidence rates of deep venous thrombosis and complications in patients after lower limb fracture surgery,and promote the normal recovery of coagulation indicators,which is worthy of clinical promotion and application.
作者
何勇强
尹红波
肖义陂
HE Yongqiang;YIN Hongbo;XIAO Yipi(First Department of Orthopedics and Traumatology,Nanchang Hongdu Hospital of TCM,Nanchang,Jiangxi,330000,China)
出处
《当代医学》
2023年第17期1-5,共5页
Contemporary Medicine
基金
江西省中医药管理局科技计划(2020B0307)。
关键词
中医定向透药疗法
下肢骨折
凝血状态
深静脉血栓
并发症
Traditional Chinese Medicine directional drug penetration therapy
Lower limb fracture
Hypercoagulable state
Deep venous thrombosis
Complications
