益气活血通脉汤对骨科大手术后下肢深静脉血栓的防治  

Clinic Research of Yiqi Huoxue Tongmai Decoction Prevention and Cure on Deep Venous Thrombosis after Major Orthopaedic Surgery

作　　者：徐国华[1] 陈品英[1] 田伟明[1] 柴仪[1] 

机构地区：[1]河北省中医院,石家庄050011

出　　处：《中国实验方剂学杂志》2014年第4期188-191,共4页Chinese Journal of Experimental Traditional Medical Formulae

基　　金：河北省中医药管理局科技项目(2010093)

摘　　要：目的：探讨益气活血通脉汤对骨科大手术后下肢深静脉血栓（DVT）形成的防治效果及作用机制。方法：将197例患者随机按住院前后顺序分为对照组96例和观察组101例。两组均进行常规DVT预防性措施，对照组采用低分子肝素钙注射液，手术前1—2h，腹壁皮下注射2500U，手术后每天腹壁皮下注射2500IU，术后连续用药14d。观察组在对照组治疗的基础上加服益气活血通脉汤，1剂／d，常规水煎分2次服用。两组疗程14d。观察DVT形成情况，计算DVT发生率；观察术后伤肢肿胀程度；检测血清肿瘤坏死因子-α（TNF—α）、白细胞介素-1（IL-1）和白细胞介素-6（IL-6）水平；检查凝血功能和血清D-二聚体（D—D）。结果：术后第7天，观察组DVT发生率5．94％，低于对照组的15．62％（P〈0．05）；术后第14天观察组DVT发生率7．92％，低于对照组的22．91％（P〈0．01）；术后第7，14天，观察组肿胀程度均轻于对照组（P〈0．01）；术后第14天观察组血清TNF-α，IL-1和IL-6水平均低于对照组（P〈0．01）；术后第14天，对照组纤维蛋白原（FIB）变化不明显，观察组FIB较术后第1天明显下降；两组术后第14天D-D均下降，观察组低于对照组（P〈0．01）。结论：骨科大手术后使用益气活血通脉汤可减轻伤肿胀，降血清FIB和D-D水平，减轻炎性症反应，预防DVT的发生，值得临床使用。Objective： The purpose is to observe Yiqi Huoxue Tongmai decoction＇s prevention and cure on deep venous thrombosis （DVT） of control effect and mechanism action after major orthopaedic surgery. Method： One hundred and ninety-seven cases of patients were randomly divided into control group （96 cases） and observation group （101 cases） according to numeric method. Both groups were treated with regular DVT preventive measures. Besides control group injected Low-Molecular-Weight Heparins Calcium injection, 1-2 hour before the operation, abdominal subcutaneous injection Of 2 500 U; after the operation, patients treated with abdominal subcutaneous injection, 2 500 U/clay. The treatment course was 14 days. Based on control group, observation group added Yiqi Huoxue Tongmai decoction, 1 does/day, conventional water decoction, orally. The treatment course was 14 days. Observe the form of DVT and record its occurrence rate. Observe the postoperative wound limb swelling degree. Detect serum tumor necrosis factor alpha （TNF-α） , interleukin-1 （IL-1） and interleukin-6 （IL-6）. Check the blood coagulation function and serum D-dimer （D-D）. Result： After the treatment, the occurrence rate of DVT in the 14 courses treatment of observation group was 7.9% , lower than 22.91% of the control group （P 〈 0.01 ）. At the seventh, fourteenth day of the surgery, degree of swelling of observation group were lighter than control group （P 〈0.01 ）. At the fourteenth day of the surgery, the TNF-α, IL-1 and IL-6 ofobservation group were lower than control group （P 〈 0.01 ）. as for fibrinogen （FIB）, change is not obvious in control group, but in the observation group the FIB is reducing from the first day after the surgery, at the fourteenth day of the surgery, the D-D of both groups reduced, observation group was inferior to control group （P 〈 0.01）. Conclusion： Yiqi Huoxue Tongmai decoction can reduce injury swelling, serum levels of FIB and D-D,reduce the inflammatory reaction an

关 键 词：深静脉血栓 骨科大手术 益气活血通脉汤 炎性因子 

分 类 号：R287[医药卫生—中药学]