消瘀宽胸汤对创伤性血胸凝血功能和血液流变学的影响  

Influence of Xiaoyu Kuanxiong Decoction on Blood Coagulation Function and Hemorheology in Treating Patients with Traumatic Hemothorax

作　　者：袁权利[1] 

机构地区：[1]唐山市工人医院,河北唐山063000

出　　处：《中国实验方剂学杂志》2015年第4期202-205,共4页Chinese Journal of Experimental Traditional Medical Formulae

摘　　要：目的:探讨消瘀宽胸汤辅助胸腔闭式引流治疗创伤性血胸的临床疗效及对患者血液流动性、凝血功能的影响。方法:将76例患者随机按入院顺序分为对照组和观察组各38例。对照组采用以胸腔闭式引流为主的综合治疗措施。观察组在对照组治疗的基础上加用消瘀宽胸汤,1剂/d。两组疗程均为2周。记录两组引流量、引流时间、住院时间;随访观察凝固血胸和纤维胸的发生情况;检测凝血酶原时间(PT),活化部分凝血活酶时间(APTT),纤维蛋白原(FIB)和血浆D-二聚体测定(D-D),检测血液流变学指标,检测血栓素2(TXB2)及6-酮前列腺素F1α(6-Keto-PGF1α)水平,以上指标于治疗前及治疗后1周各检测1次。结果:经Ridit分析,观察组临床疗效优于对照组,差异有统计学意义(P<0.05);观察组引流量少于对照组,引流时间和住院时间均短于对照组(P<0.01);对照组凝固血胸或纤维胸的发生率为18.42%,观察组发生率为2.63%,观察组发生率低于对照组,但差异无统计学意义;治疗后1周,观察组D-D和FIB水平低于对照组(P<0.01),观察组血液流变学指标(全血黏度、血浆黏度、血沉、血小板聚集率、全血还原黏度)的改善优于对照组(P<0.01);治疗后1周,观察组TXB2水平低于对照组(P<0.01),6-Keto-PGF1α水平较高于对照组(P<0.01)。结论:消瘀宽胸汤减少了创伤性血胸患者的引流量,缩短了病程,并能改善血液循环,促进血液运行通畅,减少了凝固血胸或纤维胸的发生。Objective： To discuss the clinical effect of Xiaoyu Kuanxiong decoction combined withclosed drainage of the pleural cavity in treating traumatic hemothorax and to investigate its influence on patients＇ blood coagulation and hemorheology. Method： Seventy-six patients were randomly divided into the control group （38 cases） and the observation group （38 cases） by a random number table. Patients in the control group received combined treatment, mainly closed drainage of pleural cavity therapy. Based on the treatment of the control group, patients in the observation group added 1 dose Xiaoyu Kuanxiong decoction once daily. All patients in two groups received 12 weeks of treatment. The volume and duration of drainage, and the length of hospital stays were recorded. The occurrence rates of coagulated hemothorax and fibrothorax were observed during the follow-up. Before and after one week of treatment, prothrombin time （PT） , activated partial thromboplastin time （APTT） , fibrinogen （FIB） and D-dimer （D-D） in plasma were detected, and the hemorheology indexes, levels of thromboxane B2 （TXB2） and 6-ketone-prostaglandin F1α（ 6-Keto-PGF1α） were also detected. Result： The clinical curative effect of the observation group was superior to that of control group. There was statistically significant difference between two groups （P 〈0.05 ）. The volume and duration of drainage, and the length of hospital stays in the observation group were less than those of the control group （P 〈 0.05）. The incidence of coagulated hemothorax or fibrothorax in the control group was 18.42% , which was higher than 2.63% in the observation group, but there was no statistically significant difference between two groups. After a week of treatment, the levels of D-D and FIB in the observation group were lower than those in the eontrol group （P 〈0. 01 ）. Improvement of blood rheology indexes （whole blood viscosity, plasma viscosity, erythroeyte sedimentation rate, platelet aggregation rate, wh

关 键 词：血胸 消瘀宽胸汤 凝血功能 血液流变学 

分 类 号：R287[医药卫生—中药学]