益气补肾活血方与穴位康复按摩对老年髋部骨折术后eNOS活性及表达的影响  

Yiqibushenhuoxuefang in combination with massage on the effect of hemorrheology parameters and endothelial nitric oxide synthase activity and expression following postoperative period of aged hip arthroplasty

作　　者：周剑鹏[1,2,3] 夏虹[3] 

机构地区：[1]南方医科大学研究生院,广州510515 [2]广州市中医医院骨科,广州510130 [3]广州军区广州总医院骨科医院,广州510010

出　　处：《中国临床药理学杂志》2015年第13期1242-1245,共4页The Chinese Journal of Clinical Pharmacology

基　　金：广州市医药卫生科技基金资助项目(20122A011007)

摘　　要：目的观察益气补肾活血方与穴位康复按摩对老年髋部骨折术后内皮源性一氧化氮合酶(e NOS)活性及表达的影响。方法将90例进行髋关节置换术的患者随机分为A组、B组和C组,每组各30例。A组予以腹壁皮下注射依诺肝素钠注射液4000 U,第1次使用在术后10 h,以后每24 h重复使用1次,直至术后10 d为止,并在肝素治疗的基础上予以补肾益气活血方,每日1剂,术后第1天开始服用,持续10 d,加以腓股肌穴位康复按摩,每天1次,持续11 d;B组予以皮下注射依诺肝素钠注射液4000 U,第1次在术后10 h,直至术后10 d;C组予以阿司匹林肠溶片100 mg,每天1次,术后第1天开始服用,持续10 d。观察3组术前、术后第1,10天患肢周径和肿胀率、血液e NOS、一氧化氮及血液流变学的变化,以及不良反应发生率。结果术后第10天,A组患者肢体肿胀消退率优于C组和B组(P<0.01)。术后第1天,A组血液e NOS、一氧化氮浓度和流变学指标与B组、C组相近,差异无统计学意义(P>0.05)。术后第10天,A组血液e NOS、一氧化氮浓度高于B组、C组,血液流变学指标较C组改善(P<0.01)。3组不良反应发生率相比较差异无统计学意义(P>0.05)。结论补肾益气活血方结合腓股肌穴位康复按摩能有效地提高老年髋部骨折术后血液e NOS、一氧化氮浓度,改善血液流变学指标,有利于改善循环,减少术后深静脉血栓的形成。Objective To observe the effectiveness of Yiqibushenhuoxuefang in combination with massage on endothelial nitric oxide（e NOS）synthase activity and expression following postoperative period of aged hip arthroplasty.Methods Ninety patients operated by the same group of doctors were randomly divided into A group,B group and C group.In A group,subcutaneous injection of enoxaparin sodium injection 4000 U,first used in the postoperative 10 h,after each 24 h reused again until 10 days,postoperative day 1 to begin taking Yiqibushenhuoxuefang,once with lukewarm water,one course is 10 days.Gastrocnemius-quadriceps femoris massage：immediately after the operation,once a day for 11 days.In B group,subcutaneous injection of enoxaparin sodium injection4000 U,first used in the postoperative 10 h,after each 24 h reused again until 10 days after surgery so far.In C group,postoperative day 1 tobegin taking aspirin,100 mg one time every day,one course is 10 days.Observe limb circumference,e NOS,nitric oxide（NO）,hemorrheology parameters before operation and 1 day,10 days after operation.Results Patients in A group limb swelling subsided rate was significantly difference than the B group and C group（P 〈 0.01）.e NOS,NO,hemorrheology parameters after 1 day,the difference was not statistically significant between three groups（P 〉 0.05）.After 10 days,there were more e NOS,NO in A group than in B group and in C group,more well hemorrheology parameters in A group than in C group,the difference was statistically significant（P 〈 0.01）.A group,the incidence of postoperative adverse reaction compared with the B group and C group with not significant difference（P 〉 0.05）.Conclusion It is more effective and safer using Yiqibushenhuoxuefang in combination with massage on prophylaxis of Deep vein thrombosis as well as e NOS,NO,hemorrheology parameters following postoperative period of aged hip arthroplasty.

关 键 词：内皮源性一氧化氮合酶 老年髋关节置换 益气补肾活血方 腓肠肌 股四头肌 

分 类 号：R285[医药卫生—中药学] R683[医药卫生—中医学]