补阳还五汤合四妙散治疗急性左下肢周围型下肢深静脉血栓的效果及对D-二聚体和超敏C-反应蛋白的影响  

Effect of Buyang Huanwu Decoction and Simiaosan on acute peripheral deep venous thrombosis of left lower extremity and its effect on D-dimer and hypersensitive C-reactive protein

作　　者：霍景山[1] 黄子健 贺友 HUO Jingshan;HUANG Zijian;HE You(Department of General Surgery, Foshan Hospital of Traditional Chinese Medicine, Guangdong Province, Foshan 528000, China)

机构地区：[1]广东省佛山市中医院外一科

出　　处：《中国医药导报》2019年第15期128-131,共4页China Medical Herald

基　　金：广东省佛山市科技局立项课题(2016AB002561);广东省中医药管理局立项课题(20151102)

摘　　要：目的观察补阳还五汤合四妙散配合尿激酶对急性左下肢周围型下肢深静脉血栓形成(DVT)患者D-二聚体(D-D)及超敏C-反应蛋白(hs-CRP)的变化。方法选取确诊为急性左下肢周围型DVT并属湿热下注型患者60例,并将其随机分为研究组(n = 30)和对照组(n = 30)。研究组给予中药方剂(补阳还五汤合四妙散)和西药治疗(口服利伐沙班14 d+静脉滴注尿激酶7 d),对照组给予西药治疗(口服利伐沙班14 d+静脉滴注尿激酶7 d)。两组患者均在治疗前、治疗后第1、4、7、11、14天抽血测定D-D及hs-CRP水平。观察两组患者治疗前后左下肢肿胀、疼痛、色泽、周径及舌脉等情况。结果研究组中医证候疗效显著优于对照组,差异有统计学意义(P < 0.05)。研究组治疗后第4、7、11、14天D-D水平低于对照组同期,差异有高度统计学意义(P < 0.01)。研究组治疗后第1、4、7、11、14天hs-CRP水平均低于对照组同期,差异有高度统计学意义(P < 0.01)。结论补阳还五汤合四妙散配合尿激酶治疗急性左下肢周围型DVT的临床效果优于单纯西药治疗,其机制可能与促进纤溶系统及保护血管内皮细胞两方面有关。Objective To observe the changes of Buyang Huanwu Decoction and Simiaosan combined with urokinase on D-dimer (DD) and hypersensitive C-reactive protein (hs-CRP) in patients with acute peripheral deep venous thrombosis (DVT) of left lower extremity. Methods Sixty patients with acute left lower extremity DVT were enrolled in the study. They were randomly divided into study group (n = 30) and control group (n = 30). The study group was treated with traditional Chinese medicine (Buyang Huanwu Decoction combined with Simiaosan) and Western medicine (oral Rivaroxaban 14 days + intravenous urokinase 7 days), while the control group was treated with Western medicine (oral Rivaroxaban 14 days + intravenous urokinase 7 days). The levels of D-D and hs-CRP were measured before treatment and on the 1st, 4th, 7th, 11th and 14th days after treatment in both groups. The swelling, pain, color, circumference and tongue vein of the left lower limb before and after treatment were observed. Results The efficacy of TCM syndromes in the study group was significantly better than that in the control group, and the difference was statistically significant (P < 0.05). The D-D levels on the 4th, 7th, 11th and 14th day after treatment in the study group were lower than those in the control group, and the differences were highly statistically significant (P < 0.01). The hs-CRP levels in the study group were lower than those in the control group on the 1st, 4th, 7th, 11th and 14th day after treatment, and the differences were highly statistically significant (P < 0.01). Conclusion The clinical efficacy of Buyang Huanwu Decoction combined with Simiaosan combined with urokinase in the treatment of acute peripheral DVT of left lower extremity is better than that of Western medicine alone. Its mechanism may be related to the promotion of fibrinolysis system and the protection of vascular endothelial cells.

关 键 词：补阳还五汤 四妙散 深静脉血栓 D-二聚体 超敏C-反应蛋白 

分 类 号：R743.33[医药卫生—神经病学与精神病学] R542.2[医药卫生—临床医学]