老年髋部骨折下肢血栓性疾病与中医体质的关系研究  

Study on the Relationship between Thrombotic Disease of Lower Extremity and Traditional Chinese Medicine Constitution in Elderly Patients with Hip Fracture

作　　者：曾文磊[1] 罗学辉[1] 张兆华[1] 杜绍龙 刘志波 冯兴伦[1] 李伟强[1] 林洁[1] 何婉芳[1] 刘照宏[2] ZENG Wenlei;LUO Xuehui;ZHANG Zhaohua;DU Shaolong;LIU Zhibo;FENG Xinglun;LI Weiqiang;LIN Jie;HE Wanfang;LIU Zhaohong(Sanshui Hospital of Foshan Traditional Chinese Medicine,Foshan 518200,Guangdong China;Foshan Hospital of Traditional Chinese Medicine,Foshan 528000,Guangdong China.)

机构地区：[1]广东省佛山市中医院三水医院,广东佛山518200 [2]广东省佛山市中医院

出　　处：《中国中医骨伤科杂志》2021年第1期29-33,38,共6页Chinese Journal of Traditional Medical Traumatology & Orthopedics

基　　金：广东省中医药管理局面上项目(20192099)。

摘　　要：目的:研究老年髋部骨折中医体质特点与下肢血栓性疾病(深静脉血栓(DVT)、其他静脉血栓(VT)、动脉血栓(AT)的关系及其与性别、骨折类型及D二聚体交互影响的相关关系,为老年髋部骨折血栓形成的中医防治提供理论基础。方法:收集2019年1月至2020年5月老年髋部骨折患者(年龄≥65岁)共405例,入院后分别统计患者中医体质类型、骨折类型、性别及双下肢血栓的类型,运用多元方差因素分析,探讨体质及其他因素与下肢血栓性疾病发生的相关关系。结果:体质(气虚质、平和质)及D二聚体是老年髋部骨折患者深静脉血栓的重要危险因素。在两种体质风险评估显示,气虚质比平和质患者具有更高的深静脉血栓风险,约为平和质患者的6.25倍;性别是其他静脉血栓和动脉血栓形成的危险因素,其中女性比男性有更大的风险,比男性风险高约12.112倍;但在动脉血栓方面,女性比男性有更小的风险,约为男性风险的45%。在因素的交互影响作用方面,性别和体质对动脉血栓有显著性影响;性别和体质、体质和骨折类型及性别和体质及骨折类型共同对深静脉血栓有显著的影响,差异有统计学意义(P<0.05)。结论:老年髋部骨折体质类型及D二聚体是DVT发生的独立危险因素,其中气虚质及平和质是老年髋部骨折患者深静脉血栓形成的重要危险因素。性别是其他静脉血栓和动脉血栓形成的危险因素,其中女性比男性有更大的其他静脉血栓形成的风险,女性比男性有更小的动脉血栓形成的风险。Objective:To study the relationship between the traditional Chinese medicine(TCM) constitution characteristics of the elderly hip fracture and the lower extremity thrombotic diseases(deep vein thrombosis(DVT),other venous thrombus(VT),arterial thrombus(AT))and their interaction with gender,fracture type and D-dimer,so as to provide theoretical basis for the prevention and treatment of the elderly hip fracture thrombosis in traditional Chinese medicine.Methods:A total of 405 elderly hip fracture patients(age ≥65 years old) were collected from January 2019 to May 2020.After admission,the TCM constitution type,fracture type,gender and thrombosis type of both lower limbs of the patients were counted respectively.The correlation between constitution and other factors and thrombotic disease of lower extremity was explored by multivariate analysis of variance.Results:Constitution(Qi deficiency,peace and quality) and D-dimer were important risk factors of DVT in elderly patients with hip fracture.In two kinds of physical risk assessment,the patients with Qi deficiency and quality had a higher risk of DVT,about 6.25 times of those with peace quality;gender was the risk factor of other vein thrombosis and arterial thrombosis,among which women had a greater risk of other VT than men,about 12.112 times than men;but in terms of arterial thrombosis,women had a smaller risk than men,about 45% than men.In terms of the interaction of factors,gender * constitution had a significant impact on arterial thrombosis;gender * constitution,constitution * fracture type of constitution,gender * constitution * fracture type of constitution had a significant impact on DVT,and the significance P<0.05,difference was statistically significant.Conclusion:Constitution type and D-dimer of hip fracture in the elderly are independent risk factors for DVT,among which Qi deficiency and peace are important risk factors for DVT in hip fracture patients.Gender is a risk factor for other venous and arterial thrombosis.Among them,women have a greater ris

关 键 词：老年髋部骨折 体质 下肢血栓性疾病 深静脉血栓 

分 类 号：R683.42[医药卫生—骨科学]