益气活血法对股骨颈骨折关节置换术后凝血功能的影响  

The Influence of Method of Replenishing Qi and Activating Blood Circulation on Coagulation Function After Joint Replacement of Femoral Neck Fracture

作　　者：熊巍 余志勇 王仁杰 XIONG Wei;YU Zhi-yong;WANG Ren-jie(Hubei Minzu University,Enshi,Hubei,China,445000;Xiangyang Hospital of Traditional Chinese Medicine,Xiangyang,Hubei,China,441000)

机构地区：[1]湖北民族大学,湖北恩施445000 [2]襄阳市中医医院,湖北襄阳441000

出　　处：《河南中医》2022年第8期1236-1240,共5页Henan Traditional Chinese Medicine

基　　金：湖北省卫生和计划生育委员会中医药科研项目(ZZ201717014)。

摘　　要：目的:探讨益气活血法对股骨颈骨折关节置换术后凝血功能的影响。方法:将60例单侧股骨颈骨折患者按照随机数字表法分为对照组和治疗组,每组各30例。两组患者均行股骨头置换术,对照组术后给予常规补液、抗感染、抗凝血等对症治疗,治疗组在对照组基础上以益气活血为治疗原则,给予补阳还五汤加减治疗。比较两组患者血栓发生率及治疗前后血栓弹力图[凝血时间(R值)、血凝块成形时间(K值)、Angle角、凝血综合指数(CI值)]、凝血功能[凝血酶原时间(prothrombin time,PT)、活化部分凝血活酶时间(activated partial thromboplastin time,APTT)、纤维蛋白原(Fibrinogen,FIB)、D-二聚体)]变化情况。结果:两组患者手术后第3天R值、K值低于本组手术前,手术后第3天治疗组R值、K值高于对照组,但差异无统计学意义(P>0.05);两组患者手术后第3天Angle角,CI值较高于手术前,对照组Angle角大于治疗组,差异有统计学意义(P<0.05),对照组CI值高于治疗组,但差异无统计学意义(P>0.05)。两组患者手术后第9天R值、K值高于手术后第3天,治疗组高于对照组,差异有统计学意义(P<0.05),两组患者手术后第9天Angle角,CI值较低于手术后第3天,对照组高于治疗组,但差异无统计学意义(P>0.05)。治疗组手术后第3天、第9天PT、APTT均高于对照组,TT高于对照组,差异有统计学意义(P<0.05),手术后第3天治疗组FIB低于对照组,但差异无统计学意义(P>0.05),手术后第9天治疗组FIB低于对照组,差异有统计学意义(P<0.05);手术后第3天、第9天治疗组D-二聚体的水平低于对照组,但差异无统计学意义(P>0.05)。对照组血栓发生率高于治疗组,但差异无统计学意义(P>0.05)。结论:益气活血法能改善股骨头置换术后患者血液的高凝状态,预防下肢静脉血栓形成,促进患者康复。Objective:To observe the influence of method of replenishing qi and activating blood circulation on coagulation function after joint replacement of femoral neck fracture.Methods:A total of 60 patients with unilateral femoral neck fracture were randomly divided into the control group and the treatment group,with 30 cases in each group.Both groups were treated with femoral head replacement.The control group was additionally treated with routine fluid infusion,anti-infection,anti-coagulation and other symptomatic treatments.On the basis of the control group,the treatment group took replenishing qi and activating blood circulation as the treatment principle,then was additionally treated with Modified Yang-Supplementing and Five-Returning Decoction.The incidence of thrombosis and the changes of [coagulation time(R value),clot forming time(K value),Angle,and coagulation comprehensive index(CI value)],coagulation function [(prothrombin time(PT),activated partial thromboplastin time(APTT),fibrinogen(FIB) and D-dimer)] before and after treatment were compared between the two groups.Results:On the third day after operation,the R and K values of the two groups were lower than those before operation,and the R and K values of the treatment group were higher than those of the control group,but all the differences were not statistically significant(P>0.05).On the third day after operation,the angle and CI value of the two groups were higher than those before operation,and the Angle angle of the control group was greater than that of the treatment group,and all the differences were statistically significant(P<0.05).The CI value of the control group was higher than that of the treatment group,but the difference was not statistically significant(P>0.05).The R value and K value of the two groups on the 9 th day after operation were higher than those on the 3 rd day after operation,and the above indexes of the treatment group were higher than those of the control group,and all the differences were statistically significant(P<0.05).T

关 键 词：股骨颈骨折 关节置换术 益气活血法 补阳还五汤加减 

分 类 号：R274.983.42[医药卫生—中西医结合]