鳖甲煎丸联合低分子肝素钙治疗恶性肿瘤并发下肢深静脉血栓临床研究  

Clinical Study on Biejia Decocted Pills Combined with Low Molecular Weight Heparin Calcium for Malignant Tumors Complicated with Deep Venous Thrombosis of Lower Extremities

作　　者：陈后良 鲁佩佩 陶玉 李琼瑶 CHEN Houliang;LU Peipei;TAO Yu;LI Qiongyao(Department of Oncology,Wenzhou TCM Hospital Affiliated to Zhejang Chinese Medical University,Wenzhou Zhejang 325000,China)

机构地区：[1]浙江中医药大学附属温州中医院肿瘤内科,浙江温州325000

出　　处：《新中医》2023年第17期151-156,共6页New Chinese Medicine

基　　金：温州市科学技术局基础性医疗卫生科技项目(Y2020872)。

摘　　要：目的:观察鳖甲煎丸联合低分子肝素钙治疗恶性肿瘤并发下肢深静脉血栓的临床疗效。方法:采用随机数字表法将63例恶性肿瘤并发下肢深静脉血栓患者分为试验组(31例)与对照组(32例)。2组均采用常规抗肿瘤治疗,在此基础上,对照组给予皮下注射低分子肝素钙治疗,试验组在对照组基础上加服鳖甲煎丸治疗。比较2组治疗前后中医证候评分、凝血功能指标[活化部分凝血活酶时间(APTT)、凝血酶原时间(PT)、国际标准化比值(INR)、D-二聚体(D-D)、血小板计数(BPC)]、血液流变学指标(全血高切黏度、全血中切黏度、全血低切黏度、血浆黏度)、炎症因子[肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)]、患肢腿围,并评估2组临床疗效及不良反应发生情况。结果:试验组脱落1例,纳入研究30例;对照组脱落2例,纳入研究30例。试验组总有效率93.33%,高于对照组66.67%(P<0.05)。治疗后,2组APTT、PT、INR均高于治疗前(P<0.05),D-D、BPC均低于治疗前(P<0.05);试验组治疗后APTT、PT、INR均高于对照组(P<0.05),D-D、BPC均低于对照组(P<0.05)。治疗后,2组中医证候评分、全血高切黏度、全血低切黏度、全血中切黏度、血浆黏度、TNF-α、IL-6水平均低于治疗前(P<0.05),试验组治疗后中医证候评分、血液流变学指标、炎症因子水平均低于对照组(P<0.05)。治疗后,2组患肢髌骨上15 cm、髌骨下10 cm处腿围均较治疗前缩短(P<0.05),且试验组治疗后患肢腿围短于对照组(P<0.05)。2组均未出现不良反应。结论:鳖甲煎丸联合低分子肝素钙治疗恶性肿瘤并发下肢深静脉血栓疗效确切,能有效改善患者凝血功能、血液流变学指标,降低炎症因子水平,减轻患肢肿胀程度,安全性较高。Objective:To observe the clinical effect of the therapy of Biejia Decocted Pills combined with low molecular weight heparin calcium on malignant tumors deep venous thrombosis of lower extremities.Methods:A total of 63 patients with malignant tumors deep venous thrombosis of lower extremities were divided into the trial group(31 cases)and the control group(32 cases)according to the random number table method.The two groups were treated with routine antineoplastic therapy,based on which the control group was given subcutaneous injection with low molecular weight heparin calcium,and the trial group was additionally treated with Biejia Decocted Pills based on the treatment of the control group.Before and after treatment,the traditional Chinese medicine(TCM)syndrome scores,coagulation function indexes,including activated partial thromboplastin time(APTT),prothrombin time(PT),international normalized ratio(INR),D-dimer(D-D)and blood platelet count(BPC),indexes of hemorheology,including whole blood high shear viscosity,whole blood medium shear viscosity,whole blood low shear viscosity and plasma viscosity,inflammatory factors,including tumor necrosis factor-α(TNF-α)and interleukin-6(IL-6)and the thigh of affected limb were compared between the two groups;the clinical effects and incidence of adverse reactions in the two groups were evaluated.Results:With 1 case in the trial group and 2 cases in the control group being dropped out,finally 30 cases in the trial group and 30 cases in the control group were included into the study.The total effective rate was 93.33%in the trial group,higher than that of 66.67%in the control group(P<0.05).After treatment,the APTT,PT and INR in the two groups were higher than those before treatment(P<0.05),and the D-D and BPC were lower than those before treatment(P<0.05);the APTT,PT and INR in the trial group were higher than those in the control group(P<0.05),and the D-D and BPC were lower than those in the control group(P<0.05).After treatment,the TCM syndrome scores,whole blood high she

关 键 词：恶性肿瘤 深静脉血栓 鳖甲煎丸 凝血功能 血液流变学 炎症因子 肿胀 

分 类 号：R543.6[医药卫生—心血管疾病]