独活寄生汤联合高压氧治疗减压性骨坏死的临床疗效及对血液流变学和凝血功能的影响  

Clinical efficacy of Duhuo Jisheng Decoction combined with hyperbaric oxygen in the treatment of decompression osteonecrosis and its influence on hemorheology and coagulation function

作　　者：潘颖超 郝德升 董慧 王岩 景华 徐佳丽 刘玉青 谢林青 叶梅华 敬梅 Pan Yingchao;Hao Desheng;Dong Hui;Wang Yan;Jing Hua;Xu Jiali;Liu Yuqing;Xie Linqing;Ye Meihua;Jing Mei(Department of Emergency,Naval Medical Center,Naval Medical University,Shanghai 200052,China;Diving Medical Department,Polyclinic,China Yantai Salvage,Yantai 264001,China)

机构地区：[1]海军军医大学海军特色医学中心急诊科,上海200052 [2]交通部烟台打捞局,山东264001

出　　处：《中华航海医学与高气压医学杂志》2024年第3期326-329,共4页Chinese Journal of Nautical Medicine and Hyperbaric Medicine

基　　金：上海市综合医院中西医结合专项(HYY-ZXYJHZX-202119)。

摘　　要：目的:探讨独活寄生汤联合高压氧治疗减压性骨坏死(DON)患者的临床疗效及对血液流变学和凝血功能的影响。方法:收集2022年1月至2023年6月于海军特色医学中心急诊科及合作单位收治的DON患者23例的临床资料,按照治疗方法分为3组,中药组(A组)4例,高压氧组(B组)11例,中药+高压氧组(C组)8例。A组采用独活寄生汤加减治疗,B组采用高压氧治疗,C组采用独活寄生汤联合高压氧治疗。治疗后评价患者临床疗效。采用全自动凝血分析仪检测患者凝血酶原时间(PT)、部分凝血酶原时间(APTT)、D-二聚体(D-D)和纤维蛋白原(FBG)水平。采用全自动血流变检测仪检测患者全血高切还原黏度、全血低切还原黏度和红细胞聚集指数。应用疼痛视觉模拟评分(VAS)对患者治疗前后的疼痛程度进行评价。应用日常生活能力(ADL)量表评估患者治疗前后的生活能力。结果:B组、C组患者治疗总有效率(81.8%、87.5%)明显高于A组(25.0%),差异有统计学意义( P<0.01)。治疗后B组与C组患者ADL评分明显高于A组,VAS评分明显低于A组( P<0.01),且C组患者ADL评分明显高于B组,VAS评分明显低于B组( P<0.05)。治疗后C组患者全血低切还原黏度、全血高切还原黏度及红细胞聚集指数明显低于A组、B组( P<0.01);D-D、FBG、PT、APTT明显低于A组、B组( P<0.01)。 结论:独活寄生汤联合高压氧治疗DON主要通过调节血液流变学和凝血功能,获得较好的临床治疗效果。ObjectiveTo explore the clinical efficacy of Duhuo Jisheng Decoction combined with hyperbaric oxygen in the treatment of patients with decompression osteonecrosis(DON)and its influence on hemorheology and coagulation function.MethodsThe clinical data of 23 patients with DON in Naval Medical Center of Naval Medical University and its coorperating unit from January 2022 to June 2023 were collected and divided into three groups according to their treatments:four cases in traditional Chinese medicine(TCM)decoction group(group A),11 cases in hyperbaric oxygen group(group B),and eight cases in TCM decoction+hyperbaric oxygen group(group C).The group A was treated with Duhuo Jisheng Decoction,the group B was treated with hyperbaric oxygen,and the group C was treated with Duhuo Jisheng Decoction combined with hyperbaric oxygen.The clinical efficacy was evaluated according to the Standards for Diagnosis and Curative Effect of Chinese Medical Symptom.Prothrombin time(PT),partial thromboplastin time(APTT),D-dimer(D-D),and fibrinogen(FBG)were measured by automatic coagulation analyzer.Whole blood viscosity(WBV)at high shear rate,whole blood viscosity(WBV)at low shear rate,and red blood cell aggregation index were measured by automatic hemorheological detector.Pain degree before and after treatment was evaluated by visual analogue scale(VAS).Activity of daily living(ADL)was used to evaluate the patients’living ability before and after treatment.ResultsThe total effective rates of the group B(81.8%)and group C(87.5%)were significantly higher than that of the control group(25.0%),and the differences were statistically significant(P<0.01).After treatment,the ADL scores of the group B and group C were siginificantly higher than that of the group A,and the VAS scores were significantly lower than that of the group A(P<0.01).After treatment,the ADL score of the group C was significantly higher than that of the group B,and the VAS score of the group C was significantly lower than that of the group B(P<0.05).After treatment,whole b

关 键 词：减压性骨坏死 独活寄生汤 血液流变学 凝血功能 

分 类 号：R459.6[医药卫生—治疗学] R68[医药卫生—临床医学]