补阳还五汤加减方联合抗凝干预下肢深静脉血栓形成急性期患者的疗效观察  

Clinical efficacy of modified Buyang Huanwu Decoction combined with anticoagulant therapy in treatment of acute stage of deep vein thrombosis in lower limbs

作　　者：沙斐[1] 安娜[2] 刘佳琪 王清霖[1] 曹娟[1] 安琪 李高彪 武欣[1] SHA Fei;AN Na;LIU Jiaqi;WANG Qingin;CAO Juan;AN Qi;LI Gaobiao;WU Xin(Vascular Surgery Department,Wangjing Hospital of China Academy of Chinese Medical Sciences,Beijing 100102,China;Ultrasound Department,Wangjing Hospital of China Academy of Chinese Medical Sciences,Beijing 100102;Beijing University of Chinese Medicine,Beijing)

机构地区：[1]中国中医科学院望京医院血管外科,北京100102 [2]中国中医科学院望京医院超声科,北京100102 [3]北京中医药大学,北京100029

出　　处：《北京中医药》2024年第10期1121-1125,共5页Beijing Journal of Traditional Chinese Medicine

基　　金：中国中医科学院科技创新工程(C12021A01905)。

摘　　要：目的 观察补阳还五汤加减方联合抗凝早期干预下肢深静脉血栓形成(DVT)急性期患者的临床疗效。方法 选取2021年10月—2023年7月于中国中医科学院望京医院血管外科就诊的DVT急性期患者45例,通过随机数字表法将患者分为观察组23例、对照组22例。观察组予补阳还五汤加减方颗粒制剂口服联合基础抗凝治疗,对照组给予基础抗凝治疗,疗程均为3个月。对比2组干预前及干预1、3、6个月后Villalta评分、双下肢周径差、凝血功能指标[血清D-二聚体(D-D)、凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)]及治疗6个月后下肢静脉血栓再通情况。结果 干预1个月后2组症状、体征和Villalta总评分比较,差异均无统计学意义(P>0.05);干预3、6个月后,2组症状、体征和Villalta总评分均较干预前降低,且观察组低于对照组,差异均有统计学意义(P<0.05)。干预1、3、6个月后,2组大腿周径差及小腿周径差比较均较干预前降低,且观察组均低于对照组,差异均有统计学意义(P<0.05)。干预1、3、6个月后,2组血清D-D水平较干预前均降低,APTT、PT较干预前均延长,且观察组优于对照组,差异均有统计学意义(P<0.05)。观察组完全再通率高于对照组(χ^(2)=1.463,P<0.05)。结论 补阳还五汤加减方联合抗凝早期干预DVT急性期患者,可显著改善患者临床症状,疗效优于单纯抗凝治疗。Objective To observe the clinical efficacy of modified Buyang Huanwu Decoction combined with anticoagulant therapy in the early treatment of acute stage of deep vein thrombosis(DVT)in the lower limbs.Methods A total of 45 patients with acute lower limb DVT treated at the Vascular Surgery Department of Wangjing Hospital,China Academy of Chinese Medical Sciences,from October 2021 to July 2023 were randomly divided into an observation group(n=23)and a control group(n=22)using a random number table method.The observation group received oral modified Buyang Huanwu Decoction granules combined with basic anticoagulant therapy,while the control group received basic anticoagulant therapy alone.The treatment course lasted for 3 months.The Villalta score,bilateral leg circumference differences,coagulation function indicators[serum D-dimer(D-D),prothrombin time(PT),and activated partial thromboplastin time(APTT)]at baseline(before treatment)and at 1,3,and 6 months after treatment,and lower limb venous recanalization at 6 months were compared between the two groups.Results After 1 month of treatment,there were no statistically significant differences between the two groups in terms of symptoms,signs,or total Villalta score(P>0.05).After 3 and 6 months of treatment,the symptoms,signs,and total Villalta scores of both groups had decreased compared with those before treatment,with the observation group showing significantly lower scores than the control group(P<0.05).At 1,3,and 6 months after treatment,the thigh and calf circumference differences in both groups were reduced compared with those before treatment,with the observation group showing significantly greater reductions than the control group(P<0.05).After 1,3,and 6 months of treatment,serum D-D levels in both groups were reduced,while APTT and PT were prolonged compared with those before treatment,with the observation group showing significantly better results than the control group(P<0.05).The complete recanalization rate in the observation group was significantly highe

关 键 词：下肢深静脉血栓形成后综合征 补阳还五汤 抗凝治疗 

分 类 号：R259[医药卫生—中西医结合]