祛痰化瘀方预防痰瘀型MS患者THA后DVT形成的研究  

Study on Qutan Huayu prescription in preventing DVT formation after THA in patients with phlegm stasis type MS

作　　者：马文龙 陈勤 于世超 田可为 范克杰 严嘉祥 刘英科 邝孝坤 乔一航 梁浩博 陈柯 MA Wenlong;CHEN Qin;YU Shichao;TIAN Kewei;FAN Kejie;YAN Jiaxiang;LIU Yingke;KUANG Xiaokun;QIAO Yihang;LIANG Haobo;CHEN Ke△(Luoyang Orthopedic-Traumatological Hospital of Henan Province(Henan Provincial Orthopedic Hospital),Luoyang,Henan 471002,China;Hunan Jianghua Yao Autonomous County People′s Hospital,Yongzhou,Hunan 425500,China;Universiti Tunku Abdul Rahman,Kajang 43000,Malaysia;Henan University of Traditional Chinese Medicine,Zhengzhou,Henan 450046,China)

机构地区：[1]河南省洛阳正骨医院(河南省骨科医院),河南洛阳471002 [2]湖南省江华瑶族自治县人民医院,湖南永州425500 [3]Universiti Tunku Abdul Rahman,Malaysia Kajang 43000 [4]河南中医药大学,河南郑州450046

出　　处：《现代医药卫生》2025年第2期319-323,328,共6页Journal of Modern Medicine & Health

基　　金：河南省卫生健康委员会仲景书院第四期研修班“仲景国医传人”项目(豫卫中医函[2024]3号);河南省中医药科学研究专项重点课题(2023ZY1022);河南省中医药传承与创新工程(仲景工程)中医药青苗人才第二批培养项目(豫卫中医函[2021]16号)。

摘　　要：目的探究祛痰化瘀方对痰瘀型代谢综合征(MS)患者全髋关节置换术(THA)后深静脉血栓(DVT)形成的预防效果。方法选取2021年6月至2022年12月河南省洛阳正骨医院(河南省骨科医院)接受THA的痰瘀型MS患者80例,随机分为对照组和治疗组,各40例。对照组采用单纯西医治疗,治疗组在对照组基础上联合祛痰化瘀方治疗。比较2组中医证候积分、DVT发生率、皮肤异常发生率、凝血功能指标[活化部分凝血活酶时间(APTT)、凝血酶原时间(PT)、纤维蛋白原(Fib)、凝血酶时间(TT)]、β-血小板球蛋白(β-TG)、纤溶酶原激活物抑制物1(PAI-1)水平及不良反应发生情况。结果干预前,2组主症、次症积分比较,差异无统计学意义(P>0.05)。干预后,2组主症、次症积分均明显低于干预前,且治疗组低于对照组,差异有统计学意义(P<0.05)。2组DVT、皮肤感染发生率比较,差异无统计学意义(P>0.05)。治疗组皮下瘀斑发生率显著低于对照组,差异有统计学意义(P<0.05)。2组治疗前APTT、TT、Fib、PT水平比较,差异无统计学意义(P>0.05)。治疗后,2组APTT、TT、PT水平比较,差异无统计学意义(P>0.05),但Fib水平比较,差异有统计学意义(P<0.05)。2组治疗后APTT、TT、Fib、PT水平与治疗前比较,差异有统计学意义(P<0.05)。治疗前,2组β-TG、PAI-1水平比较,差异无统计学意义(P>0.05)。治疗后,2组β-TG、PAI-1水平优于治疗前,且治疗组优于对照组,差异有统计学意义(P<0.05)。2组肝肾功能均未见明显异常,且均未发生严重出血、肺栓塞及死亡事件。结论采用祛痰化瘀方治疗痰瘀型MS患者,可有效预防THA后DVT形成,改善患者凝血功能,优化β-TG、PAI-1水平,降低血小板释放活性,且安全性较高。Objective To explore the preventive effect of Qutan Huayu prescription on deep venous thrombosis(DVT)after total hip arthroplasty(THA)in patients with phlegm-stasis metabolic syndrome(MS).Methods A total of 80 patients with phlegm-stasis MS who received THA in Luoyang Bone Orthopaedics Hospital of Henan Province from June 2021 to December 2022 were selected and randomly divided into control group and treatment group,with 40 cases in each group.The control group was treated with western medicine alone,and the treatment group was treated with Qutan Huayu prescription on the basis of the control group.Traditional Chinese medicine syndrome score,incidence of DVT,incidence of skin abnormalities,coagulation function indexes[activated partial thromboplastin time(APTT),prothrombin time(PT),fibrinogen(Fib),thrombin time(TT)],β-thromboglobulin(β-TG),plasminogen activator inhibitor-1(PAI-1)levels and their levels were compared between the two groups.Results Before intervention,there were no significant differences in the scores of main symptoms and secondary symptoms between the two groups(P>0.05).After intervention,the scores of the main symptom and secondary symptom in the two groups were significantly lower than those before the intervention,and the treatment group was lower than that of the control group,the differences were statistically significant(P<0.05).There were no significant differences in the incidence of DVT and skin infection between the two groups(P>0.05).The incidence of subcutaneous ecchymosis in the treatment group was significantly lower than that in the control group,with statistical significance(P<0.05).There were no significant differences in APTT,TT,Fib and Pt levels between the two groups before treatment(P>0.05).After treatment,there were no significant differences in APTT,TT and Pt levels between the two groups(P>0.05),but there was significant difference in Fib levels(P<0.05).The levels of APTT,TT,Fib and Pt in the two groups after treatment were significantly different from those before treat

关 键 词：祛痰化瘀方 代谢综合征 全髋关节置换术 深静脉血栓 

分 类 号：R541.4[医药卫生—心血管疾病]