补阳还五汤联合抗凝治疗下肢深静脉血栓形成的临床研究  

Clinical Study of Buyang Huanwu Decoction Combined with Anticoagulation Intervention in the Treatment of Deep Venous Thrombosis of Lower Limbs

作　　者：刘鸿涛 武欣 沙斐 王清霖 安琪 李高彪 LIU Hongtao;WU Xin;SHA Fei;WANG Qinglin;AN Qi;LI Gaobiao(Department of Vascular Surgery,Wangjing Hospital,China Academy of Chinese Medical Sciences,Beijing 100102,China)

机构地区：[1]中国中医科学院附属望京医院血管外科,北京100102

出　　处：《临床误诊误治》2025年第5期94-100,共7页Clinical Misdiagnosis & Mistherapy

基　　金：中国中医科学院科技创新工程(CI2021A01905)。

摘　　要：目的探讨补阳还五汤联合抗凝治疗下肢深静脉血栓形成的效果。方法选取2021年10月至2024年10月收治的下肢深静脉血栓形成患者117例,按照随机数字表法分为观察组及对照组,观察组59例予补阳还五汤联合基础抗凝治疗,对照组58例予基础抗凝治疗,2组均治疗3个月。治疗后比较2组临床疗效、血栓再通情况及治疗期间不良反应情况,观察并评估2组治疗前后症状体征评分、下肢周径差、凝血指标。结果治疗6个月后,观察组总有效率为94.92%(56/59)高于对照组的84.48%(49/58),差异有统计学意义(P<0.01)。治疗3个月和6个月后,2组症状、体征评分和总评分都有所下降,且观察组下降幅度明显大于对照组(P<0.05,P<0.01)。治疗后,2组大腿和小腿周径差有所减少,且观察组减少更明显(P<0.05,P<0.01)。治疗后,血清D-二聚体(D-D)水平下降,活化部分凝血活酶时间(APTT)和凝血酶原时间(PT)延长,且观察组D-D下降及APTT、PT延长更明显(P<0.05,P<0.01)。治疗6个月后,观察组血栓再通率高于对照组(P<0.05)。治疗过程中,2组均未出现皮肤破损、溃疡、出血或过敏等不良反应。结论补阳还五汤联合抗凝治疗下肢深静脉血栓形成效果优于单纯抗凝治疗,且可明显改善患者临床症状体征和和凝血指标,且安全性较好。Objective To investigate the effectiveness of Buyang Huanwu Decoction combined with anticoagulation intervention in the treatment of deep venous thrombosis(DVT)of lower limbs.Methods A total of 117 patients with DVT of lower limbs treated from October 2021 to October 2024 were divided into the observation group and the control group according to random number table method.Fifty-nine patients in the observation group were treated with Buyang Huanwu decoction combined with basic anticoagulation therapy,and 58 patients in the control group were treated with basic anticoagulation therapy.Both groups were treated for 3 months.The clinical efficacy,thrombus recanalization,and adverse reactions during treatment between two groups after treatment were compared,and the symptom and sign scores,lower limb circumference difference,and coagulation indicators before and after treatment were observed and evaluated in the two groups.Results At 6 months after treatment,the total effective rate of the observation group[94.92%(56/59)],which was higher than that of the control group[84.48%(49/58)],showing significant differences(P<0.01).At 3 and 6 months after treatment,the symptom and sign scores and total scores in the two groups were decreased,and the decrease rate in the observation group was significantly greater than that in the control group(P<0.05,P<0.01).After treatment,the difference between the circumference of thighs and calves in the two groups was reduced,and the decrease was more obvious in observation group(P<0.05,P<0.01).After treatment,serum D-dimer(D-D)level was decreased,activated partial thromboplastin time(APTT)and prothrombin time(PT)were prolonged,and the D-D decrease and APTT and PT prolongation in observation group were more significant than those in control group(P<0.05,P<0.01).At 6 months after treatment,the recanalization rate of the observation group was higher than that of the control group(P<0.05).During the treatment,there were no adverse reactions such as skin damage,ulcers,bleeding or allergies in

关 键 词：深静脉血栓形成 下肢 补阳还五汤 抗凝治疗 症状体征 D-二聚体 药物毒性 

分 类 号：R543.6[医药卫生—心血管疾病]