清热利湿凉血解毒方辅助治疗下肢骨折术后患者对凝血功能及DVT发生的影响  

Effect of Qingre Lishi Liangxue Jiedu Formula as adjuvant therapy on coagulation function and deep vein thrombosis occurrence in patients after lower limb fracture surgery

作　　者：邰文凤 陈洁 何广宏 李俊业 田可为 TAI Wen-feng;CHEN Jie;HE Guang-hong;LI Jun-ye;TIAN Ke-wei(Department of Pharmacy,Luoyang Orthopedic-Traumatological Hospital of Henan Province(Henan Provincial Orthopedic Hospital),Luoyang 471000,Henan,CHINA;Department of Neck,Shoulder,Low Back and Leg Pain,Luoyang Orthopedic-Traumatological Hospital of Henan Province(Henan Provincial Orthopedic Hospital),Luoyang 471000,Henan,CHINA;First Department of Hip Surgery,Luoyang Orthopedic-Traumatological Hospital of Henan Province(Henan Provincial Orthopedic Hospital),Luoyang 471000,Henan,CHINA)

机构地区：[1]河南省洛阳正骨医院(河南省骨科医院)药学部,河南洛阳471000 [2]河南省洛阳正骨医院(河南省骨科医院)颈肩腰腿痛科,河南洛阳471000 [3]河南省洛阳正骨医院(河南省骨科医院)髋关节外一科,河南洛阳471000

出　　处：《海南医学》2025年第7期939-944,共6页Hainan Medical Journal

基　　金：全国老药工传承工作室建设项目(编号:【2024】255号)。

摘　　要：目的观察清热利湿凉血解毒方辅助治疗下肢骨折术后患者对凝血功能及下肢深静脉血栓(DVT)发生的影响。方法采用前瞻性随机对照研究,纳入2021年3月至2023年6月河南省洛阳正骨医院收治的102例下肢骨折术后患者作为研究对象,按随机数表法将其分为对照组和观察组各51例。对照组患者给予低分子肝素钙预防治疗,观察组患者在对照组治疗基础上加用清热利湿凉血解毒方,两组患者均治疗7 d。比较两组患者治疗前、治疗7 d后的下肢凝血功能指标[血浆纤维蛋白原(FIB)、凝血酶原时间(PT)、凝血酶时间(TT)、活化部分凝血活酶时间(APTT)]、下肢周径差、下肢静脉血流平均速度、疼痛程度、感染指标[C-反应蛋白(CRP)、白细胞计数(WBC)、降钙素原(PCT)、白细胞介素-6(IL-6)]的变化,并比较两组患者治疗期间及治疗后2个月内DVT发生率和治疗期间的不良反应发生率。结果术后7 d,观察组患者的PT、APTT、TT分别为(13.25±0.62)s、(32.43±3.12)s、(15.89±0.35)s,明显高于对照组的(12.14±0.75)s、(28.55±2.68)s、(14.54±1.95)s,FIB为(2.07±0.53)g/L,明显低于对照组的(2.81±0.79)g/L,差异均有统计学意义(P<0.05);术后7 d,观察组患者的小腿、大腿周径差分别为(0.99±0.21)cm、(2.35±0.72)cm,明显小于对照组的(1.34±0.35)cm、(3.16±0.98)cm,差异均有统计学意义(P<0.05);术后7 d,观察组患者的腘静脉、股静脉血流平均速度分别为(23.65±3.19)cm/s、(26.84±3.67)cm/s,明显高于对照组的(20.71±2.33)cm/s、(24.16±3.54)cm/s,VAS评分为(3.59±0.52)分,明显低于对照组的(4.72±0.75)分,差异均有统计学意义(P<0.05);术后7 d,观察组患者的CRP、WBC、PCT、IL-6分别为(10.62±1.64)mg/L、(9.17±1.49)×10^(9)/L、(0.21±0.04)μg/L、(0.39±0.05)ng/L,明显低于对照组的(13.34±1.33)mg/L、(10.56±1.81)×10^(9)/L、(0.33±0.08)μg/L、(0.42±0.07)ng/L,差异均有统计学意义(P<0.05);观察组患者治疗期间及治疗后Objective To observe the effect of Qingre Lishi Liangxue Jiedu Formula as adjuvant therapy on coagulation function and the incidence of deep vein thrombosis(DVT)in patients after lower limb fracture surgery.Methods A prospective randomized controlled study was conducted,enrolling 102 patients who underwent lower limb fracture surgery at Luoyang Orthopedic-Traumatological Hospital of Henan Province from March 2021 to June 2023.The patients were randomly divided into a control group and an observation group,with 51 cases in each group.Patients in the control group received low-molecular-weight heparin calcium for prophylaxis,while those in the observation group received Qingre Lishi Liangxue Jiedu Formula in addition to the control group’s treatment.Both groups of patients were treated for 7 days.Coagulation function indicators(fibrinogen[FIB],prothrombin time[PT],thrombin time[TT],activated partial thromboplastin time[APTT]),lower limb circumference difference,lower limb venous blood flow velocity,pain level,and infection markers(C-reactive protein[CRP],white blood cell count[WBC],procalcitonin[PCT],interleukin-6[IL-6])were compared before and after 7 days of treatment.The incidence of DVT during and within 2 months after treatment,as well as the incidence of adverse reactions during treatment,were also compared.Results After 7 days of treatment,the PT,APTT,and TT in the observation group were(13.25±0.62)s,(32.43±3.12)s,and(15.89±0.35)s,respectively,significantly higher than(12.14±0.75)s,(28.55±2.68)s,and(14.54±1.95)s in the control group,while FIB was(2.07±0.53)g/L,significantly lower than(2.81±0.79)g/L in the control group,with statistically significant differences(P<0.05).The calf and thigh circumference differences in the observation group were(0.99±0.21)cm and(2.35±0.72)cm,respectively,significantly smaller than(1.34±0.35)cm and(3.16±0.98)cm in the control group(P<0.05).The popliteal and femoral vein blood flow velocities in the observation group were(23.65±3.19)cm/s and(26.84±3.67)cm/s,respec

关 键 词：下肢骨折 清热利湿凉血解毒方 低分子肝素钙 深静脉血栓 凝血功能 

分 类 号：R683.42[医药卫生—骨科学]