摘要
目的：观察益气通络汤对心瓣膜置换术后气虚血瘀证患者的疗效以及抗凝效果。方法：选择心脏瓣膜置换术患者共88例,所有患者按数字表法随机分成观察组和对照组各44例。对照组服用华法林钠片,第1~3天剂量为3~4 mg·d-1,第3天后给维持量2.5 mg·d-1,根据国际标准化比值（INR）每次加减华法林钠片剂量,使INR值达2~3。观察组给予益气通络汤治疗,常规水煎煮,分早晚2次内服;两组患者均连续观察3个月。比较两组中医（TCM）症状评分及凝血酶时间（TT）,活化部分凝血酶时间（APTT）,凝血酶原时间（PT）,血浆纤维蛋白原（FIB）;检测两组术后1 d和术后3个月患者的血液流变学指标水平;记录两组患者的并发症发生和死亡情况。结果：观察组术后3个月中医临床症状各指标积分均明显低于对照组（P〈0.01）;术后3个月,两组间TT,APTT,PT以及血浆FIB比较差异无统计学意义;随访1年,观察组术后发生并发症3例（6.82%）,对照组术后发生并发症12例（27.27%）,比较差异有统计学意义（P〈0.05）。两组术后3个月血液流变学各指标水平比较差异均无统计学意义。随访1年,观察组死亡1例（2.27%）,对照组死亡2例（4.55%）,比较差异无统计学意义。结论：心瓣膜置换术后气虚血瘀证患者应用益气通络汤干预抗凝效果确切,且安全性好,值得临床应用。
Objective： To observe the efficacy and anticoagulant effect of Yiqi Tongluo decoction in patients with Qi-deficency and blood-stasis syndrome after cardiac valve replacement. Method： Eighty eight patients with cardiac valve replacement were selected and randomly divided into control group（ 44 cases） and observation group（ 44 cases） according to number table method. Patients of control group were treated with warfarin sodium tablets from day one to day three with dose of 3-4 mg ·d- 1,and after day three,with a maintenance dose of 2. 5 mg·d- 1. According to the international normalized ratio（ INR）,dose of warfarin sodium tablets was added or subtracted each time to make the INR value reach 2-3. Patients of observation group were treated with Yiqi Tongluo decoction boiled conventionally in morning and evening,bid. Patients of both groups were observed for three months continuously. Score of traditional Chinese medicine（ TCM） symptoms and thrombin time（ TT）,activated partial thrombin time（ APTT）,prothrombin time（ PT）,and plasma fibrinogen（ FIB） were compared between two groups. Levels of hemorheology indexes were detected in two groups 1 d and 3 months after the operation. Complications and deaths were recorded in two groups. Result： Three months after operation,score of TCM symptoms in observation group were significantly lower than those of control group（ P 〈 0. 01）. Three months after operation,There was no statistically significant difference in TT,APTT,PT and FIB between two groups. During the 1 year of follow-up,postoperative complications occurred in 3 cases（ 6. 82%） of observation group,and 12 cases（ 27. 27%） of control group,with statistically significant differences（ P 〈 0. 05）. Three months after operation,there were no statistically significant differences in various levels of hemorheology indexes between two groups. During 1 year of follow-up,death occurred in 1 case（ 2. 27%） of observation group,and 2cases（ 4. 55%） in control group,with
出处
《中国实验方剂学杂志》
CAS
CSCD
北大核心
2016年第8期196-199,共4页
Chinese Journal of Experimental Traditional Medical Formulae
基金
河南省南阳市医学科技计划项目(2013yxkj06103)
关键词
益气通络汤
心瓣膜置换
气虚血瘀证
抗凝
Yiqi Tongluo decoction
cardiac valve replacement
Qi-deficiency and blood-stasis syndrome
anticoagulant
