摘要
目的:探讨国医大师施杞教授芪桃化瘀方预防膝关节置换术后深静脉血栓的疗效,为该方的临床推广提供循证医学依据。方法:通过随机、对照、单盲试验,收集2023年5月至2023年12月就诊,需行全膝关节置换术的患者共计110例。根据干预方式分为观察组和对照组,每组各55例;观察组芪桃化瘀方内服治疗,对照组口服利伐沙班。两组患者均进行术后14 d的随访,随访内容包括凝血功能、血常规、炎症指标、中医证候评分等。结果:110例患者均完成随访且无病例脱落。治疗14 d后观察组患者凝血功能指标(D-二聚体、纤维蛋白原、凝血酶原、活化部分凝血酶原时间)与对照组相比,差异无统计学意义(P>0.05);凝血酶原时间与对照组相比,差异有统计学意义(P<0.05)。治疗14 d后观察组患者血常规指标(红细胞计数、血红蛋白、血小板计数、淋巴细胞计数)与对照组相比,差异无统计学意义(P>0.05);中性粒细胞计数与对照组相比,差异有统计学意义(P<0.05)。治疗14 d后观察组患者的血沉、中性粒细胞与淋巴细胞比值改善程度优于对照组,差异有统计学意义(P<0.05);C反应蛋白与对照组相比,差异无统计学意义(P>0.05)。观察组中医证候评分整体有效率高于对照组,差异有统计学意义(P<0.05)。两组患者均未发生深静脉血栓,不良反应事件发生率差异无统计学意义(P>0.05)。结论:施氏芪桃化瘀方能够预防膝关节置换术后深静脉血栓,且不良反应发生率低,值得推广应用。
Objective:To analyze and evaluate the efficacy of Qi-Tao Huayu decoction by Professor Shi Qi on the prevention of deep vein thrombosis(DVT)after total knee arthroplasty(TKA),so as to provide evidence-based basis for the clinical promotion of this prescription.Methods:A total of 110 patients who needed TKA from May 2023 to December 2023 were enrolled in this randomized,controlled,single-blind trial.According to interventions,they are divided into observation group and control group,55 cases in each group.The observation group patients were treated with Qi-Tao Huayu decoction,the control group patients took Livashaban orally.Both groups were followed up 14 d,follow-up content including coagulation function,blood routine,inflammation index,traditional Chinese medicine(TCM)syndrome scores,etc.Results:All 110 patients completed the follow-up,and no case dropped out.After 14 d of treatment,there was no significant difference in coagulation function indexes(D-dimer,fibrinogen,prothrombin,activated partial thromboplastin time)between the observation group and the control group,but there was significant difference in prothrombin time between the two groups(P<0.05).After 14 d of treatment,the observation group patients with blood routine indexes(red blood cell count,hemoglobin,platelet count,lymphocyte count)compared with control group,there was no statistically significant difference,neutrophil count compared with control group,the difference was statistically significant(P<0.05).After 14 d of treatment,the observation group blood sedimentation,neutrophils and lymphocytes in patients with improved ratio is better than that of control group,the difference was statistically significant(P<0.05),C-reactive protein compared with control group,there was no statistically significant difference.The overall effective rate of TCM syndrome score in the observation group was higher than that in the control group(P<0.05).There was no DVT in the two groups,and there was no significant difference in the incidence of adverse events.Concl
作者
张成波
阿欣雨
孙松涛
施杞
肖涟波
ZHANG Chengbo;A Xinyu;SUN Songtao;SHI Qi;XIAO Lianbo(Guanghua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 200052,China;Arthritis Institute of Integrated Traditional Chinese and Western Medicine,Shanghai Institute of Traditional Chinese Medicine,Shanghai 200052,China)
出处
《中国中医骨伤科杂志》
CAS
2024年第9期41-46,共6页
Chinese Journal of Traditional Medical Traumatology & Orthopedics
基金
上海市卫健委上海市临床重点专科建设项目(shslczdzk04801)
上海市卫健委中医药三年行动计划项目(ZY(2021-2023)-0201-06)。
关键词
全膝关节置换术
深静脉血栓
气虚血瘀
凝血功能
total knee arthroplasty
deep vein thrombosis
Qi deficiency and blood stasis
coagulation function
