加味补中益气汤结合低分子肝素钠预防四肢骨折患者DVT的临床疗效研究

摘要/Abstract

摘要： 目的：探讨加味补中益气汤结合低分子肝素钠预防四肢骨折患者深静脉血栓（DVT）的临床疗效。方法：选取2020年10月至2022年10月我院收治的86例四肢骨折患者作为研究对象，按信封随机法分成试验组（n=43）和对照组（n=43）。对照组患者施行单一低分子肝素钠治疗，试验组患者施行加味补中益气汤结合低分子肝素钠治疗，对比两组患者临床疗效、凝血功能、血红蛋白指标、DVT形成率和炎性反应指标等。结果：试验组患者经加味补中益气汤结合低分子肝素钠治疗后，临床有效率为93.02%，高于对照组的76.74%（P<0.05）。治疗14 d后，两组患者凝血功能与血红蛋白指标均升高，且试验组患者凝血酶原活动度、血红蛋白与凝血酶原时间升高幅度均大于对照组（P<0.05）。试验组患者DVT形成率4.65%低于对照组的18.60%（P<0.05）。治疗14 d后，两组患者各项炎性反应指标均下降，且试验组患者IL-1和IL-8指标下降幅度均大于对照组（P<0.05）。结论：在四肢骨折疾病的治疗中，加味补中益气汤结合低分子肝素钠的临床疗效显著，有助于降低其炎性反应水平，改善凝血功能，预防术后DVT。

关键词: font-size:medium, ">加味补中益气汤；低分子肝素钠；四肢骨折；深静脉血栓；临床疗效

Abstract: Objective：To explore the clinical effect of modified buzhong yiqi decoction combined with low molecular weight heparin sodium in the prevention of deep vein thrombosis (DVT) in patients with limb fracture. Methods： A total of 86 patients with limb fracture admitted in our hospital from October 2020 to October 2022 were selected as the research objects， and randomly divided into the experimental group (n=43) and the control group (n=43). The patients of the control group were received low molecular weight heparin sodium therapy， and the patients of the experimental group received modified buzhong yiqi decoction combined with low molecular weight heparin sodium therapy. The clinical efficacy， coagulation function， and the indicators of hemoglobin， the incidence rate of DVT， and the levels of inflammatory response indicators in the two groups of patients were compared.Results：The clinical effective rate of the experimental group was 93.02% after the treatment of low molecular weight heparin sodium combined with modified buzhong yiqi decoction， which was higher than the clinical effective rate of the control group (76.74%)(P<0.05). After 14 d of treatment， the coagulation function and hemoglobin indicators of patients in both groups increased， and the increases of prothrombin activity， hemoglobin and prothrombin time of patients in the experimental groups were greater than those of the control group (P<0.05).The DVT incidence rate of the experimental group (4.65%) was lower than that of the control group (18.60%) (P<0.05). After 14 d of treatment， the inflammatory response indicators of patients in both groups decreased， and the decrease of IL-1 and IL-8 levels of patients in the experimental group were greater than those of the control group (P<0.05). Conclusion：In the treatment of limb fracture， the combination of modified buzhong yiqi decoction and low molecular weight heparin sodium has a significant therapeutic effect， which can help to reduce the level of inflammatory response， improve coagulation function and prevent postoperative DVT.

Key words: Modified buzhong yiqi decoction, Low molecular weight heparin sodium, Limb fracture, Deep vein thrombosis, Clinical efficacy

中图分类号:

郑斌, 王祝青. 加味补中益气汤结合低分子肝素钠预防四肢骨折患者DVT的临床疗效研究[J]. 中国医药导刊, 2023, 25(9): 922-926.

ZHENG Bin, WANG Zhuqing. Clinical Efficacy of Modified Buzhong Yiqi Decoction Combined with Low Molecular Weight Heparin Sodium in the Prevention of DVT in Patients with Limb Fracture[J]. CHINESE JOURNAL OF MEDICINAL GUIDE, 2023, 25(9): 922-926.

参考文献

[1]吴鹏飞，李森，徐子卿. 续骨强筋方辅助经皮微创内固定术对四肢骨折患者血清碱性磷酸酶、骨保护素表达及骨折愈合的影响[J]. 世界中西医结合杂志，2022，17(7)：1355-1359.
[2]Wang Q，Wang Y，Zhao H，et al. Correction： efficacy analysis of a double-Schanz screw external fixator combined with anti-rotating Kirschner wire in the treatment of proximal humerus fractures in skeletally immature patients[J]. J Orthop Surg Res，2023，18(1)：232-232.
[3]张宏，王礼鹏.微创经皮钢板接骨术及超声定位透药法治疗四肢骨折疗效及术后肿胀影响[J]. 贵州医药，2023，47(3)：383-384.
[4]周伟君，霍少川，蔡迎峰，等.益气活血通络汤联合阿司匹林预防人工髋关节置换术后深静脉血栓形成临床研究[J].陕西中医，2020，41(8)：1070-1073.
[5]吕志明，管发彬，苏力担卡扎·仇曼，等.胰十二指肠切除术后早期给予低分子肝素钠预防静脉血栓栓塞的有效性和安全性分析[J]. 中国普外基础与临床杂志，2021，28(5)：636-640.
[6]莫华贵，黄远翘，罗裕强，等. 阿司匹林低分子肝素钠利伐沙班预防膝关节置换术后下肢深静脉血栓形成研究[J]. 河北医学，2020，26(4)：533-537.
[7]孙明,王蔚文.临床疾病诊断及疗效判定标准[M]. 北京：中国科学技术文献出版社，2010：36-40.
[8]Zhang H，Sun F，Li Y.Application of smart healthcare in comparative analysis of effect of early external fixator and plate internal fixation treatment on postoperative complications and lower limb function recovery of patients with unstable pelvic fracture [J]. Front Public Health， 2022，10：887123.
[9]胡万彪，何玉涛，张云，等.微创钢板接骨技术联合锁定加压钢板内固定对四肢粉碎性骨折患者术后骨折愈合程度的影响分析[J]. 贵州医药，2022，46(10)：1557-1559.
[10]Campbell S， Dhyani J， Greenberg P， et al. Outcomes in patients with late debridement of open long bone fractures of the lower extremities in penetrating trauma： a retrospective review of the National Trauma Data Bank [J]. Eur J Orthop Surg Traumatol， 2020， 30(6)：1075-1081.
[11]卢建华，沈淑劲，储小兵，等.活血利水法预防全膝置换术后下肢深静脉血栓的临床研究[J]. 中国中医骨伤科杂志，2022，30(2)：31-35.
[12]霍玉龙，朱砂.阿司匹林、低相对分子质量肝素钠、利伐沙班预防膝关节置换术后下肢深静脉血栓形成研究[J]. 血栓与止血学，2020，26(6)：1004-1005.
[13]莫智媛.低分子肝素钠联合气压治疗在预防妇科肿瘤术后下肢深静脉血栓(DVT)的临床效果和应用价值[J]. 现代预防医学，2020，47(14)：2681-2684.
[14]刘利涛，周宗波，朱华亮，等. 补中益气汤合五味消毒饮预防老年下肢骨折DVT形成及切口感染的临床研究[J]. 中医药导报，2019，25(19)：97-99.
[15]吴文前，洪文格，吴成龙.自拟舒筋活络方在创伤性四肢骨折患者中的应用效果及对血液流变学、深静脉血栓形成影响[J]. 四川中医，2022，40(10)：173-176.
[16]刘军.补中益气汤合五味消毒饮预防老年下肢骨折DVT形成及切口感染的临床研究[J]. 人人健康，2020，523(14)：301.
[17]孟娜，胡莎莎，杨楠.补中益气汤合五味消毒饮结合特色中医护理对小腿骨折术后感染患者创面感染实验室指标及愈合情况影响分析[J]. 四川中医，2019，37(12)：199-201.
[18]陈武林，阮成群，孙群周，等. 骨前康颗粒与加昧补中益气汤辅助防旋股骨近端髓内钉治疗老年股骨粗隆间骨折临床研究[J]. 陕西中医，2020，41(5)：636-638.
[19]边亚倩，李晶，彭莎，等. 基于系统中药学的黄芪补气潜在功效标志物的发掘[J]. 中国中药杂志，2020，45(14)：3266-3274.
[20]陶雨凡，董凡，兀琦，等. 《中国药典》2020年版含黄芪成方制剂分析及其现代研究进展[J]. 中国现代中药，2023，25(1)：202-209.

快速检索引用检索图表检索高级检索