[1]展宝明,陈达,张庆文.桃红四物汤预防全髋关节置换术后下肢深静脉血栓形成的临床研究[J].中医正骨,2014,26(09):25-28.
　ZHAN Baoming*,CHEN Da,ZHANG Qingwen..Clinical study of oral application of TAOHONG SIWU Decoction in preventing deep venous thrombosis after total hip arthroplasty[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2014,26(09):25-28.
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桃红四物汤预防全髋关节置换术后下肢深静脉血栓形成的 临床研究()
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《中医正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第26卷
期数:
2014年09期
页码:
25-28
栏目:
临床研究
出版日期:
2014-09-30

文章信息/Info

Title:
Clinical study of oral application of TAOHONG SIWU Decoction in preventing deep venous thrombosis after total hip arthroplasty
作者:
展宝明1; 陈达2; 张庆文3
1.山东省莱芜市人民医院,山东 莱芜 271100;
2.广州中医药大学,广东 广州 510006;
3.广州中医药大学第一附属医院,广东 广州 510405
Author(s):
ZHAN Baoming*; CHEN Da; ZHANG Qingwen.
*People's Hospital of Laiwu City,Laiwu 271100,Shandong,China
关键词:
关节成形术; 置换; 髋 静脉血栓形成 手术后并发症 桃红四物汤
Keywords:
Arthroplasty; replacement; hip;  Venous thrombosis;  Postoperative complications;  TAOHONG SIWU decoction
摘要:
目的:探讨桃红四物汤预防全髋关节置换术后并发下肢深静脉血栓形成的有效性及安全性。方法:初次行单侧全髋关节置换术患者60例,随机分为2组,每组30例。观察组予以桃红四物汤口服,对照组予以利伐沙班片口服,连续服用2周。观察2组患者凝血指标、下肢深静脉血栓形成情况及用药安全情况。结果:手术前后不同时间点间活化部分凝血酶时间、凝血酶原时间及D-二聚体检测结果比较,差异均有统计学意义,存在时间效应(F=3.803,P=0.025; F=25.584,P=0.000; F=26.099,P=0.000); 2组间活化部分凝血酶时间、凝血酶原时间及D-二聚体检测结果比较,差异均无统计学差异,不存在分组效应(F=0.271,P=0.605; F=1.653,P=0.204; F=0.930,P=0.339); 时间因素与分组因素不存在交互效应(F=2.312,P=0.104; F=0.528,P=0.591; F=0.351,P=0.694)。手术前后不同时间点间国际标准化比率检测结果比较,差异无统计学意义,不存在时间效应(F=3.814,P=0.052); 2组间国际标准化比率检测结果比较,差异均无统计学差异,不存在分组效应(F=0.006,P=0.936); 时间因素与分组因素不存在交互效应(F=0.092,P=0.786)。观察组并发深静脉血栓形成3例,股静脉2例,腘静脉1例; 对照组并发深静脉血栓形成2例,股静脉1例,腘静脉1例; 2组间深静脉血栓形成发生率比较,差异无统计学意义(χ2=0.218,P=0.640)。2组间术中出血量、输血量及术后引流量比较差异均无统计学意义[(449.33±87.74)mL,(455.76±76.88)mL; t=-0.302,P=0.764;(273.33±108.07)mL,(263.33±115.92)mL; t=0.346,P=0.731;(269.68±72.36)mL,(271.59±66.96)mL; t=-0.106,P=0.916]。手术前后不同时间点间血红蛋白含量比较,差异有统计学意义,存在时间效应(F=18.019,P=0.000); 2组间血红蛋白含量比较,差异无统计学意义,不存在分组效应(F=1.950,P=0.168); 时间因素与分组因素不存在交互效应(F=0.343,P=0.710)。2组患者用药期间均无消化道出血、皮肤黏膜出血及消化道不适等不良反应发生,均未发生药物过敏反应,肝、肾功能检查无异常。结论:桃红四物汤口服用于全髋关节置换术后深静脉血栓形成的预防,有效性和安全性与口服利伐沙班片相当。
Abstract:
Objective:To observe the effectiveness and safety of oral application of TAOHONG SIWU decoction in preventing deep venous thrombosis(DVT)after total hip arthroplasty(THA).Methods:Sixty patients underwent unilateral THA were randomly divided into 2 groups,30 cases in each group.The patients in the treatment group were treated with oral application of TAOHONG SIWU decoction,while the others in control group were treated with Rivaroxaban orally.All patients in both groups were treated for 2 weeks.Then the coagulation indicators,DVT incidence and the safety indicators were observed.Results:There was statistical difference in APTT,PT and D-dimer level between different time points,in other words,there was time effect(F=3.803,P=0.025; F=25.584,P=0.000; F=26.099,P=0.000).There was no statistical difference in APTT,PT and D-dimer level between the 2 groups,in other words,there was no group effect(F=0.271,P=0.605; F=1.653,P=0.204; F=0.930,P=0.339).There was no interaction between time factor and grouping factor(F=2.312,P=0.104; F=0.528,P=0.591; F=0.351,P=0.694).There was no statistical difference in INR between different time points,in other words,there was no time effect(F=3.814,P=0.052).There was no statistical difference in INR between the 2 groups,in other words,there was no group effect(F=0.006,P=0.936).There was no interaction between time factor and grouping factor(F=0.092,P=0.786).DVT was found in 3 cases of treatment group,2 in femoral vein and one in popliteal vein.DVT was found in 2 cases of control group,one in femoral vein and one in popliteal vein.There was no statistical significance in the incidence of DVT between the 2 groups(χ2=0.218,P=0.640).There was no statistical difference in intraoperative blood loss,total blood transfusions and postoperative drainage between the two groups(449.33+/-87.74 vs 455.76+/-76.88 mL,t=-0.302,P=0.764; 273.33+/-108.07 vs 263.33+/-115.92 mL,t=0.346,P=0.731; 269.68+/-72.36 vs 271.59+/-66.96 mL,t=-0.106,P=0.916).There was statistical difference in HGB between different time points(F=18.019,P=0.000),in other words,there was time effect.There was no statistical difference in HGB between the 2 groups(F=1.950,P=0.168),in other words,there was no group effect.There was no interaction between time factor and grouping factor(F=0.343,P=0.710).No adverse effect was observed such as alimentary tract hemorrhage,skin and mucosa hemorrhage,alimentary tract indisposition,drug allergy,hepatic disfunction and renal disfunction in both groups.Conclusion:Oral application of TAOHONG SIWU decoction is similar to oral application of Rivaroxaban in effectiveness and safety in preventing DVT after THA.

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备注/Memo

备注/Memo:
通讯作者:陈达 E-mail:184996973@qq.com
更新日期/Last Update: 2014-09-30