[1]刘飞,刘刚,郭浩山,等.化瘀渗湿汤对全膝关节置换术后血浆D-二聚体 和纤维蛋白原含量的影响[J].中医正骨,2016,28(03):30-33.
　LIU Fei,LIU Gang,GUO Haoshan,et al.Effect of Huayu Shenshi Tang(化瘀渗湿汤)on plasma contents of D-dimer and fibrinogen after total knee arthroplasty[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2016,28(03):30-33.
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化瘀渗湿汤对全膝关节置换术后血浆D-二聚体 和纤维蛋白原含量的影响()
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《中医正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第28卷
期数:
2016年03期
页码:
30-33
栏目:
临床研究
出版日期:
2016-03-20

文章信息/Info

Title:
Effect of Huayu Shenshi Tang(化瘀渗湿汤)on plasma contents of D-dimer and fibrinogen after total knee arthroplasty
作者:
刘飞; 刘刚; 郭浩山; 刘晓之; 郑大伟; 安龙; 徐金华; 王东伟; 范宪辉; 路聊东
山东省聊城市中医医院,山东 聊城 252000
Author(s):
LIU Fei; LIU Gang; GUO Haoshan; LIU Xiaozhi; ZHENG Dawei; AN Long; XU Jinhua; WANG Dongwei; FAN Xianhui; LU Liaodong
Liaocheng Hospital of Traditional Chinese Medicine,Liaocheng 252000,Shandong,China
关键词:
关节成形术; 置换; 膝;  骨关节炎; 膝;  中药疗法;  化瘀渗湿汤;  D-二聚体;  纤维蛋白原;  治疗; 临床研究性
Keywords:
arthroplasty; replacement; knee;  osteoarthritis; knee;  drug therapy(TCD);  Huayu Shenshi Tang;  D- dimer;  fibrinogen;  therapies; investigational
摘要:
目的:探讨口服化瘀渗湿汤对全膝关节置换术后血浆D-二聚体(D-dimer,DD)和纤维蛋白原(fibrinogen,FBG)含量的 影响。方法:将60例膝骨关节炎患者随机分为2组,每组30例; 2组患者均进行单侧全膝关节置换术,术后均皮下注射低分子 肝素钙,双下肢使用空气压力泵。其中1组患者在此基础上予以化瘀渗湿汤口服。分别于术前、术后第1天和第7天测定并 比较2组患者血浆DD和FBG的含量。结果:手术前后不同时间点血浆DD含量比较,差异有统计学意义,存在时间效应 (F=137.114,P=0.001); 2组患者血浆DD含量比较,组间差异总体上有统计学意义,存在分组效应(F=6.484,P=0.014); 术前 和术后第1天2组患者血浆DD含量比较,差异均无统计学意义[(0.653±0.388)mg·L-1, (0.643±0.384)mg·L-1,t=0.104,P=0.918;(2.305±0.623)mg·L-1, (2.607±0.599)mg·L-1,t=-1.910,P=0.061]; 术后第7天低分子肝素钙联合空气压力泵和化瘀渗湿汤组 的血浆DD含量低于低分子肝素钙联合空气压力泵组[(0.530±0.249)mg·L-1,(0.790±0.225) mg·L-1,t=-4.246,P=0.001]; 时间因素与分组因素不存在交互效应(F=2.498,P=0.099)。手术前后不同时间 点血浆FBG含量比较,差异有统计学意义,存在时间效应(F=245.334,P=0.001); 2组患者血浆FBG含量比较,组间差异总体上 无统计学意义,不存在分组效应(F=2.380,P=0.128); 术前和术后第1天2组患者血浆FBG含量比较,差异均无统计学意义 [(3.010±0.511)g·L-1,(2.909±0.563)g·L-1,t=0.728,P=0.470; (4.621±0.421)g·L-1,(4.739±0.614)g·L-1,t=-0.870,P=0.388],术后第7天低分子 肝素钙联合空气压力泵和化瘀渗湿汤组的血浆FBG含量低于低分子肝素钙联合空气压力泵组[(2.958±0.397) g·L-1,(3.336±0.488)g·L-1,t=-3.294,P=0.002]; 时间因素与分组因素存在交互效应 (F=3.964,P=0.022)。结论:在皮下注射低分子肝素钙联合双下肢使用空气压力泵的基础上,给予口服化瘀渗湿汤,能降低 全膝关节置换术后血浆DD和FBG的含量,改善术后血液高凝、高黏状态,其效果优于皮下注射低分子肝素钙联合双下肢使用 空气压力泵。
Abstract:
Objective:To explore the effect of oral application of Huayu Shenshi Tang(HYSST)on plasma contents of D-dimer(DD)and fibrinogen(FBG)after total knee arthroplasty(TKA).Methods:Sixty patients with knee osteoarthritis were randomly divided into group A and group B,30 cases in each group.Unilateral TKA were performed on patients in both of the 2 groups.After the surgery,the patients were treated with subcutaneous injection of low-molecular-weight hepacarin(LMWH)and air force-pump in both lower limbs.Meanwhile,the patients in group B were treated with oral application of HYSST.The plasma contents of DD and FBG were measured and compared between the 2 groups before the operation and at the 1st and 7th day after the operation respectively.Results:There was statistical difference in the plasma DD contents between different timepoints before and after the operation,in other words,there was time effect (F=137.114,P=0.001).There was statistical difference in the plasma DD contents between the 2 groups in general,in other words,there was group effect(F=6.484,P=0.014).There was no statistical difference in the plasma DD contents between the 2 groups before the operation and at the 1st day after the operation (0.653+/-0.388 vs 0.643+/-0.384 mg/l,t=0.104,P=0.918; 2.305+/-0.623 vs 2.607+/-0.599 mg/l,t=- 1.910,P=0.061).The plasma DD contents were lower in group B compared to group A at the 7th day after the operation(0.530+/-0.249 vs 0.790+/-0.225 mg/l,t=-4.246,P=0.001).There was no interaction between time factor and grouping factor(F=2.498,P=0.099).There was statistical difference in the plasma FBG contents between different timepoints before and after the operation,in other words,there was time effect (F=245.334,P=0.001).There was no statistical difference in the plasma FBG contents between the 2 groups in general,in other words,there was no group effect(F=2.380,P=0.128).There was no statistical difference in the plasma FBG contents between the 2 groups before the operation and at the 1st day after the operation(3.010+/-0.511 vs 2.909+/-0.563 g/l,t=0.728,P=0.470; 4.621+/-0.421 vs 4.739+/-0.614 g/l,t=- 0.870,P=0.388).The plasma FBG contents were lower in group B compared to group A at the 7th day after the operation(2.958+/-0.397 vs 3.336+/-0.488 g/l,t=-3.294,P=0.002).There was interaction between time factor and grouping factor(F=3.964,P=0.022).Conclusion:Combination of oral application of HYSST with subcutaneous injection of LMWH and air force-pump in both lower limbs can decrease the plasma contents of DD and FBG after TKA,and improve the postoperative blood state of high coagulability and high viscosity,and its therapeutic effect is better than that of subcutaneous injection of LMWH combined with air force-pump in both lower limbs.

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更新日期/Last Update: 2016-03-30