[1]曾文磊 罗学辉 张兆华 杜绍龙 刘志波 冯兴伦李伟强 林洁 何婉芳 刘照宏.老年髋部骨折下肢血栓性疾病与中医体质的关系研究[J].中国中医骨伤科杂志,2021,29(01):29-33.
　ZENG Wenlei LUO Xuehui ZHANG Zhaohua DU Shaolong LIU ZhiboFENG Xinglun LI Weiqiang LIN Jie HE Wanfang LIU Zhaohong.Study on the Relationship between Thrombotic Disease ofLower Extremity and Traditional Chinese MedicineConstitution in Elderly Patients with Hip Fracture[J].Chinese Journal of Traditional Medical Traumatology & Orthopedics,2021,29(01):29-33.
点击复制

老年髋部骨折下肢血栓性疾病与中医体质的关系研究()
分享到：

《中国中医骨伤科杂志》[ISSN:1005-0205/CN:42-1340/R]

卷:
第29卷
期数:
2021年01期
页码:
29-33
栏目:
临床研究
出版日期:
2021-01-15

文章信息/Info

Title:
Study on the Relationship between Thrombotic Disease ofLower Extremity and Traditional Chinese MedicineConstitution in Elderly Patients with Hip Fracture
文章编号:
1005-0205(2021)01-0029-05
作者:
曾文磊1 罗学辉1 张兆华1 杜绍龙1 刘志波1 冯兴伦1李伟强1 林洁1 何婉芳1 刘照宏2
Author(s):
ZENG Wenlei1 LUO Xuehui1 ZHANG Zhaohua1 DU Shaolong1 LIU Zhibo1FENG Xinglun1 LI Weiqiang1 LIN Jie1 HE Wanfang1 LIU Zhaohong2
1 Sanshui Hospital of Foshan Traditional Chinese Medicine,Foshan 518200,Guangdong China; 2 Foshan Hospital of Traditional Chinese Medicine,Foshan 528000,Guangdong China.
关键词:
老年髋部骨折;  体质;  下肢血栓性疾病;  深静脉血栓
Keywords:
hip fracture;  constitution;  thrombotic disease of lower extremity;  deep vein thrombosis(DVT)
分类号:
R683.42
文献标志码:
A
摘要:
目的:研究老年髋部骨折中医体质特点与下肢血栓性疾病(深静脉血栓(DVT)、其他静脉血栓(VT)、动脉血栓(AT)的关系及其与性别、骨折类型及D二聚体交互影响的相关关系,为老年髋部骨折血栓形成的中医防治提供理论基础。方法:收集2019年1月至2020年5月老年髋部骨折患者(年龄≥65岁)共405例,入院后分别统计患者中医体质类型、骨折类型、性别及双下肢血栓的类型,运用多元方差因素分析,探讨体质及其他因素与下肢血栓性疾病发生的相关关系。结果:体质(气虚质、平和质)及D二聚体是老年髋部骨折患者深静脉血栓的重要危险因素。在两种体质风险评估显示,气虚质比平和质患者具有更高的深静脉血栓风险,约为平和质患者的6.25倍; 性别是其他静脉血栓和动脉血栓形成的危险因素,其中女性比男性有更大的风险,比男性风险高约12.112倍; 但在动脉血栓方面,女性比男性有更小的风险,约为男性风险的45%。在因素的交互影响作用方面,性别和体质对动脉血栓有显著性影响; 性别和体质、体质和骨折类型及性别和体质及骨折类型共同对深静脉血栓有显著的影响,差异有统计学意义(P<0.05)。结论:老年髋部骨折体质类型及D二聚体是DVT发生的独立危险因素,其中气虚质及平和质是老年髋部骨折患者深静脉血栓形成的重要危险因素。性别是其他静脉血栓和动脉血栓形成的危险因素,其中女性比男性有更大的其他静脉血栓形成的风险,女性比男性有更小的动脉血栓形成的风险。
Abstract:
To study the relationship between the traditional Chinese medicine(TCM)constitution characteristics of the elderly hip fracture and the lower extremity thrombotic diseases(deep vein thrombosis(DVT),other venous thrombus(VT),arterial thrombus(AT))and their interaction with gender,fracture type and D-dimer,so as to provide theoretical basis for the prevention and treatment of the elderly hip fracture thrombosis in traditional Chinese medicine.Methods:A total of 405 elderly hip fracture patients(age ≥65 years old)were collected from January 2019 to May 2020.After admission,the TCM constitution type,fracture type,gender and thrombosis type of both lower limbs of the patients were counted respectively.The correlation between constitution and other factors and thrombotic disease of lower extremity was explored by multivariate analysis of variance.Results:Constitution(Qi deficiency,peace and quality)and D-dimer were important risk factors of DVT in elderly patients with hip fracture.In two kinds of physical risk assessment,the patients with Qi deficiency and quality had a higher risk of DVT,about 6.25 times of those with peace quality; gender was the risk factor of other vein thrombosis and arterial thrombosis,among which women had a greater risk of other VT than men,about 12.112 times than men; but in terms of arterial thrombosis,women had a smaller risk than men,about 45% than men.In terms of the interaction of factors,gender * constitution had a significant impact on arterial thrombosis; gender * constitution,constitution * fracture type of constitution,gender * constitution * fracture type of constitution had a significant impact on DVT,and the significance P<0.05,difference was statistically significant.Conclusion:Constitution type and D-dimer of hip fracture in the elderly are independent risk factors for DVT,among which Qi deficiency and peace are important risk factors for DVT in hip fracture patients.Gender is a risk factor for other venous and arterial thrombosis.Among them,women have a greater risk of other venous thrombosis than men,women have a smaller risk of arterial thrombosis than men.

参考文献/References:

[1] 孙健平,张堃,王鹏飞,等.骨折患者近端深静脉血栓形成临床特征及危险因素[J].中华创伤杂志,2019,35(7):625-630.
[2] 王超群,常运鹤,郑洋,等.多学科医护协作模式在老年髋部骨折围术期的应用研究[J].中国修复重建外科杂志,2019,33(10):1283-1286.
[3] 范吉星,李宁,龚晓峰,等.老年髋部骨折术前下肢深静脉血栓形成的影响因素研究[J].中国矫形外科杂志,2017,25(22):2027-2031.
[4] 中华医学会外科学分会血管外科学组,李晓强,王深明.深静脉血栓形成的诊断和治疗指南(第一版)[J].中华普通外科杂志,2008,23(3):235-238.
[5] 李文东,李晓强,钱爱民,等.下肢深静脉血栓形成治疗进展[J].中国实用外科杂志,2014,34(12):1190-1193.
[6] 唐佩福.老年髋部骨折的诊治现状与进展[J].中华创伤骨科杂志,2020,22(3):197-199.
[7] 李浩,窦群立,范秀风,等.七味三芎汤治疗髋部骨折术后下肢深静脉血栓[J].长春中医药大学学报,2019,35(3):483-486.
[8] 孙贺军.红元胶囊治疗老年患者髋部骨折疗效及对患者术后TPINP、FIB、N-MID水平的影响[J].陕西中医,2019,40(7):909-912.
[9] 孙树椿,中国标准化协会.中医临床诊疗指南释义:骨伤疾病分册[M].北京:中国中医药出版社,2015.
[10] 王琦.9种基本中医体质类型的分类及其诊断表述依据[J].北京中医药大学学报,2005,24(4):1-8.
[11] 中华中医药学会.中医体质分类与判定[J].中华养生保健,2009(9):38-39.
[12] 卢锌祥,路磊.髋部骨折后下肢深静脉血栓形成的诊断MR和影响因素及预防措施研究进展[J].中医正骨,2019,31(2):36-38.
[13] 王深明,武日东.下肢深静脉血栓形成治疗指南与实践[J].中国实用外科杂志,2015,35(12):1264-1266.
[14] 中华医学会外科学分会血管外科学组,李晓强,王深明.深静脉血栓形成的诊断和治疗指南(第二版)[J].中国血管外科杂志(电子版),2013,23(1):235-238.
[15] 李倩茹,王琦,李玲孺,等.中医体质辨识在“治未病”中的应用[J].中医学报,2019,34(8):1586-1589.
[16] 罗熙林,关丽娜,任丹,等.对南充地区4 440例样本人群中独立中医体质者的流行病学调查[J].中国中医基础医学杂志,2019,25(5):621-623.
[17] 王睿林,郑守曾.气虚体质与气虚证的关系探讨[J].辽宁中医杂志,2004,31(7):555-556.
[18] 陈洁瑜,韩双双,颜文凯,等.广东地区亚健康状态与中医体质的相关性研究[J].中国中西医结合杂志,2019,39(11):1340-1344.

备注/Memo

备注/Memo:
基金项目:广东省中医药管理局面上项目(20192099)
1广东省佛山市中医院三水医院(广东 佛山,518200)
2广东省佛山市中医院
更新日期/Last Update: 2021-01-15