[1]吴志方,罗毅文△,王斌,等.补肾活血法预防肾虚血瘀型下肢骨折术后深静脉血栓形成的临床研究[J].中国中医骨伤科杂志,2017,25(09):12-16.
 WU,Zhifang,LUO,et al.Clinical Study on Prevention of Postoperative Deep Venous Thrombosis Formation in Kidney Deficiency and Blood Stasis Type of Lower Limb Fracture by Bushenhuoxue Method[J].Chinese Journal of Traditional Medical Traumatology & Orthopedics,2017,25(09):12-16.
点击复制

补肾活血法预防肾虚血瘀型下肢骨折术后深静脉血栓形成的临床研究()
分享到:

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

卷:
第25卷
期数:
2017年09期
页码:
12-16
栏目:
临床研究
出版日期:
2017-09-08

文章信息/Info

Title:
Clinical Study on Prevention of Postoperative Deep Venous Thrombosis Formation in Kidney Deficiency and Blood Stasis Type of Lower Limb Fracture by Bushenhuoxue Method
文章编号:
1005-0205(2017)09-0012-05
作者:
吴志方1罗毅文1△王斌1黄杰文1程英雄1黄永铨2黄菲1罗辉1
1广州中医药大学附属骨伤科医院(广州,510240) 2广东省中医院
Author(s):
WUZhifang1LUOYiwen1△WANGBin1HUANGJiewen1 CHENGYingxiong1HUANGYongquan2HUANGFei1LUOHui1
WU Zhifang1 LUO Yiwen1△ WANG Bin1 HUANG Jiewen1 1Otrhopedics and Traumatology Hospital, Affiliated to Guangzhou University of Traditional Chinese Medicine, Guangzhou 510240,China; 2Guangdong Provincial Hospital of Traditional Chinese Medicine, Guangzhou 510120,China.
关键词:
补肾活血法 深静脉血栓 肾虚血瘀 下肢骨折
Keywords:
Bushenhuoxue method deep venous thrombosis deficiency of kidney and blood stasis lower limb fracture
分类号:
R274.39
文献标志码:
A
摘要:
目的:观察补肾活血法对肾虚血瘀型下肢骨折术后深静脉血栓(DVT)形成的预防效果。方法:回顾分析本院2013年9月至2016年9月收治需行手术治疗的下肢骨折患者,术后辨证为肾虚血瘀型,共72例。根据是否服用补肾活血汤分为观察组和对照组。观察组与对照组均给予骨科基础治疗,观察组从术后第1天至术后第14天服用补肾活血汤,1剂/d.观察两组术后第1天及第7天大小腿周径差,术后第1天及第14天凝血功能指标和血液流变学指标及两组DVT阳性率。结果:观察组术后第7天的大小腿周径差和术后第14天的活化部分凝血活酶时间(APTT)、凝血酶原时间(PT)、 纤维蛋白原(FIB)、D-二聚体(D-D)、全血黏度高低切,血浆黏度较同期的对照组,差异有统计学意义(P<0.01)。观察组DVT的阳性率2.86%,与阳性率为18.92%的对照组比较,差异有统计学意义(P<0.01)。结论:补肾活血法能改善肾虚血瘀型下肢骨折术后的血栓前状态,有效防止DVT的形成,具有临床应用价值。
Abstract:
Abstract Objective:To observe the preventive effect of Bushenhuoxue decoction on the formation of deep venous thrombosis(DVT)in kidney deficiency and blood stasis type of lower limb fractures. Methods: Retrospective analysis a total of 72 cases in our hospital from September 2013 to September 2016, which patients underwent the surgery of the lower limb fractures, postoperative syndrome for kidney deficiency and blood stasis type. The patients were divided into the observation group and the control group according to whether taking or not taking the Bushenhuoxue decoction. The observation group and the control group were given orthopedic basic treatment, the observation group was added with Bushenhuoxue decoction for two weeks after surgery. The difference of lower limb perimeter was observed at 1st and 7th day after surgery. The blood coagulation indexes, the hemodynamic indexes and the positive rate of DVT were observed at 1st and 14th day after surgery. Results: Compared with the same period of the control group, there were significant differences in the lower limb perimeter at 7th day after surgery. And at 14th day after surgery, the activated partial thromboplastin time(APTT), prothrombin time(PT), fibrinogen(FIB), D-dimer(D-D), the whole blood viscosity at high and low shear and plasma viscosity in the observation group were statistically significantly different(P<0.01). The incidence of DVT in the observation group was 2.86%, compared with that in the control group 18.92%, there was statistically significant difference(P<0.01). Conclusion: Bushenhuoxue method can improve the post-thrombosis state of the lower limb fractures of the kidney deficiency and blood stasis type, and effectively prevent the formation of DVT, which is valuable for clinical application.

参考文献/References:

[1] Spain DA,Bergamini TM,Hoffmann JF,et al.Comparison of sequential compression devices and foot pumps for prophylaxis of deep venous thrombosis in high-risk trauma patients[J].Am Surg,1998,64(6):522-525.
[2] 邱贵兴.中国骨科大手术静脉血栓栓塞症预防指南[J].中华关节外科杂志:电子版,2009,29(3):380-383.
[3] 中华医学会.临床诊疗指南:骨科分册[M].北京:人民卫生出版社,2009:15-16.
[4] 国家中医药管理局.中医病症诊断疗效标准[M].南京:南京大学出版社,1994:206.
[5] 中华医学会外科学分会血管外科学组.深静脉血栓形成的诊断和治疗指南[J].中华外科杂志,2012,50(7):611.
[6] 鲁迪,巴克利,莫兰.骨折治疗的AO原则 [M].2版.上海:上海科技出版社,2010:713.
[7] 邱贵兴,戴尅戎.骨科手术学[M].3版.北京:人民卫生出版社,2006:226.
[8] 胡炎权,张国超.下肢骨折患者深静脉血栓形成的影响因素分析[J].中国骨与关节损伤杂志,2016,31(9):1001-1003.
[9] 单玮.下肢深静脉血栓形成的中医治疗概况[J].上海中医药大学学报,2011,25(4):99-102.
[10] 徐国华,陈品英,田伟明,等.益气活血通脉汤对骨科大手术后下肢深静脉血栓的防治[J].中国实验方剂学杂志,2014,20(4):188-191.
[11] 徐金海,马长山,潘长鸣.补阳还五汤加减对下肢骨科手术后气虚血瘀证患者凝血和血液流变学指标的影响[J].中国中医骨伤科杂志,2016,24(4):37-40.
[12] 李满峰,施定娥.身痛逐瘀汤预防下肢骨折围手术期深静脉血栓形成疗效观察[J].现代中西医结合杂志,2016,25(23):2564-2566.
[13] Horlander KT,Mannino DM,Leeper KV.Pulmonary embolism mortality in the United States,1979-1998:an analysis using multiple-cause mortality data[J].Arch Intern Med,2003,163(14):1711-1717.
[14] Gjores JE.The incidence of venous thrombosis and its sequelae in certain districts of Sweden[J].Acta Chir Scand Suppl,1956,206:1-88.
[15] 程英雄,罗毅文,王斌,等.补肾活血法在老年肱骨近端骨折围手术期的应用研究[J].中国中医骨伤科杂志,2016,24(10):16-19.
[16] 刘剑刚,张大武.活血化瘀中药有效组分的细胞流变学研究进展[J].中国血液流变学杂志,2015(1):1-6.
[17] 杨剑.活血利湿法治疗下肢深静脉血栓48例[J].中国现代医药杂志,2005,7(1):11.
[18] 董涛.疏血通注射液联合中药外敷治疗骨科术后下肢深静脉血栓疗效观察[J].辽宁中医药大学学报,2017,19(3):1-3.
[19] 黄永铨,罗毅文,王斌,等.补肾活血汤治疗老年桡骨远端骨折的临床疗效观察[J].中国中医骨伤科杂志,2015,23(3):5-8.
[20] 刘亚梅,王斌,罗毅文,等.补肾活血法调控大鼠骨髓间充质干细胞增殖活性的实验研究[J].中国中医骨伤科杂志,2015,23(3):1-4.
[21] 罗毅文,王斌,吴志方,等.补肾活血汤提取物促进大鼠骨髓间充质干细胞体外迁移及CXCR4表达的研究[J].中药新药与临床药理,2016,27(3):356-361.
[22] 张巍.70岁以上髋部骨折患者围手术期的中药治疗分析[J].中国医学装备,2014,11(2):312.
[23] 周剑鹏,张胜,高锦丽.补肾益气活血方配合下肢肌肉康复防治老年髋关节置换术后深静脉血栓形成[J].新中医,2014,46(3):96-98.
[24] 曾小粤,罗陆一,杨焕斌,等.补肾祛瘀汤治疗下肢深静脉血栓形成30例临床报告[J].中国中西医结合外科杂志,2002,8(1):29-30.
[25] 范文,周慧,刘燕捷.外伤骨折凝血功能等常规实验检测的改变及其临床意义[J].血栓与止血学,2013,19(3):129-131.
[26] Diamond PT,Macciocchi SN.Predictive power of clinical symptoms in patients with presumptive deep venous thrombosis[J].Am J Phys Med Rehabil,1997,76(1):49-51.

备注/Memo

备注/Memo:
基金项目:国家自然科学基金(81473699,81273783) 1广州中医药大学附属骨伤科医院(广州,510240) 2广东省中医院 通信作者 E-mail:gzhluoyw@126.com
更新日期/Last Update: 1900-01-01