| 摘要: |
| 目的：补阳还五汤对全膝关节置换（total knee arthroplasty，TKA）患者术后高凝状态的影响。方法：84 例接受全膝关节置换术患者按就诊顺序分为治疗组 42 例，对照组 42 例。对照组患者术后皮下注射低分子肝素钙 4100 U，1 次 /d， 治疗组皮下注射低分子肝素钙基础上，口服补阳还五汤，1 剂 /d，分 2 次口服。结果：治疗组与对照组血浆纤维蛋白原（plasma ?brinogen，Fib）、D- 二聚体（D-dimmer，D-D）术后 14 天与术前相比均显著升高，统计学有显著性差异（P<0.05），两组术后 14 天相比，统计学有显著性差异（P<0.05）；两组纤维蛋白溶酶原（PLG）术后 14 天与术前相比均显著降低，统计学有显著性差异（P<0.05），两组术后 14 天相比，统计学有显著性差异（P<0.05）；两组凝血酶原时间（PT）、活化部分凝血活酶时间（APTT）术后 1 天与术前相比，时间缩短，但统计学无显著性差异（P>0.05），术后 7、14 天与术前相比时间延长，统计学亦无显著性差异（P>0.05），两组术后 14 天相比，统计学无显著性差异（P>0.05）；两组患者治疗前后 tPA、PAI-1变化情况比较，术前和术后 1 天，统计无显著性差异（P>0.05），治疗组血浆组织型纤溶酶原激活物（tPA）、纤溶酶原激活物抑制物 -1（PAI-1）术后 7、14 天分别与治疗前比较，差异均有统计学意义（P<0.05）。术后 14 天，两组 tPA、PAI-1 组间比较，差异均有统计学意义（P<0.05）。结论：补阳还五汤能有效改善膝关节置换患者的高凝状态，缓解临床症状，提高生活质量。 |
| 关键词: 补阳还五汤 膝关节置换术 高凝 影响 |
| DOI：10.3969/j.issn.1007-6948.2019.05.013 |
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| 基金项目:天津市中医药管理局中医中西医结合科研专项课题（2015127） |
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| Effect of Buyang Huanwu Decoction on Hypercoagulable State after Total Knee Arthroplasty |
| LI Qin-zong,WEI Wan-li,ZHENG Kun-lun,XIN Jin-dang,GU Fu-shun |
| Department of Orthopaedics, the Second Affiliated Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin (300150), China |
| Abstract: |
| Objective To observe the effect of Buyang Huanwu Decoction (BHD) on postoperative hypercoagulability in patients after total knee arthroplasty (TKA). Methods Eighty-four patients after TKA were randomly divided into treatment group (n=42) and control group (n=42). In the control group, the patients were treated with subcutaneous intramuscular injection of low molecular weight heparin calcium (4100 U, QD, once daily), and the patients in treatment group were injected subcutaneously with low molecular weight heparin calcium combined with oral BHD (QD, 100 mL/time, twice daily). Results Plasma fibrinogen (Fib) and D-dimmer (DD) in the treatment and control groups were signi?cantly higher than those after 14 d of surgery, with statistically signi?cant difference (P<0.05), and there was statistically signi?cant difference (P<0.05) after 14 d of surgery. The levels of plasminogen (PLG) of two groups 14 d after surgery were lower than those preoperative, with a signi?cant difference, and there was a statistically signi?cant difference between the two groups after 14 d (P<0.05). Prothrombin time (PT) and activated partial thromboplastin time (APTT) were compared with those before surgery. The time was signi?cantly shortened, but there was no statistically signi?cant difference (P>0.05). The time was signi?cantly longer than that before surgery on day 7 and 14 after surgery. There was no signi?cant difference in statistics (P>0.05), there was no statistically signi?cant difference between the two groups (P>0.05).The changes of tPA and PAI- 1 before and after treatment in the two groups were compared before and 1 d after surgery. There was no signi?cant difference (P > 0 . 05 ). There were significant differences in the treatment group between tPA and PAI-1 at 7 and 14 d after treatment, respectively (P<0.05). There were signi?cant differences between the two groups in tPA and PAI- 1 at 14 d postoperatively (P <0.05). Conclusion BHD can effectively improve the percoagulable state of patients after TKA, relieve clinical symptoms and improve quality of life. |
| Key words: Buyang Huanwu Decoction total knee arthroplasty hypercoagulability effet |
