益气渗湿法对预防髋关节置换患者下肢深静脉血栓形成的影响.PDF

·26 · 现代中医临床 2014年3月，21（2） 益气渗湿法对预防髋关节置换患者下肢深静脉血栓形成的影响 # 温鑫柱 方志远 张凡帆 柏立群 （北京中医药大学东方医院 北京100078） 摘要：目的观察益气渗湿中药汤剂对预防髋关节置换术后下肢深静脉血栓形成的影响。方法将63例患者 按随机对照原则分为A组和B组，手术术式为全麻下行人工髋关节置换术，术后A组给予低分子肝素钙，B 组在A组基础上给予益气渗湿类中药汤剂。给药1周，观察下肢股静脉血流速度、彩超是否有下肢深静脉血 栓形成、血小板计数及纤维蛋白原数值、疼痛评分（VAS）及肢体周径的变化，并比较组间差异。结果2组下 肢股静脉血流速度、血小板计数及纤维蛋白原数值术后3，7d各时段组间比较，差异均有统计学意义（P 0.05）；2组VAS评分术后3d组间比较，差异有统计学意义（P0.05）。结论益气渗湿法可有效地降低髋关节 置换术后下肢静脉血栓发生的风险。 关键词：益气渗湿；髋关节置换；下肢深静脉血栓 中图分类号：R274 doi：10.3969/j.issn.2095-6606.2014.02.010 Preventive effect of therapy of tonifying qi and draining dampness on lower extremity deep vein thrombosisinpatientsafterhiparthroplasty WENXin-zhu,FANGZhi-yuan,ZHANGFan-fan,BAILi-qun (DongfangHospital,BeijingUniversityofChinese# Medicine,Beijing100078) Abstract:Objective Toobservethepreventiveeffectofdecoctionwiththeactionsoftonifyingqianddraining dampnessonlowerextremitydeepveinthrombosis(DVT)inthepatientsafterhiparthroplasty. Method The patients(n=63)wererandomlydividedintobasictreatmentgroup(groupA)andbasictreatmentcombinedwith decoctiongroup(groupB).Allthepatientswereoperatedbygeneralanesthesia.Thepostoperativepatientsingroup Awereadministratedwithlowmolecularweightheparin(LMWH),whilethepatientsingroupBwereadditionally givenoraldecoctionwithactionsoftonifyingqiandexcretingdampness.After 1woftreatment,bloodflowvelocity offemoralveinwasobservedbyvascularultrasoundandvenousthrombosisoflowerextremitieswascheckedby colorDopplerultrasound.Platelet(PLT),fibrinogen(FBG),VASpainscoreandchangesoflimbcircumferencewere detectedbeforeandaftertreatmentindifferentgroups. Results Therewassignificantdifferenceinbloodflow velocityoffemoralvein,PLTandFbgbetweengroupAandgroupB 3dand7 dafteroperation(P0.05). There was significant difference in VAS pain score between group A and group B 3 d after operation (P0.05). Conclusion Thetherapyoftonifyingqiandexcretingdampnesscaneffectiv