Clinical study on prevention and treatment of lower extremity deep veinous thrombosis after hip fracture surgery in elderly by combining Bushen Huoxue Formula with low molecular weight heparin and other measures

Yuting ZHANG; Hongsheng ZHAN; Zhongxiang YU

doi:10.16305/j.1007-1334.2021.1910073

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Clinical study on prevention and treatment of lower extremity deep veinous thrombosis after hip fracture surgery in elderly by combining Bushen Huoxue Formula with low molecular weight heparin and other measures

更新时间：2022-08-03

- Clinical study on prevention and treatment of lower extremity deep veinous thrombosis after hip fracture surgery in elderly by combining Bushen Huoxue Formula with low molecular weight heparin and other measures
- Shanghai Journal of Traditional Chinese Medicine Vol. 55, Issue 12, Pages: 61-64,73(2021)
- 作者机构：
  
  1.上海中医药大学附属普陀医院（上海　200333）
  2.上海中医药大学附属曙光医院（上海　201203）
- 作者简介：
- 基金信息：
- DOI：10.16305/j.1007-1334.2021.1910073
  CLC：
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Yuting ZHANG, Hongsheng ZHAN, Zhongxiang YU. Clinical study on prevention and treatment of lower extremity deep veinous thrombosis after hip fracture surgery in elderly by combining Bushen Huoxue Formula with low molecular weight heparin and other measures. [J]. Shanghai Journal of Traditional Chinese Medicine 55(12):61-64,73(2021)
DOI：

Yuting ZHANG, Hongsheng ZHAN, Zhongxiang YU. Clinical study on prevention and treatment of lower extremity deep veinous thrombosis after hip fracture surgery in elderly by combining Bushen Huoxue Formula with low molecular weight heparin and other measures. [J]. Shanghai Journal of Traditional Chinese Medicine 55(12):61-64,73(2021) DOI： 10.16305/j.1007-1334.2021.1910073.

摘要

目的,2,观察补肾活血方联合低分子肝素等防治老年髋部骨折术后患者下肢深静脉血栓（LDVT）的临床疗效。,方法,2,将220例老年髋部骨折术后患者随机分为治疗组与对照组，每组110例。对照组术后予低分子肝素皮下注射联合弹力绷带及功能练习，治疗组在对照组治疗措施基础上加服补肾活血方中药。两组疗程均为14 d，观察试验期间患者LDVT及其并发症的发生情况，比较血浆凝血酶原时间（PT）、部分活化凝血活酶时间（APTT）、D-二聚体（D-D）水平以及患肢疼痛视觉模拟评分（VAS）、肢体肿胀消退程度（大腿、小腿周径差值）指标的变化情况。,结果,2,①最终完成试验者210例，治疗组105例，对照组105例。②试验期间，治疗组3例发生LDVT（2.86%），对照组11例发生LDVT（10.48%）；组间LDVT发生率比较，治疗组明显低于对照组（,P,<,0.05）。③治疗前后组内比较，两组PT、APTT水平均明显升高，D-D水平均明显降低；组间治疗后比较，治疗组对PT、APTT、D-D水平的改善明显优于对照组（,P,<,0.05）。④组内治疗前后比较，两组患肢VAS评分均明显降低（,P,<,0.05）；组间治疗后比较，治疗组患肢VAS评分明显低于对照组（,P,<,0.05）。⑤组间治疗7 d、治疗14 d比较，治疗组大腿、小腿周径差值均明显大于对照组（,P,<,0.05）。,结论,2,补肾活血方联合低分子肝素等较单独应用低分子肝素等，可更加显著改善老年髋部骨折术后患者血液的高凝状态，降低LDVT的发生率，还能改善其下肢疼痛与肿胀。

Abstract

Objective,2,To explore the effect of Bushen Huoxue Formula combined with low molecular weight heparin (LMWH) and other measures in the prevention and treatment of lower extremity deep venous thrombosis (LDVT) after the hip fracture surgery in the elderly.,Methods,2,Two hundred and twenty elderly patients with postoperative hip fracture were randomly divided into treatment group (,n,=110) and control group (,n,=110). The control group was administered with subcutaneous injection of LMWH combined with elastic bandage and functional exercises after surgery, while the treatment group was administered with Bushen Huoxue Formula in addition to the treatment measures of the control group. Both groups were treated for 14 days. During the trial, we observed the incidence of LDVT and its complications, and compared the changes of plasma prothrombin time (PT), activated partial thromboplastin time (APTT), D-dimer (D-D) levels, as well as the pain visual analogue scale (VAS) score in the affected extremities and the degree of swelling reduction of the lower extremities (differences in circumference of thigh and calf).,Results,2,①Finally 210 cases completed the trial, 105 cases in the treatment group and 105 cases in the control group. ②During the trial, there were 3 cases of LDVT in the treatment group (2.86%) and 11 cases in the control group (10.48%); the incidence of LDVT in the treatment group was significantly lower than that in the control group (,P,<,0.05). ③The PT and APTT were significantly longer and D-D levels were significantly lower after treatment in both groups; the improvement of PT, APTT and D-D levels in the treatment group was significantly better than that in the control group (,P,<,0.05). ④The VAS scores of the affected extremities were significantly lower after treatment in both groups (,P,<,0.05); after treatment the VAS scores of the affected extremities in the treatment group were significantly lower than those in the control group (,P,<,0.05). ⑤According to the inter-group comparison after 7 days and 14 days of treatment, the differences in circumference of the thigh and calf in the treatment group were significantly greater than those in the control group (,P,<,0.05).,Conclusion,2,In the elderly patients, the combined use of Bushen Huoxue Formula with LMWH and other measures can improve the hypercoagulable state of blood and reduce the incidence of LDVT more significantly than the single use of LMWH and other measures, and it can also improve their lower limb pain and swelling.

关键词

髋部骨折老年下肢深静脉血栓补肾活血方低分子肝素中西医结合

Keywords

hip fractureelderlylower extremity deep veinous thrombosisBushen Huoxue Formulalow molecular weight heparinintegrated traditional Chinese and western medicine

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