摘要
目的:探讨活血化瘀法(方选通脉汤)对骨折患者术前术后D-二聚体(D-Di)、血小板计数(PLC)浓度的影响,证实中药活血化瘀法对降低机体高凝状态反应,有效预防深静脉血栓(DVT)、肺栓塞等严重病变的发生有良好的效果。为临床运用提供一定的理论依据。方法:选择符合纳入、排除标准的股骨骨折患者100例,采用随机数字表法随机分为4组,每组各25例。治疗方法:Ⅰ组,田七丸,4g,po.Bid;Ⅱ组;田七丸,4g,po,Bid;通脉汤,水煎,200ml,po,Bid;Ⅲ组:田七丸,4g,po,Bid,;可塞风注射液,8mg,im,Qd;Ⅳ组:田七丸,4g,po,Bid;可塞风注射液,8mg,im,Qd,通脉汤,水煎,200ml,po,Bid。上述药物均在入院第二天开始运用,4组患者于入院后第(2、7)(术前)天、(8、13)(术后)天清晨6:40未静脉输液前采取外周静脉血,分别测定D2-聚体(D-Di)、血小板计数(PLC)血中的含量;第(2、12)天分别监测肝、肾功能,所测结果采用采用SPSS 17.0统计学软件进行方差分析、最小显著差异(LSD)t检验。结果:4组患者入院第二天相互比较,各种指标之间差异无显著性,P>0.05;入院第7天及手术后第7天,四组患者监测指标Ⅱ、Ⅳ组患者四种指标差异显著P<0.05。结论:骨折围手术期内患者血清中D-Di、PLC显著增高,运用活血化瘀法对降低机体高凝状态反应,减少创伤后早期并发症有一定的作用。
Objective：To explore the effect of activating blood circulation to dissipate blood stasis（Tong Mai Tang） on D-dimer （D-Di）. Platelet count（PLC）in the peroperative period of fracture and conform the effectiveness of the treatment of activating blood circulation to dissipate blood stasis on decreasing the hypercoagulability state, preventing the deep vein thrombosis（DVT） and pulmonary embolism（PE）, with the intent of providing the theoretical evidence for the use of the treatment of activating blood circulation to dissipate blood stasis. Methods： Selected 100 cases of traumatic femoral shaft fracture patients according to the inclusion criteria and exclusion criteria, which were randomized dividend into four groups（1,II,IIl,IV respectively）of the same size based on the random number table method of 25 patients each. Therapeutic methods of four groups following as： Group I, Tpanax Notoginseng Pills, 4g, PO, BID; Group If, Tpanax Notoginseng Pills, 4g, PO, BID; Lomoxicam For Injection,8mg, M, QD; Group lII, Tpanax Notoginseng Pills 4g, PO, BID; Tong Mai decoctions,decocting with water,200ml, PO, BID. Group IV, Tpanax Notoginseng Pills 4g, PO, BID;Lornoxicam For Injection,Smg, IM, QD; Tong Mai decoctions,decocting with water,200ml, PO, BID. The above medications were administered to the four groups after admission to hospital the next day. Peripheral blood samples were taken for immune determination of pro-inflammatory cytokines of D-Di, PLC in blood serum on the days 2,7 before operation and on days 8,13 after operation at six forty before intravenous infusion in the morning. And all patients received liver and kidney function examination 2, 7 days after admission Analysis of variance and least significant difference-test were done with the help of SPSS 17.0 statistic software. Results：The difference among four groups in D-Di and PLC after admission 2 days and post-operative 2 days were not statistically significant （P〉0.05.）, but significant difference at after admission 7 days and post-operative 7 days（P〈0.05）. Conclusion：The serum concentrations of D-Di and PLC level were significantly increased in peroperative period. These results seem to indicate that the treatment of activating blood circulation to dissipate blood stasis may play an important role in inhibiting the release of TNF-α, IL-6, D-Di and PLC into the blood stream and decreasing the incunabula complication at early traumatic stage.
出处
《中国医药导刊》
2011年第4期653-655,共3页
Chinese Journal of Medicinal Guide
基金
广东省中医药管理局课题
课题编号:2007275
关键词
通脉汤
骨折
D-Di
PLC
活血化瘀
围手术期
Tong Mai Tang
Fracture
D-Di
PLC
Activating Blood Circulation to Dissipate Blood Stasis
Perioperative Period
