| 杨静,王峰,王植荣,等.芪箭消栓通组方联合导管溶栓治疗老年急性中央型下肢深静脉血栓(气虚血瘀型)的临床疗效观察[J].安徽医药,2022,26(11):2318-2322. |
| 芪箭消栓通组方联合导管溶栓治疗老年急性中央型下肢深静脉血栓(气虚血瘀型)的临床疗效观察 |
| Clinical efficacy of Qijian Xiaoshuantong recipe combined with catheter thrombolysis in the treatment of the acute deep venous thrombosis of lower extremity in elderly patients with Qi deficiency and blood stasis type |
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| DOI：10.3969/j.issn.1009-6469.2022.11.044 |
| 中文关键词: 静脉血栓形成 抗凝药 芪箭消栓通组方 下肢深静脉血栓 腔静脉滤器 导管溶栓 气虚血瘀 |
| 英文关键词: Venous thrombosis Anticoagulants Qijian Xiaoshuantong recipe LEDVT Inferior vena cava filter Catheter thrombolysis Qi deficiency and blood stasis |
| 基金项目:河北省中医药管理局中医药类科研计划课题(2020495) |
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| 中文摘要: |
| 目的观察芪箭消栓通组方联合导管溶栓治疗老年急性中央型下肢深静脉血栓(气虚血瘀型)的临床疗效及安全性。方法选取 2020年 1月至 2021年 1月在河北省沧州中西医结合医院住院治疗的老年急性中央型下肢深静脉血栓中医辨证为气虚血瘀证的病人 70例，按照随机数字表法分为治疗组 35例，对照组 35例。对照组单纯给予导管溶栓治疗，治疗组在对照组基础上加服芪箭消栓通组方治疗。观察对比两组治疗前后凝血功能指标［ D-二聚体( D-D)、纤维蛋白原( FIB)、活化部分凝血酶时间( APTT)］与炎症因子［超敏 C反应蛋白( CRP)、血清白细胞介素 -6(IL-6)、肿瘤坏死因子 -α(TNF-α)］的变化情况以及治疗后血栓清除率、患肢肿胀缓解情况与治疗期并发症，对比随访 6个月后的后遗症发生率、复发率以及髂股静脉通畅率。结果两组治疗前后 APTT比较，差异无统计学意义( P>0.05)。但治疗 14 d后，两组 D-D、FIB水平均显著降低( P<0.05)，治疗组 D-D［(1.06±1.19)mg/L比( 2.52±1.13)mg/L］、 FIB［(2.21±0.67)g/L比( 3.77±0.89)g/L］水平优于对照组( P<0.05)。治疗 14 d后，两组血清 CRP浓度、 IL-6、TNF-α含量均显著下降( P<0.05)，治疗组 CRP浓度［( 2.14±2.37)mg/L比( 5.73±4.14)mg/L］、 IL-6［( 1.09± |
| 英文摘要: |
| Objective To observe the clinical effects and sefety of Qijian Xiaoshuantong recipe combined with catheter thromboly.sis in treatment of the acute lower limbs' deep venous thrombosis (DVT) in elderly patients with Qi deficiency and blood stasis type.Methods Seventy elderly patients with the acute lower limbs' DVT who were diagnosed Qi deficiency and blood stasis type and hospi.talized in Cangzhou Integrated Traditional Chinese and Western Medicine Hospital from January 2020 to January 2021 were selectedand assigned into two groups according to the random number table method. 35 cases in control group were treated only by catheterthrombolysis, and 35 cases in treatment group were treated by Qijian Xiaoshuantong recipe on the basis of the control group. The chang. es of coagulation function indexes [D-dimer (D-D), fibrinogen (FIB), activated partial thromboplastin time (APTT)] and inflammatory factors [high-sensitivity C-reactive protein (CRP), serum interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α)] before and after treat.ment as well as the thrombus clearance rate, limb swelling relief and complications during treatment in the two groups were observed,and the incidence of sequelae, recurrence rate and iliofemoral vein patency rate were compared after 6 months of follow-up.Results There was no significant difference in activated partial thromboplastin time between the two groups before and after treatment (P>0.05). But, after treatment, the levels of D-D and FIB in the two groups were significantly decreased (P<0.05), and the levels of D-D [(1.06± 1.19) mg/L vs. (2.52±1.13) mg/L] and FIB [(2.21±0.67) g/L vs. (3.77±0.89) g/L] in the treatment group were better than those in the con. trol group (P<0.05). After treatment, the levels of serum high-sensitivity CRP, IL-6 and TNF-α in the two groups were significantly de. creased (P<0.05), and the levels of serum high-sensitivity CRP [(2.14±2.37) mg/L vs. (5.73±4.14) mg/L], IL-6 [(1.09±0.65) ng/L vs. (2.15±0.91) ng/L] and TNF-α [(3.67±4.22) ng/L vs. (6.42±4.33) ng/L] in the treatment group were better than those in the control group (P<0.05). After thrombolytic therapy, the thrombus clearance rate of the treatment group was 88.57%, and that of the control group was65.71%, the difference was statistically significant (P<0.05). After treatment, the circumference difference of 20 cm above the knee and15 cm below the knee in the treatment group was significantly lower than that in the control group (P<0.05); in addition, there was no significant difference in the incidence of adverse reactions between the two groups during treatment (P>0.05). After 6 months of follow-up, the incidence of sequelae in the treatment group was significantly lower than that in the control group (P<0.05); the patency rate of iliofemoral vein in the treatment group was significantly higher than that in the control group (P<0.05).Conclusion Qijian Xiaoshuan. tong recipe combined with catheter thrombolysis in treatment of the acute lower limbs' DVT in elderly patients with Qi deficiency andblood stasis type has definite curative effect, can significantly improve coagulation function, inhibit inflammatory reaction, and has goodprognosis and high safety. |
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