补阳还五汤防治关节置换术后下肢深静脉血栓形成的疗效研究

目的：进一步探讨加味补阳还五汤在防治人工关节置换术所致的下肢深静脉衄栓形成的疗效确切性及其安全性。方法：将50例人工全髋置换术或人工全膝关节置换术病例随机分成治疗组及对照组，分别予补阳还五汤及速碧林治疗，观察两组病例的临床症状、休征、出血倾向、彩色多普勒超声的改变，同时观测其血液流变学、血小板指标的变化，凝血酶原时间（PT）和部分凝血活酶时间（APTT）指标变化。结果：50例病例中，共有4例发生DVT，总发生率8．00％，其中对照组发牛2例DVT发生率为8．00％，治疗组发牛2例DVT发生率为8．00％，其患肢肿胀率、血液流变学指标变化、血小板计数指标变化与对照组相比有统计学差异（P〈0．01或P〈0．05）、两组患者在治疗前后自身比较APTT和PT指标有显著性差异（P〈0．01或P〈0．05），术后15d两组患者比较APTT和PT指标有显著性差异（P〈0．01或P〈0．05）。结论：补阳还五汤具有明显的抗凝、溶栓功能，能通过改善血液流变性、降低血粘度达到防治人工关节置换术后下肢深静脉血栓的形成的作用，而且比速碧林具钉更好的安全性。

Clinical Study on the Buyanghuanwu Decoction in the Prevention and the Treatment of Arthroplasty Caused by DVT

objective：To further explore the Modified Buyanghuanwu Decoction in the prevention and the treatment of artificial joint replacement caused by deep vein thrombosis of the efficacy and safety of cartainty. Methods：Fifty cases of total hip replacement or total knee arthroplasty patients were randomized into the treatment group and the control group, respective ly. With Buyanghuanwu Decoction and nodroparin treatment. Patients were observed for the clinical symptoms, signs, hemorrhage tendency, color Doppler ultrasound changes at the same time observing their blood rheology, the changes in platelet indicators, prothrombin time（PT） and activated partial thromboplastin time （APTT） index changes. Results：Fifty cases, a total of four cases occurred DVT, with a total incidence of 8.00 percent, in which the control group occurred two cases of DVT rate of 8.00 percent, the treatment group occurred two cases of DVT rate of 8.00 percent. The rate of limb swelling, blood rheological parameters change, indicators of changes in platelet count compared with those of the control group statistically difference （P〈0.01 ,P〈0. 05）. The difference of APTT and PT indicators for patients in both groups before and after treatment was significant （P〈0.01 or P〈0.05）. After 15 days, the difference APTT PT indicators in the two groups was significant（P〈0.01, P〈0.05）. Conclusion： Buyanghuanwu Decoction has obvious anticoagulant, thrombolytic function and so can improve blood rheology and reduce blood viscosity artificial joint replacement to control deep vein thombosis after the formation of the role. And it has better security than nodroparin.