| 陈烨[],张春晓,陈兰勇,胡松峰.理气四物汤联合贝米肝素对膝关节置换术后膝功能及血栓风险疗效的回顾性研究[J].浙江中西医结合杂志,2025,35(7): |
| 理气四物汤联合贝米肝素对膝关节置换术后膝功能及血栓风险疗效的回顾性研究 |
| Evaluation of the efficacy of Liqi Siwu Decoction combined with Bemiparin on knee function and thrombotic risk after knee arthroplasty |
| 投稿时间：2024-11-24 修订日期：2025-06-03 |
| DOI： |
| 中文关键词: 理气四物汤 贝米肝素 膝骨关节炎 膝关节置换术 下肢深静脉血栓 |
| 英文关键词:Liqi Siwu Decoction Bemiparin Knee osteoarthritis Total knee arthroplasty Deep vein thrombosis |
| 基金项目:浙江省创伤性骨病诊治中医药传承创新团队项目(浙卫发[2023]31号) |
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| 中文摘要: |
| 目的 观察理气四物汤联合贝米肝素对膝关节置换术后膝功能及血栓风险的疗效。方法 以浙江省绍兴市中医院关节骨科2023年3月至2024年3月收治的100例行单侧全膝关节置换手术的膝骨关节炎患者，根据术后是否服用理气四物汤将患者分为对照组及治疗组，对照组于术后第1天开始注射贝米肝素，治疗组在此基础上口服理气四物汤。记录两组患者手术前后的凝血酶原时间测定(PT)、活化部分凝血活酶时间（APTT）、凝血酶时间（TT）、D-二聚体、血栓形成情况、膝关节功能评分(HSS)、健康状况调查问卷(SF-36)评分、小腿腿围、肝肾功能及不良事件发生情况等。结果 经统计两组患者术前PT、APTT、TT、D-二聚体均无明显差异（P＞0.05）；术后第1天、术后第7天，治疗组PT、APTT、TT较同期对照组有所延长(P＜0.05)，术后第7天D-二聚体水平较同期对照组下降(P＜0.05)，且治疗组小腿腿围明显小于对照组，术后血栓发生率治疗组明显低于对照组(P<0.05),两组术后HSS评分无统计学差异(P＞0.05)，SF-36中生理机能、躯体疼痛指标治疗组较对照组升高(P＞0. 05)，且肝肾功能未见异常，未发生不良事件。结论 理气四物汤联合贝米肝素治疗能改善膝关节置换术后临床症状，预防DVT效果好，安全性较高，利于术后康复。 |
| 英文摘要: |
| Objective To observe the efficacy of Liqi Siwu Decoction combined with bemiparin on knee function and thrombosis risk after knee arthroplasty. Methods The 100 patients with osteoarthritis of the knee who underwent unilateral total knee arthroplasty admitted to the Department of Joint Orthopaedics, Shaoxing Hospital of Traditional Chinese Medicine, Zhejiang Province, from March 2023 to March 2024 were divided into a control group and a treatment group according to whether or not they were taking Liqi Siwu Decoction after the operation, and the control group began to inject bemiparin on the 1st day of the postoperative period, while the treatment group took Liqi Siwu Decoction orally on this basis. The prothrombin time measurement (PT), activated partial thromboplastin time (APTT), prothrombin time (TT), D-dimer, thrombosis, knee function score (HSS), health status questionnaire (SF-36) score, calf leg circumference, liver and kidney function and the occurrence of adverse events in the two groups before and after surgery were recorded. Results Statistically there was no significant difference in preoperative PT, APTT, TT and D-dimer between the two groups of patients (P>0.05); on the first postoperative day and on the seventh postoperative day, PT, APTT and TT were prolonged in the treatment group compared with the same period of the control group (P<0.05), and the level of D-dimer on the seventh postoperative day was decreased compared with the same period of the control group (P<0.05), and the circumference of calf and leg in the treatment group was significantly smaller than that in the control group. The incidence of postoperative thrombosis was significantly lower in the treatment group than in the control group (P<0.05), and there was no statistically significant difference in the HSS scores between the two groups (P＞0.05), while physiological function and physical pain indexes in the SF-36 were higher in the treatment group than in the control group (P＞0.05), and the liver and kidney functions were not abnormal, and no adverse events occurred. Conclusion The treatment of Liqi Siwu Decoction combined with bemiparin can improve the clinical symptoms after knee arthroplasty, prevent DVT with good effect and high safety, which is conducive to postoperative rehabilitation. |
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