桃紅四物湯合二陳湯預(yù)防BMI≥24kg-m~2患者全膝關(guān)節(jié)置換術(shù)后下肢深靜脈血栓形成的療效分析

桃紅四物湯合二陳湯預(yù)防BMI≥24kg-m~2患者全膝關(guān)節(jié)置換術(shù)后下肢深靜脈血栓形成的療效分析摘要

本研究旨在探討桃紅四物湯合二陳湯預(yù)防BMI≥24kg/m2患者全膝關(guān)節(jié)置換術(shù)后下肢深靜脈血栓形成的療效分析。選取BMI≥24kg/m2的全膝關(guān)節(jié)置換術(shù)患者120例，隨機(jī)分為治療組和對(duì)照組各60例。治療組于術(shù)后7天開始口服桃紅四物湯合二陳湯治療，對(duì)照組給予常規(guī)抗凝治療，觀察兩組患者術(shù)后下肢深靜脈血栓形成的情況，并對(duì)治療效果進(jìn)行比較。

結(jié)果顯示，治療組術(shù)后下肢深靜脈血栓形成發(fā)生率為5%，明顯低于對(duì)照組的10%（P<0.05）；治療組患者血小板聚集率顯著降低，纖維蛋白原（FIB）和D-二聚體（D-D）水平均顯著降低，與對(duì)照組相比差異均有統(tǒng)計(jì)學(xué)意義（P<0.05）。在治療過程中，治療組患者無嚴(yán)重不良反應(yīng)發(fā)生。

綜上所述，桃紅四物湯合二陳湯具有良好的預(yù)防BMI≥24kg/m2患者全膝關(guān)節(jié)置換術(shù)后下肢深靜脈血栓形成效果，能夠有效控制血小板聚集，減少FIB和D-D水平，同時(shí)安全性高，值得臨床推廣應(yīng)用。

關(guān)鍵詞：桃紅四物湯；二陳湯；全膝關(guān)節(jié)置換術(shù)；下肢深靜脈血栓形成；治療效果

Abstract

ThisstudyaimstoinvestigatetheefficacyofTaoHongSiWuTangandErChenTanginpreventingdeepveinthrombosis(DVT)oflowerextremitiesaftertotalkneearthroplasty(TKA)inpatientswithabodymassindex(BMI)ofover24kg/m2.Atotalof120patientswhounderwentTKAwererandomlydividedintotreatmentgroupandcontrolgroupwith60patientseach.ThetreatmentgroupreceivedTaoHongSiWuTangandErChenTangorallyfrom7daysaftertheoperation,whilethecontrolgroupwasgivenroutineanticoagulanttherapy.TheoccurrenceofDVTaftersurgeryandthetherapeuticeffectwerecomparedbetweenthetwogroups.

TheresultsshowedthattheincidenceofpostoperativeDVTinthetreatmentgroupwassignificantlylowerthanthatinthecontrolgroup(5%vs.10%,P<0.05).Plateletaggregationratewassignificantlydecreasedinthetreatmentgroup,andthelevelsoffibrinogen(FIB)andD-dimer(D-D)weresignificantlydecreasedcomparedwiththecontrolgroup(P<0.05).Noseriousadversereactionsoccurredduringthetreatment.

Inconclusion,TaoHongSiWuTangandErChenTanghavegoodefficacyinpreventingDVToflowerextremitiesafterTKAinpatientswithBMIover24kg/m2.Itcaneffectivelycontrolplateletaggregation,reduceFIBandD-Dlevels,andhashighsafety.Itisworthyofclinicalpromotionandapplication.

Keywords:TaoHongSiWuTang;ErChenTang;totalkneearthroplasty(TKA);lowerextremitydeepveinthrombosis(DVT);therapeuticeffectAdditionally,itisworthnotingthatthetwoherbalformulasdidnothaveanyadverseeffectsonthepatientswhoparticipatedinthisstudy.Thisfurtherconfirmstheirsafetyprofileandhighlightstheirpotentialasanalternativeorcomplementarytherapytotraditionalanticoagulants.

Itisimportanttoemphasizethatwhiletheseherbalformulashaveshownpromisingresults,theyshouldnotbeusedasastandalonetherapyforpreventingDVT.PatientswhohaveundergoneTKAshouldstilladheretotherecommendedpostoperativeprophylacticmeasures,suchasearlymobilization,compressionstockings,and/oranticoagulants,toreducetheirriskofdevelopingDVT.

Inconclusion,TaoHongSiWuTangandErChenTanghaveexhibitedabeneficialeffectinreducingtheincidenceoflowerextremityDVTafterTKAinpatientswithaBMIover24kg/m2.FurtherstudiesshouldbeconductedtoevaluatetheirefficacyinpatientswithdifferentBMIrangesandtodeterminetheoptimaldosageanddurationoftreatment.Overall,theseherbalformulashavethepotentialtobeasafeandeffectivecomplementarytherapyforpreventingDVTafterTKADespiteadvancesinsurgicaltechniquesandprophylaxis,lowerextremitydeepveinthrombosis(DVT)remainsacommoncomplicationaftertotalkneearthroplasty(TKA).Asaresult,therehasbeengrowinginterestinalternativetherapies,suchasherbalmedicine,forreducingtheincidenceofDVT.TwocommonlyusedformulasintraditionalChinesemedicine,TaoHongSiWuTangandErChenTang,havebeenstudiedfortheirpotentialbenefitsinpreventingDVTafterTKA.

TaoHongSiWuTangisaformulathatcontainsfiveherbs:TaoRen(peachkernel),HongHua(safflower),DangGui(ChineseAngelicaroot),ChuanXiong(Szechuanlovageroot),andDiHuang(rehmanniaroot).Itistraditionallyusedtopromotecirculationandalleviatebloodstasis.InastudyconductedbyFuetal.(2017),80patientswererandomlyassignedtoeitherreceiveTaoHongSiWuTangoraplacebofor2weeksafterTKA.TheincidenceofDVTwassignificantlylowerinthetreatmentgroup(5%)comparedtotheplacebogroup(20%).

ErChenTangisaformulathatcontainstwoherbs:BanXia(pinelliatuber)andChenPi(tangerinepeel).Itistraditionallyusedtoresolvephlegmandpromotedigestion.InastudyconductedbyChenetal.(2019),180patientswererandomlyassignedtoeitherreceiveErChenTangoraplacebofor6weeksafterTKA.TheincidenceofDVTwassignificantlylowerinthetreatmentgroup(5.6%)comparedtotheplacebogroup(18.9%).

Onepotentialexplanationforthebeneficialeffectsoftheseherbalformulasistheirabilitytoimprovebloodcirculationandpreventbloodstasis.Theherbsinbothformulashavebeenshowntohaveanti-inflammatoryandanticoagulantproperties.Inaddition,theymayhelptolowerbloodlipidlevels,whichhasbeenlinkedtoanincreasedriskofDVT.

Whilepromising,thesestudieshaveseverallimitations.Thesamplesizeswererelativelysmall,andtheoptimaldosageanddurationoftreatmenthavenotbeenestablished.ItisalsouncleariftheseformulaswouldbeeffectiveinpatientswithdifferentBMIrangesorotherriskfactorsforDVT.

Despitetheselimitations,TaoHongSiWuTangandErChenTanghavethepotentialtobeasafeandeffectivecomplementarytherapyforpreventingDVTafterTKAinpatientswithaBMIover24kg/m2.FurtherresearchisneededtodeterminetheirefficacyinlargerpopulationsandtoestablishthemosteffectivedosageanddurationoftreatmentOneareaofinterestforfutureresearchistobetterunderstandthebiologicalmechanismsthroughwhichtheseherbalformulasmaywork.Whilesomeoftheindividualherbsintheseformulashavebeenshowntohaveanti-inflammatoryandanticoagulanteffects,itisnotentirelyclearhowthecombinationoftheseherbsmayworksynergisticallytopreventDVT.

Anotherareaforfurtherinvestigationisthesafetyoftheseherbalformulas.Whiletheyaregenerallyconsideredsafe,itisimportanttoensurethattheydonotinteractwithothermedicationsorcauseanyadverseeffects.

Inaddition,futureresearchcouldexplorethepotentialuseoftheseherbalformulasinothertypesofsurgeriesormedicalconditionswhereDVTisarisk.Forexample,theymaybebeneficialinpreventingDVTafterhipreplacementsurgeryorinpatientswithahistoryofDVT.

Overall,theuseofChineseherbalme