Effect On Lower Extremity Deep Venous Thrombosis With Prevention By Nourishing Qi And Activating Blood After Operation Of Gynecologic Malignancy

Objective:The primacy purpose of this study was to observe the clinical manifestation, laboratory tests and adjunct examination of the 27 patients after operation of gynecologic malignancy, study the curative effect and security of Chinese medicine tongmaiyin for lower extremity deep venous thrombosis (LEDVT) prevetion, explore the influence of all laboratory data, the feasibility and mechanisms of lower extremity deep venous thrombosis by nourishing qi and activating blood, and develop new preventive measure for gynecologic patient with LEDVT.Methods:In strict accordance with inclusion and exclusion criteria, we chose 27 cases who was hospitalized in gynecology department of the first affiliated hospital of Guangzhou university of TCM from March,2009 to April, 2010, would be performed operation of the abdomen malignant tumor also. By way of simple randomization (Number patients in proper order by operation date, then look up random number table and group them),we divided them into the treatment group of 13 cases and matched group of 14 cases to make a prospective study. Afterwards, we observed the clinical manifestation in relation to LEDVT of the two groups after operation with Chinese medicine treatment.In the meantime, we collected blut-routine-untersuchung, coagulative function, plasma D-dimer, and haemorheology data, as well as color Doppler flow imaging (CDFI) in diagnosis of lower limb vein before and after operation, even on the 15th day postoperatively in these two groups. In the end, we analyzed platelet count (PLT), prothrombin time (PT), activated partial thromboplastin time (APTT), plasma D-dimer,whole blood viscosity data, and CDFI results. Results:(1)Clinical Observation:Only one patient experienced suspicious clinical symptom of LEDVT. The clinical symptoms and signs of the person was improved after treating with tongmaiyin. (2)Laboratory Indices:After the operation, platelet count was obviously reduced in comparison with pre-operation in two groups (P< 0.01); PT and APTT were both extened (P< 0.01), furthermore, FIB rised significantly by comparison (P< 0.01), so did D-dimer (P< 0.01);Whole blood viscosity (higher, middle and lower shear rate) were all declined (P< 0.01).Compared with the control group, platelet count was increased considerably (P< 0.01), and D-dimer was decreased noticeably as well (P< 0.01), but PT, APTT, FIB and whole blood viscosity had no significant difference (P> 0.05). (3)Auxiliary Examination:Only one suspicious LEDVT patient was examined by CDFI diagnosed suspicious LEDVT, and later was returned after 15 days treatment.The rest patients examined by CDFI didn't diagnose LEDVT on the postoperative 15th day. (4)Adverse Reaction:There was no report on clinical adverse incidents such as bleeding in the duration, suggested that tongmaiyin was safe and had no side effect.Conclusion:(1)This research shows that nourishing qi and activating blood Chinese medicine is safe and effective in the prevention of LEDVT after operation of gynecologic malignancy. The results may be related to the drugs effects of inhibiting platelet aggregation, increasing the number and activity of platelets in the blood, releasing plasminogen activator factor, and activating anti-cruor system and fibrinolysis system. (2)There was only one patient experienced LEDVT, and finally had been cured. Because of small samples, researches on treatment rate of prevention by nourishing qi and activating blood after operation of gynecologic malignancy still remain farther test and verify in cohort studies. (3)This research observed curative effect on lower extremity deep venous thrombosis with prevention by nourishing qi and activating blood after operation of gynecologic malignancy. It provided a new idea and method with prevention after gynecologic operation. In addition,it is a new attempt of using Chinese medicine during gynecologic operation period, worthy to recommend its clinical use.