A Clinical Study On The Effect Of Traditional Chinese Medicine Regulating Qi And Blood Prescription On Bleeding And Coagulation During Perioperative Period Of Total Hip Arthroplasty

Objective: In this study,the perioperative blood status of patients with total hip arthroplasty(THA)was intervened by using traditional Chinese medicine(TCM)regulating qi and blood decoction,and to observe the effect of traditional Chinese medicine regulating qi and blood decoction on bleeding and coagulation during perioperative period of total hip arthroplasty,which was used to clarify the principle of activating blood,stopping bleeding and stopping bleeding without leaving stasis.Besides,it provided a referable basis for solving the contradiction between hemostasis and anticoagulation during perioperative period of total hip arthroplasty,and traditional Chinese medicine can reduce blood lossing and prevent thrombosis from the angle of regulating qi and blood method.Methods: From March 2016 to September 2017,60 patients with avascular necrosis of femoral head in Guangxi Orthopaedic Traumatology Hospitall were included in the study,who were divided into treatment group(29 cases)and control group(31 cases)with using random grouping method.The patients in the treatment group began to take the traditional Chinese medicine regulating qi and blood decoction at 2 times a day,200 ml at a time on the third day before the total hip arthroplasty,and took a piece of rivaroxaban(10mg/piece)every day at least ten days after the operation.The patients in the control group began to take a piece of rivaroxaban(10mg/piece)every day at least ten days after the operation.The changes of blood loss and six items of coagulation function in the two groups of patients were observed,and got the statistical processing of data.Results: In the area of blood loss during perioperative perio,the actual total blood loss,intraoperative blood loss,postoperative flow blood loss and recessive blood loss in the treatment group were significantly less than those of the control group.In the area of coagulation function,the quantity of the six items of coagulation function(PT,TT,APTT,FIB,D-Dimer,INR)in the treatment group were so similar to those of the control group before the total hip arthroplasty that there is no statistical significance in the difference(P>0.05).The quantity of three items of coagulation function(PT,APTT,INR)in the treatment group were were significantly less than those of the control group on the third day and tenth day after operation(P=0.00).The quantity of three items of coagulation function(TT,FIB)in the treatment group were similar to those of the control group on the third day and tenth day after operation(P> 0.05),and the values of TT and FIB of the treatment group were slightly smaller than those of the control group.The the values of D-Dimer of the treatment group was similar to the control group on third days after operation,and the difference was not statistically significant(P=0.238),and The value of D-Dimer was less than that of the control group on the tenth day after the operation,and the difference was statistically significant(P=0.024).In the area of prevention of thrombosis,the effective rate of the two groups was so similar that there is no statistical significance in the difference(P=0.667).Conclusion(s):The traditional Chinese medicine regulating qi and blood prescription can not only effectively reduce the actual total blood loss,intraoperative blood loss,postoperative flow blood loss and recessive blood loss during the perioperative period of total hip arthroplasty,but also may has obvious effect on the prevention of thrombosis,that is a good two-way regulation of the function of bleeding and coagulation.