The Clinical Observation Of Yiqi Huoxue Tongyu Decoction In Preventing DVT Of Lower Limbs In Elderly Patients With Hip Fracture After Operation

Objectives:To study the clinical efficacy and safety of Yiqi Huoxue Tongyu Decoction combined with low molecular weight heparin sodium in preventing lower extremity deep venous thrombosis(DVT)after hip fracture surgery in elderly patients,and to explore its mechanism,so as to provide theoretical basis and experimental basis for clinical application of Chinese medicine in preventing DVT after hip fracture surgery in elderly patients.Methods:According to the inclusion criteria and exclusion criteria,60 elderly patients with hip fracture were selected from Heze Hospital of Traditional Chinese Medicine,Affiliated Hospital of Shandong University of Traditional Chinese Medicine from March 2018 to January 2019.They were randomly divided into experimental group and control group with 30 cases in each group.In the control group,low molecular weight heparin sodium was injected subcutaneously from 12 hours postoperatively until the 14 th day postoperatively.On this basis,the experimental group began to take Yiqi Huoxue Tongyu Decoction on the first day after operation until the 14 th day after operation.The other routine treatment measures were the same in bothgroups.The changes of coagulation index(D-2 polymer,APTT,PT),inflammation index(CRP),blood cell index(PLT,HGB),thigh circumference difference,calf circumference difference,pain score(VAS score),postoperative drainage and DVT incidence were recorded and analyzed.The collected data were analyzed by SPSS17.0 statistical software.Results:1.There was no significant difference between the two groups in the basic data(age,sex,fracture site,operation mode),preoperative coagulation index(D-2 polymer,APTT,PT),preoperative blood cell index(PLT,HGB)(P> 0.05).2.The coagulation indexes(D-dimer,APTT,PT)of the two groups were compared on the 7th day after operation and the 1st day after operation,with statistical difference(P < 0.05).The coagulation indexes(D-dimer,APTT,PT)of the two groups were compared on the 14 th day after operation and the7 th day after operation,with statistical difference(P < 0.05).The coagulation indexes(D-dimer,APTT,PT)of the two groups were compared on the first day after operation,the difference was not statistically significant(P > 0.05),but on the seventh and fourteenth day after operation,the improvement of coagulation indexes(D-dimer,APTT,PT)of the experimental group was significantly better than that of the control group,the difference was statistically significant(P < 0.05).3.Compared with the control group,the CRP,VAS pain score,postoperative drainage,thigh circumference difference and calf circumference difference of the experimental group had no statistical significance on the first day after operation(P>0.05),but on the seventh and fourteenth day after operation,the data of the experimental group were lower than those of the control group,with statistical significance(P<0.05).In addition,the CRP of the experimental group was significantly different from that of the control group on the 14 th day after operation(P<0.01).4.There was no significant difference in blood cell index(PLT,HGB)between the experimental group and the control group on the first day after operation(P>0.05),but there was significant difference betweenthe two groups on the 7th and 14 th day after operation(P<0.05).There was no significant difference in blood cell index(PLT,HGB)between the two groups on the first day after operation compared with the preoperative group(P<0.05).The intra-group comparison was made on the 7th day after operation and the 1st day after operation,and the intra-group comparison on the 14 th day after operation and the 7th day after operation had statistical significance(P<0.05).5.There was no significant difference in the incidence of DVT between the two groups(P>0.05).Conclusion:The combination of Yiqi Huoxue Tongyu decoction and low molecular weight heparin sodium can effectively prolong PT and APTT,reduce D-2 aggregates,reduce platelet proliferation,improve blood hypercoagulability,reduce CRP level,inhibit inflammation,relieve pain,reduce bleeding,promote hemoglobin recovery and reduce swelling of affected limbs in elderly patients with hip fracture after operation,which is worthy of clinical application.