| Objective: through clinical contrast research, clinical efficacy and safety of application and use Taohong Siwu Decoction in the treatment of lower extremity deep vein thrombosis research of hip and knee arthroplasty.Method: 120 cases in the Tai He hospital artificial hip and knee replacement surgery patients as the research object, according to the principle of random average packet, divided into the control group(60 patients, aged between 50-80 years old, mean age(65.1 + 10.1) years, male 34 cases, female 26 cases; hip joint replacement in 29 cases, knee joint replacement in 31 cases) and observation group(60 patients, aged between 50-80 years old, mean age(63.2 + 11.3) years, male 29 cases, female 31 cases; hip joint replacement in 33 cases, knee joint replacement in 27 cases). Inclusion criteria: 1. Inclusion criteria: Tai He hospital for hip, knee arthroplasty patients; the age >50 years, <80 years old; the weight of 45 ~ 100 kg; the diagnosis of clear, no operation contraindication; the informed consent, volunteers. Exclusion standard of cases: a) with thromboembolic diseases in vascular surgery, medical history,history of gastric and duodenal ulcer; b) must be comprehensive treatment of patients with severe, such as liver and kidney disease, serious cardiovascular and cerebrovascular diseases, endocrine system, hematopoietic system and other serious primary diseases; c) allergies, such as heparin allergy or patients with multiple drug allergies the history of D); pregnancy; E) preoperative continuous use of heparin, low molecular weight heparin, fibrinolytic agents and oral anticoagulants in patients after operation; F) of traditional Chinese medicine in patients with poor compliance, unwilling or exclusion of patients with oral medicine; g) to terminate the clinical test cases: serious adverse reactions; don’t fit or operation do not want to continue clinical trials in patients with. All the selected object will in perioperative accept oral Chinese medicine treatment or hypodermic injection of low molecular heparin therapy, and signed the informed consent, willing to let researchers continuous observation of disease development. The control group received subcutaneous low molecular weight heparin 4000 iu qd observation group were to be Taohongsiwutang orally in the control group on the basis of comparative analysis and observation of patients in the control group, after the first seven days of C- reactive protein(CRP), platelet count, red blood cell count, white blood cell count; 48 hours after removal of suction drainage tube when the patient record for wound drainage; measuring the diameter of the patient’s thigh respectively, and recorded preoperatively, patients first three days after administration the first seven days and then thigh circumference were measured and recorded; pain in patients after the first five days were VAS score; compare two groups of patients the incidence of hip and kneereplacement surgery and treatment of deep vein thrombosisResults: The study group and the control group of patients white blood cell count, red blood cell count, platelet count, C- reactive protein(CRP) count, preoperative thigh circumference of numerical analysis of variance were ①.t value:-1.22, p value : 0.108; ② t values:.-1.894, p value: 0.061(P> 0.05); ③.t values: 0.454, p value: 0.650(P> 0.05); ④.t values: 1.843, p value: 0.068(P> 0.05); ⑤.t value:-0.725, p value: 0.470(P> 0.05); the indicators compared to the previous surgery that is not statistically significant. Wound drainage in patients in the observation group than the control group, by analysis of variance: t value: 10.780, p value <0.001(P <0.05), the difference was statistically significant(P <0.05); patients in the observation group after 3 day, seven days a thigh circumference were relatively lower than in the control group, after the first three days(t test: t-value comparison group:-16.521, p value: <0.001, then P <0.05), medicine Observer Group t value:-15.545, p value: <0.001, then P <0.05); each compared with the first seven days after the first three days of the reduction measured thigh thigh circumference, that their swelling situation using independent samples t-test, t value: 2.152, p value: 0.033, circumference significantly reduced(P <0.05) difference was statistically significant(P <0.05); observation of patients after the first five days of the VAS pain scores were lower than the control group, after scoring two t statistical analysis(using independent sample t test) data later, t value: 6.744, p value: <0.001, the difference was statistically significant(P <0.05); After the observation group and control group patients after the first seven days of each white blood cell counts werestatistically analyzed by using independent sample t test, t value: 12.084, p value: <0.001, significant differences(P <0.05); postoperative red blood cell count using independent sample t test: t value:-0.699, p value: 0.486(P> 0.05), no statistically significant; their postoperative platelet count using independent sample t test, t-value: 5.351, p-value: <0.001, statistically significant(P <0.05); postoperative C-reactive protein values using independent samples t-test analysis of statistical data for: t value of 10.355, p value: <0.001, so the results are statistically learn the meaning(P <0.05). Observed in patients with deep vein thrombosis did not occur in the control group patients, 6 cases of deep vein thrombosis, because the condition does not meet the chi-square test, using fisher’s exact test, the fisher exact p value(0.027), the difference was statistically significant(P <0.05).Conclusion: Taohong Siwu Decoction can significantly reduce the postoperative inflammation, swelling, and remission in patients with DVT of the limb relieve the postoperative pain, reduce the patient postoperative drainage and so on to vanish in patients with thrombosis, and finally Doppler inspection further verify Taohongsiwu Decoction in patients taking blood all the smooth, no thrombosis. A review of all clinical trial results can explain the DVT patients, Taohong Siwu Decoction and low molecular weight heparin calcium this two drug combination therapy of hip and knee replacement after effect. Compared with the single use of low molecular weight heparin calcium, use Taohong Siwu Decoction Combined with low molecular weight heparin in the prevention and treatment of deep venous thrombosis obviously more advantages. Is not only reflected in the postoperative inflammation control witha better therapeutic effect, also can make the limb swelling eliminating speed, reduce postoperative bleeding, postoperative pain relief, so as to improve the quality of life of patients after operation, improve the treatment compliance, has better clinical efficacy and certain safety, it is worth in the clinical application. |
