The Clinical Research On Preventing Deep Venous Thrombosis After Total Knee Anthroplasty With Huoxue Tongmai Decoction And Rivaroxaban

Objective:By observing the clinical effect of preventing deep venous thrombosis(DVT) after total knee anthroplasty(TKA) with Huoxue Tongmai Decoction and rivaroxaban,to accumulate the experience of traditional Chinese medicine preventing the limp deep venous thrombosis.Methods:60 patients who were 50-80 years old and received TKA were selected as research object of this study.The study subjects were randomly divided into control group and study group, 30 cases in each group. The control group were treated with oral rivaroxaban after operation; the study group were treated with oral Huoxue Tongmai Decoction and rivaroxaban after operation. All the patients were given conventional treatment preoperative and postoperative. Both groups were treated 15 days. Observe two groups of patients with postoperative pain visual analogue scale method(Visual analogue scales,VAS) score, the variation of PT,APTT and D-dimer, the swelling degree of shanks, the area of ecchymosis, the incidence of DVT and other indexes of recording data.Results:1?Compared with the control group and the treatment group in first, third, seventh, fourteenth postoperative days, the difference of VAS score has statistical significance(P<0.05).2?There was a significant difference in circumference levels after operation(P<0.05). Compared preoperation with postoperation, there was a significant difference in circumference levels of both groups(P<0.05).3?Between the two groups before surgery and the third postoperative days, PT and APTT have no statistical significance(P>0.05). Between the two groups the seventh postoperative days and the fourteenth postoperative days, PT and APTT have statistical significance(P<0.05). The seventh postoperative days and the fourteenth postoperative days, PT and APTT less than those of preoperation in both groups, there was a significant difference(P<0.05).4?Between the two groups before surgery, D-dimer has no statistical significance(P>0.05). Between the two groups the third postoperative days, the seventh postoperative days and the fourteenth postoperative days, D-dimer has statistical significance(P<0.05).5?There was a significant difference in ecchymosis area scores after operation of both groups in first, third, seventh, fourteenth postoperative days(P<0.05). Compared with each other, the ecchymosis area scores of the first, third, seventh, fourteenth postoperative days, there was a significant difference(P<0.05).6?The comparison of the two groups the incidence of DVT has significant difference(P<0.05).Conclusion:The result of this clinical research showed that Huoxue Tongmai Decoction can prolong the PT,APTT and reduce the D-dimer during the postoperative period, can improve the blood high condensation, so that it can prevent the DVT of patients after operation safely and effectively. Though the two treatments can prevent the DVT after TKA, Huoxue Tongmai Decoction can reduce the pain, the ecchymosis area scores and the swelling degree of limb more significantly than the way only use the rivaroxaban.These effects reflect that Huoxue Tongmai Decoction can replenish qi and invigorate the circulation of the blood, can disperse blood stasis and relieve pain. This study reflects the specialty and advantage of traditional Chinese medicine which is the prevention before disease onset and treatment based on syndrome differentiation. It is worthy of further study, so that the result can be widely used in clinical as soon as possible.