Clinical Study Of Buyang Huanwu Tang And Si Miao San Combined With Urokinase In Treating Acute LEDVT

ObjectiveIn recent years,Acute Lower Extremity Deep Vein Thrombosis(LEDVT)has been increasing year by year and has become a high incidence of vascular diseases.Orthopedics,surgery,gynecology and intensive care unit and other departments have a higher incidence.Without timely and effective treatment,it leads to a series of complications such as pulmonary embolism(PE)and deep venous thrombosis(PTS).So effective treatment is particularly important.Clinically,most patients with LEDVT have clinical manifestations of dampness-heat pouring downward syndrome.Western medical treatment include anticoagulant,thrombolytic and endovascular treatment,but all have the risk of bleeding,and may cause fatal pulmonary embolism.Therefore,in this study,we measured the levels of D-dimer(DD),plasminogen(PLG),homocysteine(Hcy),high sensitivity C-reactive protein(hs-CRP)by Chinese and Western integrative Medicine treatment method to explore the differences and the effectiveness of traditional Chinese medicine in treating acute LEDVT between Chinese and Western integrative Medicine and Western medicine from fibrinolysis and vascular endothelial cell status,for providing a reference to treat LEDVT by Chinese and Western integrative Medicine.MethodsA randomized controlled trial was conducted to select 60 patients with acute lower extremity deep venous thrombosis and the 60 patients have clinical manifestations of dampness-heat pouring downward syndrome in the department of general surgery of Foshan Hospital of Traditional Chinese Medicine from March 2017 to December 2017.They were randomly divided into study group and control group,30 cases each.In the study group,the prescriptions of Chinese medicine(Buyang Huanwu Tang combined with Si Miao San)and Western medicine(take rivaroxaban 14 d and intravenous infusion of urokinase 7d)were given on the next day after admission.The medication was administered from the next day after admission to the 14 th day.In the control group,take Western medicine(take rivaroxaban 14 d and intravenous infusion of urokinase 7d).D-D,PLG,Hcy and hs-CRP were measured before treatment and on days 1,4,7,11 and 14 after treatment in both groups.At the same time,Doppler color Doppler ultrasound examination was performed.Before and after treatment,the two groups of patients were also observed left leg swelling,pain,color,circumference and tongue veins,etc.,and all the data were analyzed statistically after obtained.Results1.There was no significant difference between the study group and the control group in gender,age and onset time(P> 0.05).The two groups were well balanced and comparable.2.There was no significant difference in TCM symptom scores between the two groups before treatment(P> 0.05).After treatment,the score of TCM symptom in the study group was significantly lower than that in the control group(P <0.05).3.In the level of vascular recanalization,the study group completely recanalized vascular lumen in 22 cases,the complete recanalization rate was 73.33%.The control group completely recanalized vascular lumen in 14 cases,the complete recanalization rate was 46.67%.The recanalization rate of the study group was better than that of the control group,the difference was statistically significant(P <0.05).4.Before treatment,there was no significant difference between the two groups of D-dimer levels(P> 0.05).On the first day after treatment,there was no significant difference in D-dimer levels between the two groups(P> 0.05).On the 4th,7th,11 th and 14 th days after treatment,the differences of D-dimer levels between the two groups were statistically significant(P <0.05).5.Before treatment,the two groups of plasminogen activity levels were no significant difference(P> 0.05).On the 1st,4th,7th,11 th and 14 th days after treatment,the levels of plasminogen in the study group were lower than those in the control group,with statistical significance(P <0.05).6.Before treatment,on the 1st,4th,7th,11 th and 14 th days after treatment,there was no significant difference in homocysteine levels between the two groups(P> 0.05).7.Before treatment,the two groups of high-sensitivity C-reactive protein was no significant difference(P> 0.05).On the 1st,4th,7th,11 th and 14 th days after treatment,the levels of Hs-CRP in the study group were lower than those in the control group,with statistical significance(P <0.05).ConclusionBuyang Huanwu Tang and Si Miao San Combined with urokinase in the treatment of acute LEDVT is more effective than only western medicine,mainly in the improvement of symptoms,vascular recanalization,fibrinolysis and vascular endothelial cell status.The treatment of Chinese and western integrative medicine has no obvious,major complications,and is a safe and reliable method,which is worth to be used and promoting.