| Objective: To evaluate the effect of modified Shentongzhuyu Decoction on the early blood hypercoagulability after thoracolumbar vertebral fracture operation.Method: From March 2018 to September 2019,60 patients with thoracolumbar(T10-L2)fracture diagnosed in the orthopedic department of the people's Hospital Affiliated to Fujian University of traditional Chinese medicine were randomly divided into experimental group and control group,30 in each group.The control group was given 14 days of functional exercise and physical basic treatment,while the experimental group was given 14 days of oral Shentongzhuyu Decoction on the basis of the same treatment as the control group.D-dimer(D-Dmer),fibrinogen(Fib),plasma prothrombin time(PT),activated partial thrombin time(APTT),thromboelastic diagram(R value,MA value,Angle value,CI value)and other indicators were monitored and recorded in the two groups of patients before surgery,1 day after surgery,7 days after surgery,and 14 days after surgery.The positive signs of venous thromboembolism were observed in the two groups,and the incidence of thrombus in the two groups was calculated and analyzed on the 14 th day after operation.The VAS pain score,the flow rate and the incidence of adverse events were recorded on the first day,the seventh day and the fourteenth day.Then,to evaluate the intervention effect of Shentongzhuyu Decoction on the early blood hypercoagulability after the operation of thoracolumbar fracture.Result: 1.There was no significant difference between the two groups in terms of sex,fracture type,age,Body Mass Index(BMI),operation time,intraoperative bleeding volume and other general conditions before operation,which was comparable(P > 0.05).2.D-Dimer and Fib values: the D-Dimer and Fib values of the patients in the two groups were lower on the 14 th day after operation and higher on the 1st day after operation(P < 0.05).The values of D-Dimer and Fib in the experimental group were lower than those in the control group on the7 th and 14 th day after operation,and there was statistical significance between the two groups(P < 0.05).3.PT and APTT: the PT value of the test group on the 14 th day after operation was higher than that on the 1st day after operation,and there was significant difference between the two groups(P < 0.05);there was no significant difference between the two groups(P >0.05).The APTT value of 14 days after operation in the two groups was higher than that of 1day after operation,and there was significant difference between the two groups(P < 0.05).On the 14 th day after operation,the PT value of the experimental group was higher than that of the control group,and there was statistical significance between the two groups(P < 0.05);the APTT value of the two groups had no statistical significance(P > 0.05).4.Thromboelastography: the R value of the patients in the two groups on the 14 th day after operation was higher than that before operation and on the 1st day after operation,with significant difference(P < 0.05);the MA value,angle value and CI value of the patients in the two groups on the 14 th day after operation were lower than those before operation and on the1 st day after operation,with significant difference in the comparison between the two groups.The R value,MA value and CI value of the patients in the experimental group were higher than those in the control group on the 7th and 14 th day after operation,and the Angle value was lower than that in the control group,which was statistically significant(P < 0.05).5.VAS pain score: the difference between the two groups was statistically significant(P < 0.05).The VAS pain score of the experimental group was lower than that of the control group on the 7thand 14 th day after operation,and there was statistical significance between the two groups(P< 0.05).6.Incidence of thrombus: there were no positive signs of VTE in the two groups.The incidence of thrombus was 7.41% in the control group and 3.45% in the control group,and there was no significant difference between the two groups(P > 0.05).7.Safety test: the vital signs and three routines of the two groups of patients were normal during the study period;there were no adverse or toxic reactions in the two groups of patients during the study period.Conclusion: The modified Shentongzhuyu decoction can effectively improve the early blood hypercoagulable state after thoracolumbar vertebral fracture operation,and then reduce the risk of venous thrombosis after thoracolumbar vertebral fracture operation;at the same time,it can reduce the postoperative pain symptoms of patients,which is worthy of clinical promotion. |
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