Clinical Observation Of Jiawei Taohong Siwu Decoction Combined With Apixaban On Preventing DVT After TKA And Promoting The Recovery Of Knee Joint Function

Objective: By observing the clinical efficacy of Jiawei Taohong Siwu Decoction combined with Apixaban on preventing DVT after TKA and promoting the knee joint function recovery,assessing its safety and application value,so as to provide theoretical support and data reference for clinical use of traditional Chinese and western medicine on preventing DVT and promoting the recovery of knee joint function after TKA.Methods: From November 2019 to October 2020,60 elderly patients who were admitted to the Department of Joint Orthopedics of Shandong Provincial Hospital of Traditional Chinese Medicine and undergoing unilateral total knee arthroplasty for the first time were randomly divided into observation group A and control group Group B,30 patients in each group.Patients in group A were treated with Jiawei Taohong Siwu Decoction on the basis of routine anticoagulation of Apixaban after operation,and patients in group B were treated with anticoagulant regimen of Apixaban routinely after operation.Both groups of patients were routinely applied basic and physical preventive measures after surgery.To observe the difference in clinical efficacy between the two groups of patients,and to evaluate the effect of Jiawei Taohong Siwu Decoction combined with Apixaban on the prevention of deep vein thrombosis of the lower limbs and the promoting of knee joints functional recovery in patients undergoing unilateral total knee arthroplasty for the first time.Results: This clinical study started 1 day before the operation and ended1 week after surgery.There was no statistically significant difference in the basic data of the two groups(P>0.05).There was no significant difference between the two groups in the preoperative activated partial thromboplastin time,prothrombin time,plasma D-dimer,visual analog score,and calf circumference of the affected limb between the two groups of patients(P>0.05).There was no significant difference in the range of motion of the knee(P>0.05).On the first day after operation,the activated partial thromboplastin time and prothrombin time of the two groups were shorter than those before the operation(P<0.01),and the plasma D-dimer was significantly higher than that before the operation(P < 0.05).There was no significant difference between the two groups of patients in hematological examination indexes,knee mobility and calf circumference(P>0.05).On the 4th day after the operation,the activated partial thromboplastin time of the two groups was longer than that of the first day after the operation and the observation group was prolonged more significantly(P < 0.05);the prothrombin time of the two groups was prolonged to varying degrees compared with the preoperative and the first day after the operation(P<0.05);the plasma D-dimer of the two groups was significantly higher than that before the operation(P<0.05)but lower than that compared to the first day after the operation(P<0.05).There was no significant difference in the activated partial thromboplastin time and the plasma D-dimer between the two groups(P>0.05);there was a statistically significant difference in the prothrombin time between the two groups(P<0.05).On the 7th day after surgery,the activated partial thromboplastin time and the prothrombin time of the two groups were prolonged to varying degrees compared with preoperative,postoperative day 1 and postoperative day 4,and the difference was statistically significant(P<0.05);the plasma D-dimer level of the two groups was lower than the preoperative level on the first day and the fourth day after the operation,but still higher than the preoperative level,the difference was statistically significant(P<0.05).The difference between the two groups in terms of the activated partial thromboplastin time,the prothrombin time,the plasma D-dimer,the visual analogue score,the knee mobility and calf circumference of the surgical side was statistically significant(P<0.05).Conclusion: Jiawei Taohong Siwu Decoction combined with Apixaban can improve the blood hypercoagulability of patients after total knee arthroplasty and reduce the risk of deep vein thrombosis in the lower extremities by adjusting the plasma D-dimer level and prolonging the activated partial thromboplastin time and thromboplastin time.It can also improve the degree of postoperative limb swelling,reduce postoperative pain,and promote postoperative functional recovery of patients.It has good safety and effects and is worthy of clinical promotion.