Study Of Modified Dangguishaoyao Decoction Combined With Small Dose Of Low Molecular Weight Heparin In The Prevention Of Lower Extremity Deep Venous Thrombosis After Total Knee Arthroplasty

Objective:This study was devoted to explore the clinical efficacy of Modified Dangguishaoyao Decoction combined with small dose of low molecular weight heparin in the prevention of deep venous thrombosis(DVT)after total knee arthroplasty(TKA)by designing a clinical controlled trial.We were bended our efforts for helping patients recover early and reducing the incidence of complications after TKA.In addition to these,we can provide a reference for bringing the superiority of Chinese medicine into full play.Methods:We selected 60 patients who met the inclusion criteria in total and divided 30 of them in the observation group and remainder in the control group by random number.After operation,the regular dose of low molecular weight heparin(Xifuquan 0.4ml:4250I.U)was used in the control group,and another group was cured by modified Dangguishaoyao decoction and small dose of low molecular weight heparin(Xifuquan 0.2ml:2125I.U).Statistical data was analyzed on coagulation indexes,hemoglobin,clinical symptoms and the incidence of lower extremity deep venous thrombosis after total knee arthroplasty during the treatment.Results:There was 59 patients finally completed this study,29 cases in the observation group and 30 cases in another.1.Basic data:Had no statistically significant differences in age,sex,weight,location and duration of disease between the two groups(P>0.05),The two groups has comparability.2.Laboratory examination:There was statistically comparability between D-D,Fib,PT,APTT and Hb before surgery of two groups(P>0.05).The D-D values of two groups increased on postoperative day 1,and the difference between the groups was not statistically significant(P>0.05),the D-D values of the observation group decreased slowly on postoperative day 4 and 7,and the values of the observation group were lower than those of the control group on postoperative day 7,and there had statistically difference between them(P<0.05);The Fib values and APTT values of two groups were not statistically significant(P>0.05)when compared between the groups at each point in time;On the first postoperative day,the PT value of the observation group was higher than that of the control group,on the4 th and 7th days,the PT value of the observation group was lower than that of the control group(P<0.05);There was no statistically significant difference in Hb values between the two groups before postoperative day 4(P>0.05),and the Hb values in the observation group on postoperative day 7 were higher than those in the control group,and the difference was statistically significant(P<0.05).3.Clinical observation:There was no significant difference in VAS and the circumference of lower legs between the two groups on postoperative day 2(P>0.05),and the lower legs circumference difference,VAS and subcutaneous ecchymosis in the observation group were lower than those in the control group on 7th postoperative days,and the difference was statistically significant(P<0.05);the difference of the incidence rate of DVT between the two groups was not statistically significant(P>0.05).Conclusion:The combination of Modified Dangguishaoyao Decoction and small dose of low molecular weight heparin has good outcome on preventing lower extremity DVT after TKA and reducing the D-D of patients on postoperative day 7,preventing the excess of PT,reducing the risk of bleeding,decreasing subcutaneous ecchymosis,and also reducing postoperative edema and pain and postoperative anaemia,which has high value of clinical application.