活血化瘀方联合纤溶酶治疗急性下肢深静脉血栓形成

姚佳春

(武警北京总队医院中医科，北京 100027)

摘要：目的观察活血化瘀方联合纤溶酶治疗急性下肢深静脉血栓形成(LEDVT)的临床疗效。方法患者共80名，纤溶酶处理组40例，联合治疗处理组40例。采用活血化瘀方联合纤溶酶治疗及单纯纤溶酶治疗。检测D-D二聚体，炎症细胞因子肿瘤坏死因子(TNF-α)、白介素(IL)-1、IL-6、内皮素(ET-1)的变化情况，观察临床治疗效果。结果联合治疗组的D-D二聚体含量下降速度更快，明显低于单纯纤溶酶处理组，差异有统计学意义(P<0．05)。纤溶酶组和联合治疗组中4种炎症因子含量之间比较差异有统计学意义(P<0．05)。但是在2组中4种炎症因子含量都较治疗前有所下降,而联合治疗组中炎症因子含量下降更为明显。纤溶酶组和联合治疗组的临床有效率都达到了90%以上，联合治疗组可以显著提高LEDVT的治愈率(治愈率由纤溶酶组的15%提高到22．5%,P<0．05)，临床显效率2组之间比较差异无统计学意义。而临床治疗无效率，联合治疗组显著低于纤溶酶组。总有效率联合治疗组也高于纤溶酶组(P<0．05)。结论活血化瘀方联合纤溶酶治疗急性LEDVT，临床效果比单纯应用纤溶酶治疗有显著改善，说明活血化瘀与西药的有机结合运用，辨病辨证相结合可以提高临床疗效。

关键词：下肢深静脉血栓形成；活血化瘀方；炎症细胞因子；中西医结合疗法

DOI:10.13463/j.cnki.jlzyy.2015.11.019

中图分类号：R364.1文献标志码： A

基金项目：北京市中医药科技项目(JJ2003-5)。

作者简介：姚佳春(1978-)，女，大学本科，主治医师，主要从事中医周围血管病方向研究。

收稿日期:(责任编辑：张晔2015-06-11)

Combined therapy of Huoxuehuayu recipe with fibrinolysis

enzyme on lower extremity deep venous thrombosis

YAO Jiachun

(Department of Traditional Chinese Medicine, The Armed Police General Hospital, Beijing 100027, China)

Abstract：ObjectiveTo study the effect of the combined therapy of Huoxuehuayu recipe with fibrinolysis enzyme in lower extremity deep venous thrombosis (LEDVT) patients. MethodsThe 80 LEDVT patients were randomized into two groups: the combined therapy group (huoxuehuayu recipe with fibrinolysis enzyme) (n=40) and fibrinolysis enzyme therapy group (n=40). The concentration of D-D dimer, TNF-α, IL-1, IL-6, ET-1 were examined. The clinical effect was also recorded. ResultsThe significant difference in the decrease rate of D-D dimer between the two groups indicated that the combined therapy was much better than the fibrinolysis enzyme therapy(P<0．05).Although the concentration of inflammatory factors was down-regulated in two groups, but the decrease rate of the combined therapy (90%) was much faster than the fibrinolysis enzyme therapy (P<0.05). Furthermore, the curing rate of combined therapy was higher than the fibrinolysis enzyme therapy (The curing rate of the combined therapy was 22.5%, but the curing rate of fibrinolysis enzyme therapy was 15%)(P<0.05). ConclusionCompared with the canonical fibrinolysis enzyme therapy, combined therapy could significantly decrease the concentration of inflammatory factors, can improve the clinical effective.

Keywords：lower extremity deep venous thrombosis; Huoxuehuayu recipe; inflammatory factors;combine traditional Chinese and Western medicine therapy

下肢深静脉血栓形成(LEDVT)是指血液在静脉腔内不正常地凝结，阻塞静脉管腔，导致静脉回流障碍的疾病，是常见的周围血管疾病之一，以下肢肿胀疼痛及浅静脉扩张为临床表现[1]。老年患者多由于行大手术后长期卧床所致。其急性期严重时可并发肺栓塞而导致猝死危及生命，后期也常出现一系列的后遗症，会严重影响患者的生活质量。随着我国老龄人口的增加，LEDVT的发病率呈上升趋势，因此如何有效预防及早期治疗LEDVT对提高老年患者生活质量具有重要意义。西医治疗LEDVT急性期多采用尿激酶溶栓、低分子肝素抗凝等药物。近年来发现，以中西医结合方法治疗LEDVT效果较好，逐渐受到临床医师的重视[2]。……