鳖甲煎丸联合低分子肝素钙治疗恶性肿瘤并发下肢深静脉血栓临床研究
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R543.6

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温州市科学技术局基础性医疗卫生科技项目(Y2020872)


Clinical Study on Biejia Decocted Pills Combined with Low Molecular Weight Heparin Calcium for Malignant Tumors Complicated with Deep Venous Thrombosis of Lower Extremities
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    摘要:

    目的:观察鳖甲煎丸联合低分子肝素钙治疗恶性肿瘤并发下肢深静脉血栓的临床疗效。方法:采 用随机数字表法将63 例恶性肿瘤并发下肢深静脉血栓患者分为试验组(31 例) 与对照组(32 例)。2 组均采 用常规抗肿瘤治疗,在此基础上,对照组给予皮下注射低分子肝素钙治疗,试验组在对照组基础上加服鳖甲煎 丸治疗。比较2 组治疗前后中医证候评分、凝血功能指标[活化部分凝血活酶时间(APTT)、凝血酶原时 间(PT)、国际标准化比值(INR)、D-二聚体(D-D)、血小板计数(BPC)]、血液流变学指标(全血高切黏 度、全血中切黏度、全血低切黏度、血浆黏度)、炎症因子[肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)]、 患肢腿围,并评估2 组临床疗效及不良反应发生情况。结果:试验组脱落1 例,纳入研究30 例;对照组脱落 2 例,纳入研究30 例。试验组总有效率93.33%,高于对照组66.67% (P<0.05)。治疗后,2 组APTT、PT、 INR 均高于治疗前(P<0.05),D-D、BPC 均低于治疗前(P<0.05);试验组治疗后APTT、PT、INR 均高于 对照组(P<0.05),D-D、BPC 均低于对照组(P<0.05)。治疗后,2 组中医证候评分、全血高切黏度、全血 低切黏度、全血中切黏度、血浆黏度、TNF-α、IL-6 水平均低于治疗前(P<0.05),试验组治疗后中医证候评 分、血液流变学指标、炎症因子水平均低于对照组(P<0.05)。治疗后,2 组患肢髌骨上15 cm、髌骨下 10 cm 处腿围均较治疗前缩短(P<0.05),且试验组治疗后患肢腿围短于对照组(P<0.05)。2 组均未出现不 良反应。结论:鳖甲煎丸联合低分子肝素钙治疗恶性肿瘤并发下肢深静脉血栓疗效确切,能有效改善患者凝血 功能、血液流变学指标,降低炎症因子水平,减轻患肢肿胀程度,安全性较高。

    Abstract:

    Abstract: Objective: To observe the clinical effect of the therapy of Biejia Decocted Pills combined with low molecular weight heparin calcium on malignant tumors deep venous thrombosis of lower extremities. Methods: A total of 63 patients with malignant tumors deep venous thrombosis of lower extremities were divided into the trial group (31 cases) and the control group (32 cases) according to the random number table method. The two groups were treated with routine antineoplastic therapy,based on which the control group was given subcutaneous injection with low molecular weight heparin calcium, and the trial group was additionally treated with Biejia Decocted Pills based on the treatment of the control group. Before and after treatment, the traditional Chinese medicine (TCM) syndrome scores, coagulation function indexes,including activated partial thromboplastin time (APTT),prothrombin time (PT), international normalized ratio (INR),D-dimer (D-D) and blood platelet count (BPC),indexes of hemorheology, including whole blood high shear viscosity,whole blood medium shear viscosity,whole blood low shear viscosity and plasma viscosity, inflammatory factors, including tumor necrosis factor- α (TNF- α) and interleukin- 6 (IL- 6) and the thigh of affected limb were compared between the two groups; the clinical effects and incidence of adverse reactions in the two groups were evaluated. Results:With 1 case in the trial group and 2 cases in the control group being dropped out , finally 30 cases in the trial group and 30 cases in the control group were included into the study. The total effective rate was 93.33% in the trial group,higher than that of 66.67% in the control group (P<0.05). After treatment,the APTT,PT and INR in the two groups were higher than those before treatment (P<0.05),and the D- D and BPC were lower than those before treatment (P<0.05);the APTT,PT and INR in the trial group were higher than those in the control group (P<0.05),and the D- D and BPC were lower than those in the control group (P<0.05). After treatment, the TCM syndrome scores, whole blood high shear viscosity, whole blood medium shear viscosity,whole blood low shear viscosity and plasma viscosity,and the levels of TNF-α and IL-6 in both groups were lower than those before treatment (P<0.05),and the TCM syndrome scores,indexes of hemorheology and levels of inflammatory factors in the trial group were lower than those in the control group (P<0.05). After treatment,the thighs at 15 cm above and 10 cm below the patella of affected limb in the two groups were shortened when compared with that before treatment (P<0.05), and the thigh of affected limb in the trial group was shorter than that in the control group (P<0.05). There was no adverse reaction in the two groups. Conclusion:The therapy of Biejia Decocted Pills combined with low molecular weight heparin calcium has a definite curative effect on malignant tumors deep venous thrombosis of lower extremities, which can effectively improve the coagulation function and indexes of hemorheology, decrease the levels of inflammatory factors and reduce the swelling degree of the affected limb with good safety.

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陈后良,鲁佩佩,陶玉,李琼瑶.鳖甲煎丸联合低分子肝素钙治疗恶性肿瘤并发下肢深静脉血栓临床研究[J].新中医,2023,55(17):151-156

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  • 在线发布日期: 2023-09-07
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