The Clinical Curative Effect Of XIAO SAI TONG Cipher Prescription Combined With Low Molecular Weight Heparin Calcium In The Preventive Treatment Of Deep Vein Thrombosis After Lower Extremity Arthroplasty

Objective: To explore the clinical curative effect and safety of XIAO SAITONG cipher prescription combined with low molecular weight heparincalcium(LMWHC) in the preventive treatment of deep vein thrombosis afterlower extremity arthroplasty．Methods: The data was collected from June2012to March2013inHebei province Cang zhou cooperation of Chinese and Western medicinehospital,from the62senile orthopedics resident patients who received totalknee、hip arthroplasty.The62patients met the requirements were randomlydivided into treatment group and control group with random digits tablemethod.All the patients were operated by the same group doctor,with sameanesthesia approach and operation procedure.Contrast group simple with lowmolecular weight heparin calcium at the preventive treatment ofthrombosis,Control group with low molecular weight heparin calcium andXIAO SAI TONG cipher prescription at the preventive treatment ofthrombosis,both were total of seven days.The two groups examinedcoagulation functions(PT、APTT)、platelet aggregation、High-sensitivity C-reactive protein (hs CRP)、The lower extremity circumference five indexesat the1st post admission day、the3rd postoperative day、the7th postoperativeday to compare its prophylactic effect.And calculate two groups’ DVTincidence at the7th postoperative day,compare the preventive result;Throughincision drainage、 ostoperative hemorrhage(Incisions hematomas、Ecchymosis、Intracranial hemorrhage、Gastrointestinal tract hemorrhage)andtransfusions,to compared the two groups’ safety difference.SPSS13.0softwarepackage was used for statistical analysis. Results:1The analysis of Contrast group and Control group’s Preoperative generalsituationAge、Sex、Fat、Blood pressure、Blood sugar、Complications、Prosthesistypes、Blood rheology、Coagulation indexes、D-dimer、Platelet count、Hemoglobin count.The variance analysis wasn’t statistical significance(P＞0.05）.2The analysis of Contrast group and Control group’s DVT incidenceThe Contrast group’s DVT incidence was2.9%,Control group was11.1%,there was statistical significance（P＜0.05）.3The analysis of Contrast group and Control group’s blood rheology indexThe two groups’ blood rheology index in postoperative3rd day increasedsignificantly compared to Preoperative (High Blood viscosity、Middle Bloodviscosity、 Low Blood viscosity、 Plasma viscosity、 Erythrocyte rigidityindex),there was statistical significance(P<0.05);Contrast group bloodrheology index at7th postoperative day decreased apparently compared to the3rd postoperative day,there was statistical significance(P<0.05),also comparedto Control group (P<0.05).4The analysis of Contrast group and Control group’s platelet aggregationThe platelet aggregation at the3rd postoperative day both was improvedsignificantly compared to Preoperative; Contrast group’s blood flow index atthe7th postoperative day was decreased significantly compared to the3rdpostoperative day,there was statistical significance (P<0.05),there was notstatistical significance compared to Preoperative (P＞0.05).5The analysis of Contrast group and Control group’s postoperative High-sensitivity C-reactive proteinThe two groups’ High-sensitivity C-reactive protein was increasedsignificantly compared to Preoperative， there was statisticalsignificance(P<0.05)，The contrast group’s High-sensitivity C-reactiveprotein at the7th postoperative day was decreased significantly compared tothe3rd postoperative day,also compared to Control group(P＜0.05). 6The analysis of the lower extremity circumference analysisNot all of the thigh circumferences were same at three measurements(F=36.242,P=0.003),there was difference in circumference between the2groups totally (F=25.977,P=0.007); the circumference of treatment group was1ess than that of control group at the7th postoperative day through the furthercomparison(F=89.824,P=0.000);there was all interaction between the twomethods and time factor(F=25.616,P=0.000).Not all of the calf circumferenceswere same at three measurement (F=51.291,P=0.000);there was difference incircumference between the two groups totally (F=3.694,P=0.023),thecircumference of treatment group was less than that of control group at the3rd、7th postoperative day though the further comparison(F=45.560,P=0.000；F=87.734,P=0.000)；there was an interaction between the two methods andtime factor(F=45.305,P=0.000)．7The analysis of Contrast group and Control group’s postoperativecoagulation functionThere was no statistical difference in prothrombin time(PT)andactivated partial thromboplastin time(APTT)between the2groups at the3rdpostoperative day(t=1.480,P=0.147;t=0.821,P=0.417);The difference in PTand Am between the7th postoperative day value and the3rd postoperative dayvalue of the treatment group were all larger than those of the controlgroup(t=2.117,P=0.041;t=2.104,P=0.042)．8The Comparison of the two groups’ Blood transfusion amount、Incision drainageThere was no difference about the two groups difference in Bloodtransfusion amount and Incision drainage,there was not statisticalsignificance(P＞0.05).9The Comparison of the postoperative hematomas and ecchymosisadverse reactionThere was no statistical significance in comparison of hematomas andecchymosis adverse reaction between the2groups(P=0.534,P=0.624). 10The Comparison of Contrast group and Control group’s postoperativeadverse reactionThe two groups both were no such severe complications and obviousmedicine untoward reaction obvious as gastrointestinal bleeding、urinatingblood、black stool、intracranial hemorrhage.Conclusions:1Compared to apply simply low molecular weight heparin calcium inabdominal wall Subcutaneous injection, Oral XIAO SAI TONG cipherprescription combined with low molecular weight heparin calcium inabdominal wall Subcutaneous injection therapy could further decrease thepatients’ DVT incidence.2Oral XIAO SAI TONG cipher prescription combined with lowmolecular weight heparin calcium in abdominal wall Subcutaneous injectiontherapy could reduce faster the limb swelling after7days of joint replacement.3Oral XIAO SAI TONG cipher prescription combined with lowmolecular weight heparin calcium in abdominal wall Subcutaneous injectiontherapy could obviously prolong PT and APTT, decrease the plateletaggregation rate,decrease high agglutination、 high viscosity condition,increase Femoral vein blood flow velocity.4Oral XIAO SAI TONG cipher prescription combined with lowmolecular weight heparin calcium in abdominal wall Subcutaneous injectiontherapy is not increase postoperative hemorrhage obviously,not increase bloodtransfusion and other adverse reaction,The safety of Chinese and Westernmedicine is no worse than simple western medicine.5Compared to apply simply low molecular weight heparin calcium inabdominal wall Subcutaneous injection in DVT prevention, Chinese andWestern medicine had better effects.