Clinical Study Of Low Molecular Weight Heparin Calcium Combined With Buyang Huanwu Decoction To Prevent DVT After Hip Fracture In The Elderly

Objective:To explore the clinical prevention and curative ef-fects and usage safety of low molecular weight heparin calcium combined with Buyang Huanwu Decoction for DVT caused by elderly hip fracture and evalu-ate its applied value,provide theoretical support and practical basis for the prevention of deep vein thrombosis in lower limb after the operation of hip fracture in the elderly with the integration of traditional Chinese and western medicine therapy.Methods:According to the inclusion criteria,60 cases of elderly hip fracture(including intertrochanteric fracture or femoral neck frac-ture)selected from the trauma department of orthopedics of Southwest Medi-cal University from January 2017 to January 2018 were randomly divided in-to control group and treatment group,30 for each.The control group was treated with low molecular weight heparin calcium,and the treatment group was treated with Buyang Huanwu Decoction additionally,with no differences between the two groups of the other treatment measures,7 days treatment for both groups.The VAS score,blood cell index(HGB,PLT),coagulation index(APTT,PT,D-dimer),inflammatory index(CRP),the difference of the cir-cumference of thigh,the incidence of DVT and postoperative leading flow in two groups of patients were observed and analyzed,evaluating the difference in the efficacy of two groups of treatment measures.The data were analyzed using SPSS statistics 17 statistical software,measurement data were presented by mean±standard deviation((?)X±S),meanwhile,the measurement data were compared using t test,count data were compared using?~2 test.The difference is statistically significant if P<0.05.Results:1.Compared with the first,fourth,seventh postoperative days in two groups,the difference of VAS score has sig-nificant statistical difference(P<0.01).Between the fourth postoperative days and the seventh postoperative days,VAS score have statistical signifi-cance(P<0.05).2.Compared with the first postoperation day with preoperation,the difference of the content of blood cell(HGB and PLT)has statistical sig-nificance(P<0.05).Compared with the first,fourth,seventh postoperative days of both groups,the difference has significant statistical significance(P<0.01).Compared with the seventh postoperative days,the content of blood cell(HGB and PLT)has statistical significance(P<0.05).3.Compared the first postoperation day with preoperation,the coagulation index(APTT?PT?D-dimer)of both groups have statistical significance(P<0.05).Compared with the first,fourth,seventh postoperative days ofboth groups,the difference has statistical significance(P<0.05).In addition,between the seventh postoperative days,APTT and PT havestatistical significance(P<0.05).Between the fourth postoperative days and the seventh postoperative days,D-dimer has statistical significance(P<0.05).4.Compared with the first,fourth,seventh postoperative days of both groups,the difference of inflammatory index(the levels of CRP)has significant statistical significance(P<0.01).Between the fourth postopera-tive days and the seventh postoperative days,it also has statistical signifi-cance(P<0.05).5.Compared with the treatment group and the control group in preoperation and the first,fourth,seventh postoperative days,the difference of thecircumferential of thigh has significant statistical difference(P<0.01).Compared with the seventh postoperative days,it also has significant statistical difference(P<0.01).6.There was no significant difference in the incidence of DVT in the two groups(P>0.05).7.There was significant difference in the postoperative leading flow of the two groups(P<0.01).Conclusion:The clin-ical observation results show that low molecular weight heparin calcium com-bined with Buyang Huanwu decoction can obviously prolong PT and APTT,reduce plasma D-dimer,inhibit the proliferation of platelet(PLT),can effec-tively improve postoperative blood level of high pour-point and high viscous and reduce the incidence of DVT after the hip fracture surgery in the elderly.And compared with the simple use of low molecular heparin weight calcium,combined with Buyang Huanwu Decoction can obviously promote the hemo-globin(HGB)recovery,reduce the postoperative leading flow,relieve pain and limb swelling after surgery significantly,and it has higher security as well.This study applies the idea of"syndrome differentiation"of traditional Chinese medicine to choose Buyang Huanwu Decoction to prevent DVT by using Yiqi Huoxue and Tongluo to relieve pain,reflects the traditional Chinese medicine characteristics of"no disease prevention first",it is worthy of clinical in-depth study and popularization.