Clinical Observation Of Taohong Siwu Decoction Combined With Low Molecular Weight Heparin Calcium In Prevention Of Lower Extremity Deep Venous Thrombosis After Knee Arthroplasty

Objective: To observe the preventive effect and safety of Taohong Siwu Decoction combined with low molecular weight heparin calcium on lower limb deep venous thrombosis after knee arthroplasty,and to explore the application value and effectiveness of Taohong Siwu Decoction in preventing DVT of lower limbs after knee arthroplasty,so as to provide more therapeutic options for clinicians in preventing deep venous thrombosis of lower limbs after knee arthroplasty.Methods: According to the criteria of case selection,60 patients with knee osteoarthritis aged 65-80 years who were admitted to the orthopaedic ward of Rui Kang Hospital Affiliated to Guangxi University of Traditional Chinese Medicine from November 2017 to December 2019 were randomly divided into control group and treatment group,30 cases in each group according to the order of admission.After operation,the control group was treated with low molecular weight heparin calcium alone,while the treatment group was treated with Taohong Siwu Decoction combined with Taohong Siwu Decoction.The other prevention and treatment schemes of the two groups were basically the same,and the course of treatment was 7 days.The changes of blood cell parameters(HGB,PLT),coagulation parameters(APTT,PT,D-II aggregates),VAS pain score,DVT incidence of lower limbs and postoperative drainage volume were observed at different time before operation and 1,4 and 7 days after operation.The efficacy of the two preventive measures was evaluated by comparing the differences of each index at different time between the two groups.Results: 1.There was significant difference in blood cell index(HGB,PLT)between the two groups on the first day after operation and before operation(P < 0.05).There was significant difference in blood cell index(HGB,PLT)between the two groups on the fourth and seventh day after operation(P < 0.05).There was no significant difference in blood cell index(HGB,PLT)between the two groups on the first and fourth day after operation(P > 0.05).On the 7th day after operation,the difference between the two groups was statistically significant(P < 0.05).It shows that the effect of treatment group on blood cell index is better than that of control group.2.The coagulation indexes(APTT,PT,D-dimer)of the two groups were compared on the first day after operation with those before operation,the difference was statistically significant(P<0.05).The coagulation indexes(APTT,PT,D-dimer)of the four and seven days after operation were significantly different from those of the first day after operation(P<0.05).The coagulation indexes(APTT,PT,D-dimer)of the two groups were compared before and on the first and fourth days after operation,and there was no statistical difference.Significance(P > 0.05),7 days after operation,the difference between the two groups was statistically significant(P < 0.05).It shows that the effect of treatment group on coagulation index is better than that of control group.3.The VAS pain scores of the two groups on the 4th day after operation were significantly different(P < 0.05),indicating that the pain relief of the treatment group was better than that of the control group.4.There was no significant difference in the incidence of DVT between the two groups(P > 0.05).It shows that the incidence of DVT in the treatment group is similar to that in the control group.5.There was significant difference in drainage volume between the two groups(P < 0.05).It shows that the drainage volume in the treatment group is lower than that in the control group.Conclusion: The results of this study show that the combination of low molecular weight heparin calcium and Taohong Siwu decoction can not only improve blood viscosity,stabilize blood internal environment and reduce the risk of DVT in lower limbs by prolonging prothrombin time,inhibiting platelet aggregation and reducing plasma D-dimer concentration after knee arthroplasty,but also play an effective role in reinforcing blood circulation.To restore blood volume,reduce hemorrhage,improve anemia after operation and relieve pain of patients,its safety and effectiveness are higher than that of low molecular weight heparin alone,which is worthy of further clinical research and application.