Clinical Study On Prevention Of Deep Venous Thrombosis Of Lower Limbs After Total Hip Replacement For Femoral Head Necrosis By Tongmai Yiqi Clearing Damp Prescription

Objective:By observing the clinical effect of the self-designed traditional Chinese medicine tongmayiqi clearing damp formula combined with low molecular weight heparin calcium to prevent the formation of deep venous thrombosis(DVT)of lower extremity after total hip replacement,the effectiveness and safety were evaluated,providing reference for the combined use of traditional Chinese and western medicine to prevent deep venous thrombosis after total hip replacementMethods:From January 2017 to January 2019,60 patients who were admitted to the department of orthopedics of the first affiliated hospital of guangxi university of traditional Chinese medicine due to necrosis of femoral head and underwent unilateral total hip replacement were selected and screened.The patients were randomly divided into experimental group and control group,with 30 cases in each group.Patients in both groups were treated by the same group of doctors.In the control group,low-molecular heparin calcium was used for preventive treatment;in the experimental group,tongmai yiqi clearing damp formula combined with low-molecular heparin calcium was used for prevention;other treatment measures showed no difference.The observation course of treatment was 10 days.D-dimer(d-dimer),FIB,VAS score,healthy and peri-diameter difference of affected side of thigh were detected respectively on the first and 11 th days after the operation of the 2 groups,and the situation of deep vein thrombosis and drug safety evaluation were evaluated by lower limb vascular color ultrasound after the operation,and the data were analyzed statistically.Results:(1)deep vein thrombosis: on the 11 th day after the operation,60 patients received color ultrasound examination of both lower limbs,and a total of 1 patient developed DVT,with an overall incidence of 1.67%.In the control group,no cases of DVT occurred in the experimental group.(2)comparison of d-dimer and FIB values on the first day after surgery showed no statistically significant difference(P > 0.05).D-dimer and FIB values were compared between groups on the 11 th day after the operation,and the difference was statistically significant(P < 0.05).The above results were compared within the two groups on the first and 11 th day after surgery,and the difference was statistically significant(P < 0.05).(3)there was no significant difference in the peri-diameter difference and VAS score between the two groups on the 1st day after surgery(P > 0.05),and there was significant difference between the two groups on the 11 th day after surgery(P < 0.05).(4)there was no statistically significant difference in adverse reactions between the two groups(P > 0.05).Conclusions:(1)Tongmai Yiqi Qushi Decoction combined with low molecular weight heparin calcium and low molecular weight heparin calcium alone can effectively prevent deep vein thrombosis after total hip replacement for femoral head necrosis.Chinese medicine intervention can better reduce the level of D-dimer and FIB and reduce the risk of DVT.(2)Chinese medicine intervention can better alleviate the symptoms of swelling and pain of affected limbs after hip replacement.(3)The intervention of traditional Chinese medicine does not increase the risk of drug use and has high safety.