Regularity Of Recipe Composition Of Fang Shuan Fang And The Clinical Study On Prevention Of Deep Venous Thrombosis Of Lower Extremity After Gynecological Pelvic Surgery With Refined Prescription Of Fang Shuan Fang

Objective:The Fang shuan fang were divided into groups by orthogonal experimental design.Study the clinic effects of Fang shuan fang splitting group in prevention the occurrence of leg deep vein thrombosis(LDVT)after the operation of gynaecology pelvic surgery and selected its main ingredients and got a slimmer side for prevention of thrombosis.To explore the therapeutic effect of the redevelopment of antithrombotic prescription and the possible mechanism of action on LDVT.Methods:According to the orthogonal design table of L12(211),Fang Shuan fang was divided into 12 groups.Low molecular weight heparin group was set as control group.From March 2019 to December 2020 in the department of Obstetrics and Gynecology of Affiliated Hospital of Traditional Chinese Medicine of Southwest Medical university,patients with high risk factors for the occurrence of lower extremity deep venous thrombosis who would have a gynecological pelvic surgery were selected as the study groups.Patients were randomly assigned according to a random number table.The patients in each of the Fang shuan fang splitting group were given the corresponding dose of the Chinese medicine decoction after 24 hours after surgery,for three times a day,one packet each time.Then we determine related indicators within 24 hours after surgery,72 hours and 120 hours after surgery.We observed the curative effect of Fang shuan fang splitting group in prevention the occurrence after gynecological pelvic surgery,so that screen out the bolt side of smaller parties.Results:Comparison of Fang shuan fang group and low molecular weight heparin calcium group,there were no significant changesin PT and APTT levels between the two groups(P>0.05).The coagulation parameters(FIB,D-dimer,FDP)in 2 groups were increased 24 h after surgery(P<0.05),and compared with 24 h after surgery,they decreased at 72 h and 120 h after surgery(P<0.05).Comparison between groups showed that the D-dimer in the LMWHC group at 120 h after surgery was significantly lower than that in the Fang shuan fang group(P<0.05),and the FDP in the LMWHC group at 72 h and120h after surgery was lower than that in the Fang shuan fang group,with statistical significance(P<0.05).The hemorheology parameters(high whole blood viscosity and red blood cell aggregation index of 200 plasma viscosity)of 2 groups were increased 24 h after surgery(P<0.05),and decreased 72 h and120h after surgery compared with 24 h after surgery(P<0.05).Comparison between groups showed that the erythrocyte aggregation index of the LMWH group at 72 h and 120 h after surgery was lower than that of the whole antithrombotic prescription group,with statistical significance(P<0.05).(2)The orthogonal test results:The decomposed recipe which contains Dangshen,fruit of immature citron and wine-treated rhubarb decreased PT,while the decomposed recipe which contains radix paeoniae alba,niu xi,peach kernel and Safflower prolonged PT(P<0.05).The decoction containing Dangshen,fruit of immature citron and rhubarb decreased the APTT,while the decoction containing Angelica,Safflower and niu xi prolonged APTT(P<0.05).The decoction containing Dangshen and fruit of immature citron increased the FIB,while the decoction containing Dangshen,Angelica and Flower decreased the FIB(P<0.05).The decoction containing astragalus,Dangshen,fruit of immature citron and rhubarb increased the D-dimer,while the decoction containing salvia miltiorrhiza,safflower,Chuanxiong and Niu xi decreased the D-dimer value(P<0.05).The decoction containing astragalus,Dangshen,fruit of immature citron and rhubarb increased the serum FDP value,while the decoction containing Salviae miltiorrhiza,Angelica,peach kernel,safflower,Chuanxiong decreased the serum FDP value(P<0.05).The PLT value was increased in the decoction containing astragalus,Dangshen,fruit of immature citron and rhubarb,while PLT value was decreased in the decoction containing Salviae miltiorrhiza,Angelica,peach kernel,safflower,Chuanxiong and niu xi(P<0.05).The decoction containing fruit of immature citron and rhubarb increased the high cut value of whole blood viscosity,while the decoction containing salvia miltiorrhiza and radix paeoniae alba and chuanxiong decreased the high cut value of whole blood viscosity(P<0.05).The decoction containing astragalus,Dangshen,fruit of immature citron and rhubarb increased the plasma viscosity value,while the decoction containing Salvia miltiorrhiza,Angelica,safflower,Chuanxiong and niu xi decreased the plasma viscosity value(P<0.05).The decoction containing Dangshen,fruit of immature citron and rhubarb increased RBC aggregation index,and the decoction containing Salvia miltiorrhiza,radix paeoniae alba,Angelica,Peach kernel,Chuanxiong and niu xi had a significant effect on reducing RBC aggregation index(P<0.05).(3)There was no statistical significance in the incidence of postoperative venous thrombosis among all groups(P>0.05).Conclusion:(1)After gynecological surgery,the systemic blood was hypercoagulable and hyperviscous.Fang shuan fang can regulate fibrinolysis system,reduce plasma viscosity,improve erythrocyte aggregation and play a role in preventing LDVT after gynecological pelvic surgery by improving blood coagulation and high viscosity.Low molecular weight heparin calcium has a better effect in improving postoperative hypercoagulability,regulating fibrinolytic system activity and reducing erythrocyte aggregation than the Fang shuan fang group.However,Chinese medicine decoction is economical,convenient and non-invasive,which is more acceptable to patients.(2)Fang shuan fang and low molecular weight heparin calcium are safe and effective in the prevention of postoperative LDVT,which can be popularized in clinical practice.(3)The main ingredients with preventing thrombosis were salvia miltiorrhiza,radix paeoniae alba,niu xi,safflower,angelica,peach kernel,and chuanxiong.