益气活血法联合低分子肝素和尿激酶治疗脾切除术后门静脉系统血栓临床观察

目的观察益气活血法联合低分子肝素及尿激酶治疗脾切除术后门静脉系统血栓的疗效。方法将53例脾切除术后门静脉系统血栓患者随机分为治疗组(26例)和对照组(27例),对照组给予常规治疗及西药抗凝、溶栓治疗,治疗组除给予同对照组治疗方法外,还给予益气活血中药辨证加减治疗。观察两组治疗前后血小板(blood platelet,PLT)计数、凝血酶原时间(prothrombin time,PT)、国际标准化比率(international normalized ratio,INR)、活化部分凝血激酶时间(activated partial thromboplastin time,APTT)、D-二聚体水平以及两组临床疗效。结果与对照组比较,治疗组PT、INR、APTT差值差异均无统计学意义(P>0.05);治疗组在降低D-二聚体水平方面优于对照组(P<0.05);两组临床疗效比较,差异有统计学意义(P<0.05)。结论益气活血中药联合低分子肝素及尿激酶治疗脾切除术后门静脉系统血栓具有明显的作用和优势。

Clinical Effect of Qi-tonifying and Blood-activating Therapy Combined with Low-molecular-weight Heparin and Urokinase in Treatment of Portal Vein Thrombosis After Splenectomy

Objective To investigate the clinical effect of Qi-tonifying and blood-activating therapy combined with low-molecular-weight heparin and urokinase in the treatment of portal vein thrombosis after splenectomy.Methods A total of 53 patients were randomly divided into treatment group with 26 patients and control group with 27 patients.The patients in the control group were given routine treatment and anticoagulant and thrombolytic Western medicine treatment,and in addition to the treatment in the control group,those in the treatment group were given modified Qi-tonifying and blood-activating traditional Chinese medicine based on syndrome differentiation for portal vein thrombosis.Platelet count(PLT),prothrombin time(PT),international normalized ratio(INR),activated partial thromboplastin time(APTT),and D-dimer were observed before and after treatment,and clinical outcome was compared between the two groups.Results There were no significant differences in the changes in PT,INR,and APTT after treatment between the two groups(P>0.05).Compared with the control group,the treatment group had significantly better reduction in D-dimer(P<0.05).There was a significant difference in clinical outcome between the two groups(P<0.05).Conclusion Qi-tonifying and blood-activating traditional Chinese medicine combined with low-molecular-weight heparin and urokinase has marked clinical effect and advantages in the treatment of portal vein thrombosis after splenectomy.