益气活血方加减改善妇科恶性肿瘤患者高凝状态临床观察

目的 观察血府逐瘀汤合乌药散加减对妇科恶性肿瘤患者高凝状态的改善作用。方法 将60例妇科恶性肿瘤患者随机分为观察组和对照组，每组30例，观察组以血府逐瘀汤合乌药散加减治疗，对照组以低分子肝素及常规抗凝治疗。治疗前和治疗3周后，分别检测两组患者外周血小板计数（platelet, PLT），血浆纤维蛋白原（fibrinogen, FIB）、D-二聚体（D-Dimer，D-D）水平，并观察静脉血栓栓塞症（venous thromboembolism, VTE）积分、卡氏功能状态量表（Karnofsky’s performance scale，KPS）积分和中医证候积分。结果 两组综合疗效比较，差异无统计学意义（P>0.05）。与治疗前比较，两组治疗后D-D、FIB水平和血瘀证积分、VTE积分均显著降低（P<0.05），观察组治疗前后血瘀证积分差值显著大于对照组（P<0.05）。两组治疗后KPS变化比较，差异有统计学意义（P<0.05），观察组生活质量改善情况明显优于对照组。对照组有2例齿龈出血和2例大便带血，观察组未见不良反应。结论 血府逐瘀汤合乌药散可改善妇科肿瘤患者的高凝状态。

Clinical Effect of Modified Qi-tonifying and Blood-activating Prescription in Improving Hypercoagulability in Patients with Gynecological Malignancies

Objective To investigate the clinical effect of Xuefu Zhuyu Decoction combined with modified Wuyao Powder in improving hypercoagulability in patients with gynecological malignancies.Methods A total of 60 patients with gynecological malignancies were randomly divided into observation group and control group, with 30 patients in each group. The patients in the observation group were given Xuefu Zhuyu Decoction combined with modified Wuyao Powder, and those in the control group were given low molecular weight heparin and conventional anticoagulant treatment. Before treatment and after 3 weeks of treatment, platelet count (PLT), plasma fibrinogen (FIB) level, and D-Dimer (D-D) level were measured, and the venous thromboembolism (VTE) score, Karnofsky''s Performance Scale (KPS) score, and traditional Chinese medicine (TCM) syndrome score were observed.Results There was no significant difference in overall treatment outcome between the two groups(P>0.05).After treatment, both groups had significant reductions in the levels of D-D and FIB, blood stasis syndrome score, and VTE score (P<0.05), and the observation group had a significantly greater reduction in blood stasis syndrome score than the control group(P<0.05).There was a significant difference between the two groups in the change in KPS score after treatment(P<0.05),and the observation group had a significantly better improvement in quality of life than the control group. In the control group, two patients experienced gum bleeding and two experienced blood in stool, while no adverse events were observed in the observation group.Conclusion Xuefu Zhuyu Decoction combined with Wuyao Powder can improve hypercoagulability in patients with gynecological malignancies.