2025 年第 7 期 第 20 卷

桃红四物汤预防全膝关节置换术后深静脉血栓形成的临床研究

Clinical study of Taohong Siwu decoction in the prevention of deep vein thrombosis after total knee arthroplasty

作者：萧炜亮王晓东招志辉龚芬郭友周忠信

英文作者：Xiao Weiliang Wang Xiaodong Zhao Zhihui Gong Fen Guo You Zhou Zhongxin

单位：广州中医药大学第一附属医院介入血管外科，广州510000

英文单位：Department of Interventional Vascular Surgery the First Affiliated Hospital of Guangzhou University of Chinese Medicine Guangzhou 510000 China

关键词：全膝关节置换术；糖萼损伤标志物；桃红四物汤；深静脉血栓

英文关键词：Totalkneearthroplasty;Glycocalyxdamagemarkers;TaohongSiwudecotion;Deepveinthrombosis

• 摘要：

• 目的 探讨桃红四物汤对全膝关节置换术后深静脉血栓形成的预防作用。方法 选取2022年3月至2023年8月广州中医药大学第一附属医院收治的拟行全膝关节置换术的膝关节骨性关节炎患者120例，采用随机数字表法分为对照组和观察组，各60例。对照组行全膝关节置换术治疗，观察组在对照组基础上联合桃红四物汤治疗。比较2组症状评分、糖萼损伤标志物、炎性因子、凝血指标水平以及深静脉血栓发生率。结果 2组术后舌苔及脉象、患肢疼痛、肤色、肤温评分均低于术前，且观察组均低于对照组（均P＜0.05）。2组术后髌骨上、下10 cm腿围均小于术前，且观察组均小于对照组（均P＜0.05）。2组术后多配体聚糖1、硫酸肝素、透明质酸水平均低于术前，且观察组均低于对照组（均P＜0.05）。2组术后肿瘤坏死因子α、白细胞介素6水平均低于术前，且观察组均低于对照组，2组活化部分凝血活酶时间均长于术前，且观察组长于对照组（均P＜0.05）。观察组深静脉血栓发生率为3.3%（2/60），对照组深静脉血栓发生率为13.3%（8/60），组间比较差异有统计学意义（χ2=3.927，P=0.048）。结论 针对全膝关节置换术患者给予桃红四物汤治疗，对改善患者糖萼损伤标志物，缓解机体炎症反应作用显著，患者术后下肢深静脉血栓的发生率得到有效控制。

• Objective  To investigate the preventive effect of Taohong Siwu decoction on deep vein thrombosis after total knee arthroplasty. MethodA total of 120 patients with knee osteoarthritis who underwent total knee arthroplasty in the First Affiliated Hospital of Guangzhou University of Chinese Medicine from March 2022 to August 2023 were selected. According to the random number table method, they were divided into the control group and the observation group, with 60 cases in each group. The control group was treated with total knee replacement, and the observation group was treated with Taohong Siwu decoction on the basis of the control group. The symptom scores, glycocalyx damage markers, inflammatory factors, coagulation index and the incidence of deep vein thrombosis were compared between the two groups.Results The scores of tongue coating and pulse, pain of affected limbs, skin color and skin temperature after operation in the two groups were lower than those before operation, and those in the observation group were lower than those in the control group (all P<0.05). The leg circumferences of upper and lower 10 cm of patella in the two groups after operation were smaller than those before operation, and those in the observation group were smaller than those in the control group (all P<0.05). The levels of syndecan 1, heparin sulfate, and hyaluronic acid after operation in the two groups were lower than those before operation, and those in the observation group were lower than those in the control group (all P<0.05). The levels of tumor necrosis factor-α and interleukin-6 in the two groups after operation were lower than those before operation, and those in the observation group were lower than those in the control group. The activated partial thromboplastin times in the two groups were longer than those before operation, and that in the observation group was longer than that in the control group (all P<0.05). The incidence of deep vein thrombosis was 3.3%(2/60) in the observation group and 13.3% (8/60) in the control group, and the difference between the groups was statistically significant (χ2=3.927, P=0.048). Conclusion Taohong Siwu decoction for patients with total knee arthroplasty has a significant effect on improving the glycocalyx damage markers and alleviating the inflammatory response of the body, and the incidence of postoperative deep vein thrombosis of the lower extremities is effectively controlled.