广州中医药大学学报2026，Vol.43Issue(3)：637-643,7.DOI:10.13359/j.cnki.gzxbtcm.2026.03.013
柴黄活血汤联合利伐沙班防治髋关节置换术后下肢深静脉血栓形成的临床疗效观察
Clinical Efficacy of Chaihuang Huoxue Decoction Combined with Rivaroxaban in Preventing Lower Limb Deep Vein Thrombosis After Hip Replacement
摘要
Abstract
Objective To investigate the efficacy of Chaihuang Huoxue Decoction combined with rivaroxaban in preventing lower limb deep vein thrombosis(DVT)after hip replacement and to observe its effects on coagulation function and inflammatory cytokines of the patients.Methods A total of 82 patients who underwent hip replacement in the Department of Orthopedics,Fenyang Hospital,Shanxi Province from May 2022 to May 2024 were enrolled.The patients were randomly divided into a western medicine group and a combination group using a random number table,with 41 cases in each group.Both groups received hip replacement.Postoperatively,the western medicine group was treated with rivaroxaban,while the combination group received Chaihuang Huoxue Decoction combined with rivaroxaban.The treatment course for both groups was 2 weeks.Changes in lower limb circumference(including thigh and calf circumference),coagulation function indicators,vascular endothelial function indicators,and serum inflammatory factor levels were observed before and after treatment.The clinical efficacy and total incidence of adverse reactions were compared between the two groups.Results(1)In terms of efficacy,after 2 weeks of treatment,the total effective rate in the combination group was 87.80%(36/41),while that in the western medicine group was 68.29%(28/41).The intergroup comparison(by chi-square test)showed that the efficacy in the combination group was significantly superior to the western medicine group(P＜0.05).(2)Regarding lower limb circumference,after 7 days of treatment,both groups showed increased thigh and calf circumferences compared with those before treatment(P＜0.05).After 14 days of treatment,both groups showed decreased thigh and calf circumferences compared with those after 7 days(P＜0.05).Intergroup comparison revealed that the thigh and calf circumferences in the combination group after 7 and 14 days of treatment were significantly shorter than those in the western medicine group(P＜0.01).(3)In terms of coagulation function,after treatment,both groups showed prolonged prothrombin time(PT)and activated partial thromboplastin time(APTT)(P＜0.05)and decreased fibrinogen(FIB)levels(P＜0.05)compared with those before treatment.Moreover,the improvement in coagulation function indicators in the combination group was significantly greater than that in the western medicine group(P＜0.01).(4)Regarding vascular endothelial function,after treatment,both groups showed increased serum levels of nitric oxide(NO)and endothelial nitric oxide synthase(eNOS)compared with those before treatment(P＜0.05).The increase in serum NO and eNOS levels in the combination group was significantly greater than that in the western medicine group(P＜0.01).(5)In terms of inflammatory factors,after treatment,both groups showed decreased serum levels of procalcitonin(PCT)and interleukin-6(IL-6)compared with those before treatment(P＜0.05).The decrease in serum PCT and IL-6 levels in the combination group was significantly greater than that in the western medicine group(P＜0.01).(6)Regarding adverse reactions,the total incidence of adverse reactions during treatment was 7.32%(3/41)in the combination group and 19.51%(8/41)in the western medicine group,with no statistically significant difference between the two groups(P＞0.05).Conclusion The combined intervention of Chaihuang Huoxue Decoction and rivaroxaban in patients after hip replacement can effectively promote lower limb blood circulation,regulate coagulation function,reduce inflammatory response,and lower the risk of DVT.The treatment demonstrates favorable efficacy and high value of clinical application.关键词
髋关节置换术/下肢深静脉血栓/柴黄活血汤/利伐沙班/凝血功能/血管内皮功能/炎症因子Key words
hip replacement/lower limb deep vein thrombosis/Chaihuang Huoxue Decoction/rivaroxaban/coagulation function/vascular endothelial function/inflammatory factors分类
医药卫生引用本文复制引用
张志伟,张彬,魏健..柴黄活血汤联合利伐沙班防治髋关节置换术后下肢深静脉血栓形成的临床疗效观察[J].广州中医药大学学报,2026,43(3):637-643,7.基金项目
国家卫生健康委"十四五"规划全国重点课题资助项目(编号:WSJK41048) （编号:WSJK41048）
