摘要
目的观察针灸辅助治疗脊髓损伤后下肢静脉血栓的效果以及对患者凝血指标的影响。方法选取脊髓损伤患者86例,采用随机数表法将患者分为观察组(45例)和对照组(41例)。对照组给予低分子肝素加利伐沙班治疗;观察组在对照组基础上加温针灸治疗。对比治疗后临床效果,记录患者治疗前、治疗后活化部分凝血活酶时间(APTT)、凝血酶原时间(PT)、凝血酶时间(TT)、血清缺氧诱导因子1?(HIF-1?)、肿瘤坏死因子(TNF-?)、D-二聚体、血红蛋白、下肢静脉血流速度变化,比较患者满意率。结果观察组总有效率为95.6%,明显高于对照组的78.1%,两组比较差异有统计学意义(P<0.05);两组患者治疗前凝血功能指标APTT、PT、TT比较差异无统计学意义(P>0.05);两组患者治疗后凝血功能指标无明显变化,与治疗前比较差异无统计学意义(P>0.05)。两组患者治疗后HIF-1?、TNF-?表达水平均降低(P<0.05),观察组明显低于对照组(P<0.05);两组患者治疗后D-二聚体、血红蛋白水平均有降低(P<0.05),观察组明显低于对照组(P<0.05);两组患者治疗后下肢静脉血流均有提高(P<0.05),观察组明显高于对照组(P<0.05)。观察组满意率为91.1%,明显高于对照组的75.61%,差异具有统计学意义(P<0.05)。结论针灸辅助治疗脊髓损伤后下肢静脉血栓患者,可缓解患者临床症状,提高患者下肢静脉血流速度,对患者凝血功能无明显影响。
Objective To observe the efficacy of acupuncture-moxibustion as adjunct treatment in treating lower- extremity venous thrombosis after spinal cord injury and its effect on patient’s blood coagulation indicators. Method Eighty-six patients with spinal cord injury were divided into an observation group （45 cases） and a control group （41 cases） by using the random number table. The control group was intervened by low-molecule-weight heparin plus rivaroxaban tablets; the observation group was additionally given needle warming therapy. The clinical efficacies were compared. The activated partial thromboplastin time （APTT）, prothrombin time （PT）, thrombin time （TT）, serum hypoxia inducible factor （HIF）-1α, tumor necrosis factor （TNF）-α, D-dimer, hemoglobin and venous blood flow velocity in lower extremities were recorded before and after the treatment. The patient’s satisfaction rates were compared. Result The total effective rate was 95.6% in the observation group, higher than 78.1% in the control group, and the difference was statistically significant （P〈0.05）. There were no significant differences in the blood coagulation indicators including APTT, PT and TT between the two groups before the treatment （P〉0.05）; the blood coagulationindicators showed no significant changes after the treatment in the two groups （P〉0.05）. After the treatment, the levels of HIF-1α and TNF-α declined in both groups （P〈0.05） and the level in the observation group was significantly lower than that in the control group （P〈0.05）; the levels of D-dimer and hemoglobin dropped after the treatment in both groups （P〈0.05） and the level in the observation group was significantly lower than that in the control group （P〈0.05）. After the treatment, the venous blood flow velocities in lower extremities increased in the two groups （P〈0.05） and the value in the observation group was significantly higher than that in the control group （P〈0.05）. The satisfaction rate was 91.1% in the observation group, higher than 75.6% in the control group, and the difference was statistically significant （P〈0.05）. Conclusion Acupuncture-moxibustion as adjunct treatment can improve the symptoms and increase the lower-extremity venous blood flow velocity in treating lower-extremity venous thrombosis after spinal cord injury, but its effect on blood coagulation is insignificant.
作者
刘莹莹
朱靖
胡彩虹
LIU Ying-ying;ZHU Jing;HU Cai-hong(Taizhou Hospital,Enze Medical Group of Zhejiang Province,Linhai 317000,China)
出处
《上海针灸杂志》
2018年第10期1191-1196,共6页
Shanghai Journal of Acupuncture and Moxibustion
基金
浙江省恩泽医疗中心(集团)科学研究基金项目(15EZD22)
关键词
针灸疗法
脊髓损伤
血栓性静脉炎
下肢静脉血栓
血流速度
凝血功能
针药并用
Acupuncture-moxibustion therapy
Spinal cord injury
Thrombophlebitis
Lower-extremity venous thrombosis
Blood flow velocity
Coagulation function
Acupuncture medication combined
