三七总皂苷联合低分子肝素预防外科患者深静脉血栓形成

Chun-mei WANG; Xiang-feng GUO; Li-min LIU; Ying HUANG; Liang MENG; Li-po SONG; Ying-feng WU; Ya-chan NING; Kathleen H. Reilly; Hai-bo WANG

doi:10.1007/s11655-022-2894-3

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三七总皂苷联合低分子肝素预防外科患者深静脉血栓形成

Original Article | Updated：2022-09-08

- 三七总皂苷联合低分子肝素预防外科患者深静脉血栓形成
- Prevention of Deep Vein Thrombosis by Panax Notoginseng Saponins Combined with Low-Molecular-Weight Heparin in Surgical Patients
- Chinese Journal of Integrative Medicine 2022年28卷第9期页码：771-778
- Affiliations：
  
  1.Department of Vascular Surgery, Xuanwu Hospital, Capital Medical University, Beijing (100053), China
  2.Children's Hospital Capital Institute of Pediatrics, Beijing (100020), China
  3.Department of Orthopaedics, Xuanwu Hospital, Capital Medical University, Beijing (100053), China
  4.Centers for Disease Control and Prevention, New York City, NY (12237),USA
  5.Peking University Clinical Research Institute, Peking University First Hospital, Beijing (100191), China
- Author bio：
  
  Dr. WANG Hai-bo, E-mail: wanghb_pucri@bjmu.edu.cn
- Funds：
  
  Beijing Traditional Chinese Medicine Technology Development Fund Project(JJ2015-09);Beijing Municipal Administration of Hospitals Clinical Medicine Development of Special Funding Support(ZYLX201706)
- DOI：10.1007/s11655-022-2894-3
  中图分类号：
- 纸质出版日期：2022-09，
  
  网络出版日期：2022-07-12，
  
  录用日期：2021-10-29
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Chun-mei WANG, Xiang-feng GUO, Li-min LIU, 等. 三七总皂苷联合低分子肝素预防外科患者深静脉血栓形成[J]. Chinese Journal of Integrative Medicine, 2022,28(9):771-778.

Chun-mei WANG, Xiang-feng GUO, Li-min LIU, et al. Prevention of Deep Vein Thrombosis by Panax Notoginseng Saponins Combined with Low-Molecular-Weight Heparin in Surgical Patients[J]. Chinese Journal of Integrative Medicine, 2022,28(9):771-778.
Chun-mei WANG, Xiang-feng GUO, Li-min LIU, 等. 三七总皂苷联合低分子肝素预防外科患者深静脉血栓形成[J]. Chinese Journal of Integrative Medicine, 2022,28(9):771-778. DOI： 10.1007/s11655-022-2894-3.

Chun-mei WANG, Xiang-feng GUO, Li-min LIU, et al. Prevention of Deep Vein Thrombosis by Panax Notoginseng Saponins Combined with Low-Molecular-Weight Heparin in Surgical Patients[J]. Chinese Journal of Integrative Medicine, 2022,28(9):771-778. DOI： 10.1007/s11655-022-2894-3.

摘要

目的:

在外科住院患者

评估三七总皂苷 (panax notoginseng saponins

PNS) 联合低分子肝素 (low-molecular-weight heparin

LMWH) 预防深静脉血栓形成 (deep vein thrombosis

DVT) 真实世界疗效.

方法:

2016 年 1 月至 2018 年 11 月

在首都医科大学宣武医院外科住院患者行前瞻性队列研究. 参与者接受单独LMWH 或 PNS + LMWH 预防 DVT. 主要结果是下肢 DVT 的发生率. LMWH 组参与者通过皮下注射给予 LMWH

每天一次 4000-8000 AxaIU; PNS + LMWH组参与者给予PNS (血塞通片

100mg

每日3次) 联合LMWH

LMWH的给药方法与LMWH组相同.

结果:

在为研究筛选的 325 名患者中

281 名参与者被纳入最终分析. 该队列的 PNS + LMWH 组和 LMWH 组分别有 134 和 147 名参与者. 两组间 DVT 发生率有显着差异 (

=0.01)

PNS + LMWH 组发生 DVT 21 例 (15.7%)

LMWH 组发生 DVT 41 例 (27.9%) . 与没有 DVT 的参与者相比

诊断为 DVT 的参与者年龄更大

D-二聚体水平更高. 多变量逻辑回归模型显示

与 LMWH 组相比

PNS + LMWH 组参与者发生 DVT 的风险显着降低 (odds ratio 0.46

95% confidence interval

0.25-0.86) . 两组间血栓弹力图检测的R、K、Angle 和 MA值和严重出血事件无显着差异

研究期间未发生有症状的肺栓塞.

结论:

与LMWH单药治疗相比

PNS联合LMWH应用可有效降低外科住院患者DVT的发生率

且不增加出血风险.

Abstract

Objective:

To evaluate the efficacy of deep vein thrombosis (DVT) prevention among real-world surgical inpatients who received panax notoginseng saponins (PNS) combined with low-molecular-weight heparin (LMWH).

Methods:

A prospective cohort study was conducted among surgical patients between January 2016 and November 2018 in Xuanwu Hospital

Capital Medical University

Beijing

China. Participants received LMWH alone or PNS combined with LMWH for preventing DVT. The primary outcome was incidence of lower extremity DVT

which was screened once a week. Participants in the LMWH group were given LMWH (enoxaparin) via hypodermic injection

4000-8000 AxaIU once daily. Participants in the exposure group received PNS (Xuesaitong oral tablets

100 mg

3 times daily) combined with LMWH given the same as LMWH group.

Results:

Of the 325 patients screened for the study

281 participants were included in the final analysis. The cohort was divided into PNS + LMWH group and LMWH group with 134 and 147 participants

respectively. There was a significant difference of DVT incidence between two groups (

=0.01)

with 21 (15.7%) incident DVT in the PNS + LMWH group

and 41 (27.9%) incident DVT in the LMWH group. Compared with participants without DVT

the participants diagnosed with DVT were older and had higher D-dimer level. The multivariate logistic regression model showed a significant lower risk of incident DVT among participants in the PNS + LMWH group compared with the LMWH group (odds ratio 0.46

95% confidence interval

0.25-0.86). There were no significant differences in thromboelaslography values (including R

Angle

and MA) and differences in severe bleeding between two groups. No symptomatic pulmonary embolism occurred during the study.

Conclusion:

Combined application of PNS and LMWH can effectively reduce the incidence of DVT among surgical inpatients compared with LMWH monotherapy

without increased risk of bleeding.

关键词

三七总皂苷深静脉血栓形成低分子肝素血栓弹力图危险因素

Keywords

panax notoginseng saponinsdeep vein thrombosislow-molecular-weight heparinthromboelastographyrisk factor

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