目的 观察脉络疏通丸联合那屈肝素钙注射液治疗下肢骨折术后深静脉血栓的临床疗效。方法 选取河南省人民医院2023年8月—2024年12月收治的下肢骨折术后深静脉血栓患者86例，采用随机数字表法将患者分为对照组和治疗组，各为43例。对照组皮下注射那屈肝素钙注射液，1 mg/kg，2次/d。治疗组在对照组的基础上温开水冲服脉络疏通丸，12 g/次，3次/d。两组患者均治疗7 d。对比两组临床疗效、疼痛程度、肿胀程度、临床指标、血液流变学指标和凝血功能指标。结果 治疗组的总有效率为97.67%，高于对照组的总有效率81.40%（P＜0.05）。治疗后，两组患肢疼痛视觉模拟（VAS）评分、肿胀程度评分下降（P＜0.05），且治疗组患肢VAS评分、肿胀程度评分低于对照组（P＜0.05）。治疗组患者的首次排气时间、下床活动时间、进食时间、住院时间短于对照组，伤口引流量少于对照组（P＜0.05）。治疗后，两组全血高切黏度、全血低切黏度、血浆黏度、红细胞比容下降（P＜0.05），且治疗组全血高切黏度、全血低切黏度、血浆黏度、红细胞比容低于对照组（P＜0.05）。治疗后，两组活化部分凝血活酶时间（APTT）、凝血酶原时间（PT）、D-二聚体（D-D）升高，纤维蛋白原（FIB）降低（P＜0.05），且治疗组APTT、PT、D-D高于对照组，FIB低于对照组（P＜0.05）。结论 脉络疏通丸联合那屈肝素钙注射液治疗下肢骨折术后深静脉血栓可减轻患肢肿胀程度和疼痛症状，促进患者术后恢复，改善血液流变学和凝血功能指标。

Objective To observe the clinical efficacy of Mailuo Shutong Pills combined with Nadroparin Calcium for injection in treatment of deep vein thrombosis after lower limb fracture surgery. Methods A total of 86 patients with deep venous thrombosis after lower limb fracture surgery admitted to Henan Provincial People’s Hospital from August 2023 to December 2024 were selected. The patients were divided into control group and treatment group using a random number table method, with 43 cases each group. The control group received sc Nadroparin Calcium for injection at 1 mg/kg, twice daily. The treatment group took Mailuo Shutong Pills orally with warm water based on the control group’s regimen, 12 g per dose, three times daily. Two groups were treated for 7 d. The clinical efficacy, pain level, swelling level, clinical indicators, hemorheological indicators, and coagulation function indicators were compared between two groups of patients. Results The total effective rate of the treatment group was 97.67%, which was higher than the control group’s total effective rate of 81.40% (P < 0.05). After treatment, the visual analogue scale (VAS) scores and swelling degree scores of the affected limbs in two groups decreased (P < 0.05), and the VAS scores and swelling degree scores of the affected limbs in the treatment group were lower than those in the control group (P < 0.05). The first exhaust time, bed activity time, eating time, and hospitalization time of patients in the treatment group were shorter than those in the control group, and the wound drainage volume was less than that in the control group (P < 0.05). After treatment, whole blood high shear viscosity, whole blood low shear viscosity, plasma viscosity, and hematocrit of two groups decreased (P < 0.05), and whole blood high shear viscosity, whole blood low shear viscosity, plasma viscosity, and hematocrit of the treatment group were lower than those of the control group (P < 0.05). After treatment, the activated partial thromboplastin time (APTT), prothrombin time (PT), and D-dimer (D-D) in two groups increased, while fibrinogen (FIB) decreased (P < 0.05). Moreover, APTT, PT, and D-D in the treatment group were higher than those in the control group, while FIB was lower than that in the control group (P < 0.05). Conclusion Mailuo Shutong Pills combined with Nadroparin Calcium for injection in treatment of deep vein thrombosis after lower limb fracture surgery can reduce the degree of swelling and pain symptoms of the affected limb, promote postoperative recovery, and improve blood rheology and coagulation function indicators.

R973

河南省医学科技攻关计划联合共建项目（LHGJ20240046）