目的 探讨丹参川芎嗪注射液联合利伐沙班治疗下肢深静脉血栓的临床效果。方法 选取2012年1月—2017年10月天津市泰达医院收治的下肢深静脉血栓患者87例，随机分成对照组（43例）和治疗组（44例）。对照组口服利伐沙班片，15 mg/次，2次/d。治疗组在对照组基础上静脉滴注丹参川芎嗪注射液，10 mL加入5%葡萄糖注射液250 mL，1次/d。两组均连续治疗21 d。观察两组患者临床疗效，同时比较治疗前后两组患者患肢症状评分、血栓大小、患肢周径、皮温、凝血生化指标和炎症标志物。结果 治疗后，对照组和治疗组临床有效率分别为76.7%和93.2%，两组比较差异具有统计学意义（P<0.05）。治疗后，两组患肢皮肤温度、皮肤色泽、肿胀、疼痛、通畅度评分均显著降低（P<0.05），且治疗组患肢症状评分明显低于对照组（P<0.05）。治疗后，两组血栓大小、患肢周径和皮温值均显著减小（P<0.05），且治疗组血栓大小、患肢周径和及皮温值明显小于对照组（P<0.05）。治疗后，两组血浆D-二聚体（D-D）和纤维蛋白原（FIB）水平均显著降低（P<0.05），血浆凝血酶原时间（PT）均显著延长（P<0.05），且治疗后治疗组凝血生化指标优于对照组（P<0.05）。治疗后，两组血清超敏C反应蛋白（hs-CRP）浓度显著下降（P<0.05），血清白细胞介素-10（IL-10）含量均显著升高（P<0.05），且治疗组炎症标志物水平优于对照组（P<0.05）。结论 丹参川芎嗪注射液联合利伐沙班治疗下肢深静脉血栓可明显减轻患者症状，改善凝血–纤溶系统，疗效显著，具有一定的临床推广应用价值。

Objective To investigate the clinical effect of Salviae Miltiorrhizae and Ligustrazine Hydrochloride Injection combined with rivaroxaban in treatment of deep vein thrombosis of lower extremities. Methods Patients (87 cases) with deep vein thrombosis of lower extremities in Tianjin TEDA Hospital from January 2012 to October 2017 were randomly divided into control (43 cases) and treatment (44 cases) groups. Patients in the control group were po administered with Rivaroxaban Tablets, 15 mg/time, twice daily. Patients in the treatment group were iv administered with Salviae Miltiorrhizae and Ligustrazine Hydrochloride Injection on the basis of the control group, 10 mL added into 5% glucose injection 250 mL, once daily. Patients in two groups were treated for 21 d. After treatment, the clinical efficacy was evaluated, and the limb symptom scores, thrombus size, peripheral diameter, skin temperature, coagulation biochemical indexes, and inflammatory markers in two groups before and after treatment were compared. Results After treatment, the clinical efficacy in the control and treatment groups was 76.7% and 93.2%, respectively, and there were differences between two groups (P<0.05). After treatment, the skin temperature, skin colour, swelling, pain and patency scores in two groups were significantly decreased (P<0.05), and the limb symptom scores in the treatment group were significantly lower than those in the control group (P<0.05). After treatment, the thrombus size, limb circumference, and skin temperature in two groups were significantly decreased (P<0.05), and these indexes in the treatment group were significantly lower than those in the control group (P<0.05). After treatment, the plasma D-D and FIB levels in two groups were significantly decreased (P<0.05), but plasma PT was significantly prolonged (P<0.05), and the coagulation biochemical indexes in the treatment group were significantly better than those in the control group (P<0.05). After treatment, the serum hs-CRP concentration in two groups was significantly decreased (P<0.05), but serum IL-10 content was significantly increased (P<0.05), and the inflammatory markers in the treatment group were significantly better than those in the control group (P<0.05). Conclusion Salviae Miltiorrhizae and Ligustrazine Hydrochloride Injection combined with rivaroxaban in treatment of deep vein thrombosis of lower extremities can obviously relieve symptoms, improve blood coagulation and fibrinolytic system, has distinct curative effect, which has a certain clinical application value.