Prevention of Deep Vein Thrombosis by Panax Notoginseng Saponins Combined with Low-Molecular-Weight Heparin in Surgical Patients

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

Prevention of Deep Vein Thrombosis by Panax Notoginseng Saponins Combined with Low-Molecular-Weight Heparin in Surgical Patients

Chin J Integr Med. 2022 Sep;28(9):771-778. doi: 10.1007/s11655-022-2894-3. Epub 2022 Jul 12.

Authors

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. wanghb_pucri@bjmu.edu.cn.

PMID: 35829956
DOI: 10.1007/s11655-022-2894-3

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 AxalU 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 (P=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, K, 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.

Keywords: deep vein thrombosis; low-molecular-weight heparin; panax notoginseng saponins; risk factor; thromboelastography.

MeSH terms

Anticoagulants / therapeutic use
Hemorrhage
Heparin, Low-Molecular-Weight / adverse effects
Heparin, Low-Molecular-Weight / therapeutic use
Humans
Panax notoginseng*
Prospective Studies
Saponins* / therapeutic use
Venous Thrombosis* / chemically induced
Venous Thrombosis* / drug therapy
Venous Thrombosis* / prevention & control

Substances

Anticoagulants
Heparin, Low-Molecular-Weight
Saponins