Objective To investigate the clinical efficacy of the combined therapy of promoting blood circulation and removing blood stasis and anisodamine hydrobromide in the treatment of sepsis-induced coagulopathy (SIC).

Methods A total of 102 SIC patients treated in our hospital from September 2021 to September 2024 were selected as study subjects.They were divided into control group (n=51) and experimental group (n=51) according to different treatment methods.The control group received conventional treatment, while the experimental group received an additional combined therapy of promoting blood circulation and removing blood stasis and anisodamine hydrobromide on the basis of the control group.Coagulation function and thrombotic risk were assessed in both groups before treatment and at 24, 48, and 72 h after treatment.Clinical efficacy and treatment safety were compared, and lactate clearance rate was measured before treatment and at 2, 6, and 24 h after treatment.

Results After treatment, the levels of thrombin time (TT), prothrombin time (PT), activated partial thromboplastin time (APTT), and D-dimer (D-D) decreased, while the platelet (PLT) count and fibrinogen (FIB) levels increased compared with treatment before, with all differences being statistically significant (P < 0.05).At 24 hours post-treatment, the TT, PT, and D-D levels in the experimental group were lower than those in the control group (P < 0.05), whereas no significant differences were observed in the remaining indicators (P>0.05).At 48 hours post-treatment, the TT, PT, APTT, and D-D levels in the experimental group were lower than those in the control group, while the PLT level was higher (P < 0.05).At 72 hours post-treatment, the TT, PT, and APTT levels in the experimental group were lower than those in the control group, whereas the PLT and FIB levels were higher (P < 0.05).The levels of the four new thrombotic indicators, namely thrombomodulin (TM), thrombin-antithrombin complex (TAT), plasmin-α2-antiplasmin complex (PIC), and tissue plasminogen activator-plasminogen activator inhibitor complex (t-PAIC), decreased with prolonged treatment duration in both groups, with differences in different time points being statistically significant (P < 0.05).At 24 hours post-treatment, the TM and TAT levels in the experimental group were lower than those in the control group, with both differences being statistically significant (P < 0.05).At 48 hours post-treatment, the TM, PIC, and t-PAIC levels in the experimental group were lower than those in the control group (P < 0.05).At 72 hours post-treatment, the levels of four indicators thrombosis in the experimental group were lower than those in the control group, but only the differences in TM and PIC levels were statistically significant (P < 0.05).The thromboelastography indicators, including R value, K value, and maximum amplitude (MA) decreased, while α angle increased with prolonged treatment duration in both groups (P < 0.05).At 24 and 48 hours post-treatment, the R value in the experimental group was lower than that in the control group, with both differences being statistically significant (P < 0.05).At 72 hours post-treatment, the R value, and MA in the experimental group were lower than those in the control group (P < 0.05).The Sequential Organ Failure Assessment (SOFA) score, SIC score, and Acute Physiology and Chronic Health Evaluation Ⅱ score decreased post-treatment in both groups compared with pretreatment levels, and were lower in the experimental group than in the control group (P < 0.05).The lactate clearance rate increased with prolonged treatment duration in both groups (P < 0.05).At 2, 6, and 24 hours post-treatment, the lactate clearance rate in the experimental group was higher than that in the control group (P < 0.05).The 28-day survival rate was 100.00% in the experimental group, which was higher than 92.16% in the control group (P < 0.05).

Conclusion The combined therapy of promoting blood circulation and removing blood stasis and anisodamine hydrobromide has good clinical efficacy in the treatment of SIC.It can improve patients'coagulation function, reduce thrombotic risk, and has high treatment safety.