Objective To investigate the effect of modified Taohong Siwu Decoction combined with nadroparin in preventing deep venous thrombosis (DVT) of the lower extremities after hip replacement.

Methods A total of 85 patients undergoing hip replacement were randomly divided into experimental group (n=43) and conventional group (n=42). The conventional group received nadroparin postoperatively, while the experimental group received modified Taohong Siwu Decoction combined with nadroparin. The incidence of DVT, positive rate of limb swelling, coagulation factors D-dimer (D-D), fibrinogen degradation products (FDP), plasmin-α2 plasmin inhibitor complex (PIC), thrombin-antithrombin III complex (TAT), platelet activation markers glycoprotein Ⅱb/Ⅲa (GP Ⅱb/Ⅲa), P-selectin (CD62P), granule membrane protein 140 (GMP-140), platelet glycoprotein fibrinogen receptor-1 (PAC-1), hemorheological indicators (plasma viscosity, low-shear whole blood viscosity, medium-shear whole blood viscosity, high-shear whole blood viscosity), and the occurrence of bleeding events were compared between the two groups before and after surgery.

Results The incidence of DVT and positive rate of affected limb swelling were lower in the experimental group than those in the conventional group(P < 0.05). Fourteen days after treatment, the plasma levels of D-D, FDP, TAT, PIC, GP Ⅱb/Ⅲa, CD62P, GMP-140, PAC-1, as well as high-shear whole blood viscosity, medium-shear whole blood viscosity, low-shear whole blood viscosity, and plasma viscosity were all lower in the experimental group than those in the conventional group (P < 0.05). No bleeding events occurred in either group during treatment.

Conclusion Modified Taohong Siwu Decoction combined with nadroparin can improve the thrombin and platelet status in patients after hip replacement, restore blood microcirculation, reduce the risk of DVT in the lower extremities, and alleviate swelling.