Integrative therapy for lower limb venous thrombosis in patients with COPD: a trial of Rhodiola rosea polyglucoside and pulmonary rehabilitation as a synergistic combination.

BACKGROUND

This study aimed to evaluate the synergistic effect of salidroside and pulmonary rehabilitation in patients with chronic obstructive pulmonary disease (COPD) complicated by lower extremity deep vein thrombosis (LEDVT).

METHODS

Eighty-two patients with COPD and LEDVT were randomly assigned to a control group (n = 41; low-molecular-weight heparin calcium plus pulmonary rehabilitation) or a combined group (n = 41; pulmonary rehabilitation plus salidroside). Clinical efficacy, hemorheological parameters, and serum hypoxia-inducible factor-1α (HIF-1α) and vascular endothelial growth factor (VEGF) levels were compared.

RESULTS

The total effective rate was higher in the combined group (95.12 %) than in the control group (75.61 %; P = 0.045), with no difference in adverse event incidence (17.07 % vs 9.76 %; P = 0.331). After 14 days, the combined group showed greater improvement in swelling, pain, skin temperature, and Homans's sign (all P < 0.05). Hemorheological parameters improved more significantly, including plasma viscosity (0.70 ± 0.08 vs 1.25 ± 0.30 mPa s), high-shear viscosity (4.10 ± 0.22 vs 5.00 ± 0.45 mPa s), and low-shear viscosity (7.84 ± 0.20 vs 10.93 ± 0.43 mPa s; all P < 0.001). HIF-1α levels were lower and VEGF levels higher in the combined group (both P < 0.001).

CONCLUSION

Salidroside combined with pulmonary rehabilitation significantly improved clinical outcomes, oxygenation, and endothelial repair in COPD with LEDVT, likely via modulation of the HIF-1α/VEGF pathway, without increasing adverse effects.