加味当归补血汤治疗人工全膝关节置换术后失血性贫血临床研究  

The clinical research of the Jiawei-Danggui-Buxue decoction for the patients with postoperative hemorrhage after

作　　者：鲁超[1] 殷继超 任敬[1] 路玉峰[1] 侯卫坤[1] 郝阳泉[1] 郭浩[1] 

机构地区：[1]西安交通大学医学部附属红会医院关节病院骨坏死与关节重建病区,710054 [2]西安市中医医院骨科,710021

出　　处：《国际中医中药杂志》2017年第2期121-123,共3页International Journal of Traditional Chinese Medicine

基　　金：陕西省社会发展科技攻关项目（2016SF-409）

摘　　要：目的评价加味当归补血汤治疗人工全膝关节置换术（total knee arthroplasty，TKA）后失血性贫血的疗效。方法将符合入选标准的TKA术后63例失血性贫血患者，按随机数表法分为研究组31例和对照组32例。全部患者均于术后第2天开始服药。对照组口服琥珀酸亚铁片，研究组口服加味当归补血汤。2组均治疗4周。采用血液分析仪常规检测血红蛋白（hemoglobin，Hb）及红细胞压积（hematocrit．Hct），观察术后中医证候积分变化，评价临床疗效。结果研究组证候疗效总有效率为93．5％（29／31）、对照组为83．9％（26／32），2组比较差异有统计学意义（Х^2=6．457，P=0．034）；研究组贫血疗效总有效率为90．3％（28／31）、对照组为75．0％（24／32），2组比较差异有统计学意义（Х^2=8．557，P=0．026）。术后第15天，研究组Hb水平[（116．67±11．44）g／L比（102．77±13．14）g／L，t=5．247]、Hct水平[（0．42±0．04）％比（0．39±0．03）％，t=4．1293及术后第29天，研究组Hb水平[（129．61±13．02）g／L比（113．35±15．46）g／L，t=6．2453、Hct水平[（0．45±0．03）％比（0．41±0．04）％，f=5．962]均高于对照组（P〈0．05）。结论加味当归补血汤可改善TKA术后失血性贫血的症状，提高临床疗效。Objective To evaluate the effect of Jiawei-Danggui-Buxue decoction in the treatment for the patients with hemorrhagic anemia after total knee arthroplasty （TKA）. Methods A total of 63 TKA patients with hemorrhagic anemia were included, and were divided into the treatment group （31 patients） and the control group （32 patients）. All patients started to take medicine the second day after surgery. The control group took the Ferrous Succinate Tablets and the treatment group took Jiawei-Danggui-Buxue decoction in the following 4 weeks. The Hb and Hct were detected,and the changes of TCM syndrome scores and the total effect rates of anemiawere observed. Results The total effect rate of TCM syndrome scores in the treatment group was 93.54%, which was significantly higher than control group 83.87% （P〈0.05）; The total effect rate of anemia in the treatment group was 90.32%, which is significantly higher than control＇group 75.00% （P〈0.05）. At the fifteenth day after operation,. And at the postoperative 29th day, the levels of Hemoglobin （129.61±13.02 g/L vs. 113.35± 15.46 g/L, t=-6.245） and Hematocrit （0.45% ± 0.03 % vs. 0.41% ± 0.04%, t=5.962） in the treatment group were significantly higher than those in the control group （P〈0.05）. Conclusions The Jiawei-Danggui-Buxue decoctionimprovethe Hb, HCT and the clinical effect rates of anemia and TCM syndromes for the patients with hemorrhagic anemia after TKA.

关 键 词：手术后出血 贫血 关节成形术 置换 膝 当归补血汤 琥珀酸亚铁片 

分 类 号：R274.9[医药卫生—中西医结合]