消肿止痛合剂对膝关节置换术患者应激反应的影响  

The Influence of XiaoZhong ZhiTong Mixture on Stress Reaction of the Patients Undergoing Total Knee Arthroplasty

作　　者：尤从新[1,2] 柴喜平 李盛华[1,2] 柳海平 张锐[1,2] 贾潇 李爱强[1,2] 汪俊红 

机构地区：[1]甘肃省中医院,甘肃兰州730050 [2]甘肃陇中正骨医院

出　　处：《西部中医药》2017年第10期86-89,共4页Western Journal of Traditional Chinese Medicine

基　　金：2013年甘肃省科技计划资助(编号1308RJ ZA160)

摘　　要：目的:探究消肿止痛合剂配合曲马多对人工膝关节置换术后应激反应的影响。方法:选取60例在我院接受人工膝关节置换术的患者为研究对象,按随机法分为观察组和对照组,每组30例,对照组术后给予曲马多治疗,观察组术后给予消肿止痛剂配合曲马多治疗,治疗1周后,比较2组患者在术后第12小时、24小时、48小时、7天的VAS评分和膝关节HSS评分。采用酶联免疫吸附法(ELISA)分别测定2组患者术前、术后及术后1周、4周血清中白介素1(IL-1)、肿瘤坏死因子(TNF-α)及基质蛋白酶1(MMP-1)的水平含量。结果:观察组患者在术后第48小时和7天静息疼痛和活动时疼痛VAS评分明显低于对照组,同时观察组患者在术后第48小时和7天膝关节HSS评分明显高于对照组,差异均具有统计学意义(P<0.05)。观察组患者在术后1周和4周血清IL-1、TNF-α及MMP-1水平明显低于对照组,差异具有统计学意义(P<0.05)。观察组患者不良反应发生率明显低于对照组,差异具有统计学意义(P<0.05)。结论:消肿止痛合剂配合曲马多用于膝关节置换术后患者的镇痛和改善膝关节活动疗效显著,能降低患者血清中炎症因子IL-1和TNF-α及MMP-1的表达水平,其机制值得进一步研究。Objective：To explore the influence ofXiaoZhong ZhiTong mixture combined with tramadol on the patients after total knee arthroplasty （TKA）.Methods：Sixty patients who accepted TKA in our hospital were chosen as the objects of the study,and allocated to the observation group and the control group according to random method,30 cases in each group,the control group accepted tramadol after the operation,and the observation group took XiaoZhong ZhiTong mixture combined with tramadol after the operation,after treating for one week,VAS and HSS scales of the knee in both groups were compared in 12 hours,24 hours,48 hours and seven days after the operation.The contents ofMMP-1,TNF-α and IL-1 in the serum of the patients in both groups were detected by ELISA method before the surgery,after the surgery,in one week and four weeks after the surgery.Results：The observation group was lower than the control group in VAS scales when the patients rested and moved in seven days and 48 hours after the surgery,simultaneously higher than the control group in HSS scales of the knee in seven days and 48 hours after the surgery,and the difference had statistical meaning （P〈0.05）.The observation group was lower than the control group in the contents of MMP-1,TNF-α and IL-1 in one week and four weeks after the surgery,and the difference showed statistical meaning （P〈0.05）.The observation group was lower than the control group in the incidence of adverse reaction,and the difference had statistical meaning （P〈0.05）.Conclusion：XiaoZhong ZhiTong mixture combined with tramadol is applied to the analgesia of the patients after TKA,and effective in improve knee joint movement,decrease the contents of MMP-1,TNF-α and IL-1 in the serum of the patients,and its mechanism is worth further studying.

关 键 词：消肿止痛合剂 膝骨性关节炎 膝关节TKA 置换术 镇痛 

分 类 号：R681.8[医药卫生—骨科学]