中医手法治疗膝关节置换术后疼痛疗效观察  

Clinical Observation of Chinese Medical Manipulation for Postoperative Pain after Knee Joint Replacement

作　　者：麦秀钧[1] 黄永明[1] 冯恩辉 MAI Xiujun;HUANG Yongming;FENG Enhui

机构地区：[1]广东省中医院,广东广州510006

出　　处：《新中医》2018年第10期187-189,共3页New Chinese Medicine

摘　　要：目的:观察中医手法治疗膝关节置换术后膝关节疼痛的疗效。方法:纳入46例膝关节置换术后疼痛患者,纳入病例均在术后第3周、第4周时患者出现疼痛加重,应用中医理筋手法进行治疗,第1周、第2周、第3周、第4周、第5周、第6周采用视觉模拟评分法(VAS)进行疼痛评分,采用膝关节评分(HSS)评估膝关节术后功能情况,通过膝关节活动度(ROM)评估关节活动情况。结果:与术后第1周比较,术后第2周VAS评分下降,HSS评分及ROM升高,差异有统计学意义(P <0.05)。术后第2周与术后第3周比较,VAS评分升高,差异有统计学意义(P <0.05);HSS评分及ROM均有下降,差异有统计学意义(P <0.05)。与术后第3周比较,术后第4周的VAS、HSS、ROM均较前改善(P <0.05)。术后第5周VAS、HSS、ROM与术后第4周比较,差异有统计学意义(P <0.05)。术后第6周,VAS、HSS较术后第5周改善(P <0.05),但ROM与术后第5周比较,差异无统计学意义(P> 0.05)。结论:膝关节置换术后在短期内有出现疼痛波动及加重的情况,通过中医理筋手法松解治疗可以有效缓解,有利于术后康复,值得在临床推广应用。Objective： To observe the curative effect of Chinese medicine manipulation for knee joint pain after knee joint replacement. Methods： Included 46 patients with postoperative pain after knee joint replacement. The pain of the included patients developed at the third and fourth week after operation, and they were treated with Chinese medicine tendon-regulation manipulation.Applied visual analogue scale（VAS） to evaluate the pain at the 1 st,2 nd,3 rd,4 th,5 th and 6 th week;knee joint scores（Hospital for special surgery,HSS）,the postoperative knee function;and range of motion（ROM） of knee joint,the joint activity. Results：Compared with the first week after operation,the VAS score of the second week after operation was decreased,while the HSS scores and ROM were increased,difference being significant（P〈0.05）. Compared the second week with the third week after operation,the VAS score was increased,difference being significant（P〈0.05）;the HSS scores and ROM of the fourth week after operation were both decreased,difference being significant（P〈0.05）. Compared with the third week after operation,the VAS,HSS and ROM of the fourth week after operation were all improved（P〈0.05）. There were significant differences being found in the comparisons of VAS, HSS and ROM between the fourth week after operation and the fifth week after operation（P〈0.05）. At the sixth week after operation,VAS and HSS were improved when compared with those in the fifth week after operation（P〈0.05）, but there was no significant difference being found in the comparison of ROM with that in the fifth week after operation（P〈0.05）. Conclusion： In the short term, there is pain fluctuation and aggravation after knee joint replacement, but it can be effectively relieved by Chinese medicine tendon-regulation manipulation,which is beneficial to postoperative rehabilitation and worthy of clinical promotion and application.

关 键 词：膝关节置换术后 疼痛 中医手法 推拿 理筋 

分 类 号：R687.4[医药卫生—骨科学]