伤科黄水对全膝关节置换术后炎症反应及膝关节功能的影响  

Effect of Shangke Huangshui on the Inflammatory Response and Knee Function after Total Knee Arthroplasty

作　　者：陈金雄[1] 周观明[1] 余海波[1] 卢绍燊[1] Chen Jinxiong;Zhou Guanming;Yu Haibo;Lu Shaoshen(Foshan Hospital of Traditional Chinese Medicine,Guangdong,Foshan 528000,China)

机构地区：[1]广东省佛山市中医院,广东佛山528000

出　　处：《中国中医急症》2022年第5期840-843,共4页Journal of Emergency in Traditional Chinese Medicine

基　　金：佛山市科技创新项目(1920001000806)。

摘　　要：目的 观察伤科黄水对全膝关节置换术(TKA)后炎症反应及膝关节功能的影响。方法 选择膝骨关节炎行TKA治疗的患者100例,按随机数字表法分为对照组与观察组各50例。对照组术后1 d开始予消炎镇痛、抗凝、CPM康复训练治疗。观察组在对照组基础上加用伤科黄水外敷,每日2次,至术后30 d。比较两组不同时点的膝部肿胀程度、膝部皮温、血清炎症因子[C反应蛋白(CRP)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)]、VAS评分及HSS评分的变化。结果 术后1 d,两组膝部肿胀程度、血清炎症因子(CRP、IL-6、TNF-α)水平、VAS评分、HSS评分差异均无统计学意义(均P>0.05)。术后7、30 d,两组的膝部肿胀程度、膝部皮温、血清炎症因子(CRP、IL-6、TNF-α)水平、VAS评分均较术后1 d降低(均P<0.05)、HSS评分均较术后1 d上升(均P<0.05),且同时点观察组各指标改善情况优于对照组(均P<0.05)。两组膝部皮温差呈先上升,后下降趋势,术后1、7 d两组皮温差差异无统计学意义(P>0.05),而术后30 d观察组膝部皮温差低于对照组(P<0.05)。结论 伤科黄水能降低TKA术后炎症反应,促进膝关节功能恢复。Objective:To observe the effect of Shangke Huangshui on the inflammatory response and knee function after total knee arthroplasty(TKA). Methods:100 patients with knee osteoarthritis treated with TKA were selected and randomly divided into the control group and observation group according to the random number table method,50 cases in each group. The control group was treated with anti-inflammatory analgesia,anticoagulation and CPM rehabilitation from 1 d after surgery;the observation group was treated with external application of Shangke Huangshui on top of the control group,twice/d,until 30 d after surgery. The changes in the degree of knee swelling,knee skin temperature,serum inflammatory factors[C-reactive protein(CRP),interleukin-6(IL-6),tumor necrosis factor-α(TNF-α)],VAS score and HSS score were compared between the two groups at different time points. Results:At 1 d postoperatively,the differences in the degree of knee swelling,serum inflammatory factors(CRP,IL-6,TNF-α)levels,VAS scores and HSS scores between the two groups were not statistically significant(P>0.05). At 7 d and 30 d postoperatively,the degree of knee swelling,knee skin temperature,serum inflammatory factors(CRP,IL-6,TNF-α)levels,and VAS scores in both groups decreased compared with 1 d postoperatively(P< 0.05),and HSS scores increased compared with 1 d postoperatively(P< 0.05),and the improvement of each index in the observation group was better than that in the control group at the same time point(P< 0.05).The skin temperature difference of the knee in the two groups showed a trend of rising first and then falling,and the difference between the skin temperature difference of the two groups at 1 d and 7 d after surgery was not statistically significant(P>0.05),while the skin temperature difference of the knee in the observation group at 30 d after surgery was lower than that in the control group(P< 0.05). Conclusion:Shangke Huangshui can reduce the inflammatory reaction after TKA and promote the functional recovery of the knee joint.

关 键 词：全膝关节置换术 伤科黄水 炎症反应 功能恢复 

分 类 号：R684.3[医药卫生—骨科学]