骨伤复原汤加减联合早期功能训练对全髋关节置换术后恢复及并发症的影响  

Influence of modified GushangFuyuan Decoction combined with early functional training on recovery and complications of total hip replacement

作　　者：张道平[1] 陈先进[1] ZHANG Daoping;CHEN Xianjing(First Department of Arthrosis,Wuhu Hospital of Traditional Chinese Medicine,Wuhu,Anhui 241000)

机构地区：[1]安徽省芜湖市中医医院关节一科,安徽芜湖241000

出　　处：《河北中医》2023年第6期912-916,共5页Hebei Journal of Traditional Chinese Medicine

基　　金：安徽省卫生和计划生育委员会中医药领军人才及领军人才培养基金(中医药发展秘[2018]23号)。

摘　　要：目的 观察骨伤复原汤加减联合早期功能训练对全髋关节置换术后恢复及并发症的影响。方法 将60例行全髋关节置换术后患者按照随机数字表法分为2组,术后均予常规抗感染治疗,对照组30例术后予早期功能训练治疗,治疗组30例术后在对照组治疗基础上加骨伤复原汤加减治疗,2组均治疗12周。比较2组治疗前后Barthel指数评分、Harris髋关节评分变化;比较2组治疗前后凝血指标、炎症指标、骨愈合相关指标变化;观察2组并发症发生情况、不良反应发生情况。结果 2组治疗后Barthel指数评分、Harris髋关节评分均较本组治疗前升高(P<0.05),且治疗组升高更明显(P<0.05)。2组治疗后活化部分凝血活酶时间(APTT)、凝血酶原时间(PT)均较本组治疗前升高(P<0.05),纤维蛋白原(FIB)均较本组治疗前降低(P<0.05);治疗后治疗组APTT、PT均高于对照组(P<0.05),FIB低于对照组(P<0.05)。2组治疗后血清白细胞介素6(IL-6)、IL-1、肿瘤坏死因子α(TNF-α)、IL-2水平均较本组治疗前降低(P<0.05),且治疗组降低更明显(P<0.05)。2组治疗后血清血管细胞黏附分子-1(VCAM-1)、单核细胞黏附分子-1(ICAM-1)水平均较本组治疗前降低(P<0.05),骨形态发生蛋白-2(BMP-2)水平均较本组治疗前升高(P<0.05);治疗后治疗组血清VCAM-1、ICAM-1水平均低于对照组(P<0.05),BMP-2水平高于对照组(P<0.05)。治疗组并发症总发生率3.33%(1/30),对照组并发症总发生率20.00%(6/30),2组并发症总发生率比较差异有统计学意义(P<0.05)。结论 骨伤复原汤加减联合早期功能训练可提高全髋关节置换术后恢复效果,减轻炎性反应,加快髋关节功能恢复,改善血液高凝状态,促进骨愈合,并且能预防术后并发症发生。Objective To observe the effect of modified Gushang Fuyuan Decoction combined with early functional training on recovery and complications of total hip replacement.Methods A total of 60 patients underwent total hip replacement were randomized 1:1 to receive to routine treatment+early functional training(the control group)or routine treatment+modified Gushang Fuyuan Decoction+early functional training(the treatment group)for 12 weeks.The key observation was Barthel index score,Harris hip score,coagulation index,inflammation index,and bone healing index,complications,as well as adverse reactions between groups before and after treatment.Results After treatment,Barthel index score and Harris hip joint score ingroups were higher than those before treatment(P<0.05),and the increase was more obvious in the treatment group(P<0.05).Activated partial thrombin time(APTT)and prothrombin time(PT)were increased after treatment ingroups compared with before treatment(P<0.05),while fibrinogen(FIB)was decreased ingroups compared with before treatment(P<0.05).There were significant statistical differences between the two groups in the above indexes.The serum levels of interleukin-6(IL-6),IL-1,tumor necrosis factorα(TNF-α)and IL-2 ingroups were decreased compared with those before treatment(P<0.05),and the decrease was more significant in treatment group(P<0.05).The decreased serum vascular cell adhesion molecule-1(VCAM-1)and intercellular adhesion molecule-1(ICAM-1)and increased bone morphogenetic protein-2(BMP-2)were found ingroupscompared with before treatment(all P<0.05).There were significant statistical differences in VCAM-1,ICAM-1,BMP-2between the two groups.Difference was significant in the total incidence of complications between the treatment group and the control group(3.33%[1/30]vs 20.00%[6/30],P<0.05).Conclusion Modified Gushang Fuyuan Decoction combined with early functional training can improve the recovery effect after total hip arthroplasty,reduce inflammatory response,accelerate hip functional recovery,improve

关 键 词：髋关节 外科学 中药疗法 运动疗法 

分 类 号：R684.75[医药卫生—骨科学] R269[医药卫生—外科学] R289.6[医药卫生—临床医学]