电针联合中药熏洗对行全膝关节置换术患者术后疼痛及功能康复的影响  

Effects of electroacupuncture combined with traditional Chinese medicine fumigation on postoperative pain and functional rehabilitation in patients undergoing total knee arthroplasty

作　　者：张占磊 毕梦娜[1] 马邹 张上上[1] 王一臣 朱江伟[1] 斯焱[1] 张鹏[1] ZHANG Zhanlei;BI Mengna;MA Zou;ZHANG Shangshang;WANG Yichen;ZHU Jiangwei;SI Yan;ZHANG Peng(Sichuan Province Orthopedic Hospital,Chengdu 610041,China)

机构地区：[1]四川省骨科医院,四川成都610041

出　　处：《陕西中医》2023年第10期1469-1473,共5页Shaanxi Journal of Traditional Chinese Medicine

基　　金：四川省中医药管理局科学技术研究专项课题(2021MS044)。

摘　　要：目的:探究电针联合中药熏洗对行全膝关节置换术(TKA)患者术后疼痛及功能康复的影响。方法:选取拟进行TKA患者120例,采用随机信封法分为传统组和联合组各60例,其中传统组患者使用西医系统化功能康复方案进行治疗,联合组患者在传统组的基础上,联合电针外治及中药熏洗进行治疗。两组患者均治疗至术后1个月,并随访1年。比较两组患者术后3个月后临床康复疗效,比较两组患者术后不同时间段(术后2周、术后1个月、术后3个月、术后6个月及术后1年)膝关节功能[美国特种外科医院膝关节评分标准(HSS)]、术后疼痛(HSS膝关节疼痛评分),比较两组患者术前及术后3个月后下肢力线恢复情况[髋-膝-踝角偏倚(HKA)],比较两组患者术后3个月假体位置[胫骨平台后倾角(LTC)、冠状面股骨组件角(FFC)、矢状面股骨组件角(LFC)],并统计两组患者术后1年内并发症发生情况。结果:术后3个月,联合组患者临床康复优良率明显高于传统组(P<0.05);术后2周,两组患者HSS评分比较差异无统计学意义(P>0.05);术后1个月及之后时间段,两组患者HSS评分均明显高于术后2周,且联合组明显高于传统组(P<0.05);术后2周,两组患者HSS膝关节疼痛评分比较差异无统计学意义(P>0.05);术后1个月及之后时间段,两组患者HSS膝关节疼痛评分均明显高于术后2周,且联合组明显高于传统组(P<0.05);术后3个月,两组患者HKA明显低于术前,且联合组明显低于传统组(P<0.05);术后3个月,联合组患者LTC、LFC明显低于传统组(P<0.05);术后3个月,联合组患者FFC明显高于传统组(P<0.05);术后1年内,联合组患者并发症总发生率明显低于传统组(P<0.05)。结论:电针联合中药熏洗可有效提高行TKA患者临床康复效果,对患者膝关节功能恢复具有积极影响,对患者假体位置影响较小,且可有效降低患者术后并发症发生率,具有较好的安全性。Objective:To explore the effects of electroacupuncture combined with traditional Chinese medicine fumigation on postoperative pain and functional rehabilitation in patients with total knee arthroplasty(TKA).Methods:Totally 120 patients who were scheduled to undergo TKA were selected and divided into traditional group and combined group by the random envelope method,with 60 cases in each group.The patients in the traditional group were treated with western medicine systematic functional rehabilitation regimen while the patients in the combined group were given external treatment with electroacupuncture and traditional Chinese medicine fumigation on the basis of the traditional group.Both groups of patients were treated until 1 month after surgery and followed up for 1 year.The clinical rehabilitation efficacy at 3 months after surgery,knee function[hospital for special surgery knee score(HSS)]at different time points after surgery(2 weeks,1 month,3 months,6 months and 1 year after surgery)and postoperative pain(HSS knee pain score),recovery of lower limb alignment[hip-knee-ankle angle deviation(HKA)]before surgery and at 3 months after surgery and prosthesis position[posterior slope of tibial plateau(LTC),coronal femoral component angle(FFC),sagittal femoral component angle(LFC)]at 3 months after surgery were compared between the two groups of patients.The occurrence of complications in the two groups were counted within 1 year after surgery.Results:At 3 months after surgery,the excellent and good rate of clinical rehabilitation in combined group was significantly higher than that in traditional group(P<0.05).At 2 weeks after surgery,there was no statistical difference in HSS score between the two groups(P>0.05).At 1 month after surgery and later periods,the HSS score in the two groups was significantly higher than that at 2 weeks after surgery,and the score in combined group was significantly higher than that in traditional group(P<0.05).There was no statistical significance in HSS knee pain score between the two

关 键 词：膝关节骨关节炎 全膝关节置换术 电针外治 中药熏洗 术后疼痛 功能康复 

分 类 号：R684.3[医药卫生—骨科学]