当归补血汤加味联合氨甲环酸序贯抗凝及蔗糖铁治疗全膝关节置换术后隐性失血临床研究  

Clinical efficacy of modified Danggui Buxue decoction combined with tranexamic acid sequential anticoagulation and iron sucrose in treating hidden blood loss after total knee arthroplasty

作　　者：张丽娜 王江静[1] ZHANG Lina;WANG Jiangjing(Department of Imaging,Cangzhou Hospital of Integrative Medicine,Cangzhou 061000,China)

机构地区：[1]河北省沧州中西医结合医院影像科,河北沧州061000

出　　处：《陕西中医》2024年第1期71-74,共4页Shaanxi Journal of Traditional Chinese Medicine

基　　金：河北省中医药类科研计划项目(2020505)。

摘　　要：目的:探究当归补血汤加味联合氨甲环酸(TXA)序贯抗凝及蔗糖铁对全膝关节置换术(TKA)后隐性失血的临床疗效。方法:选择TKA治疗的92例患者,依据随机单盲分组法分为对照组和试验组,每组46例。对照组术后接受TXA序贯抗凝及蔗糖铁治疗,试验组在此基础上联合加味当归补血汤进行治疗。比较治疗前后中医症候积分、总体失血量、静脉血栓栓塞症(VTE)发生率、血常规指标[红细胞总数(RBC)、血红蛋白(Hb)、红细胞积压(Hct)]、膝关节功能[美国膝关节协会评分(KSS)]以及疼痛程度[视觉模拟法疼痛评分(VAS)]变化情况。结果:与对照组比较,试验组总失血量、隐性失血量明显较低(P<0.05),显性失血量比较无统计学差异(P>0.05);治疗后,中医证候积分、VAS评分较治疗前显著降低(P<0.05),且试验组中医证候积分、VAS评分显著低于对照组(P<0.05);治疗后,两组RBC、Hb、Hct水平、KSS评分较治疗前显著升高(P<0.05),且试验组RBC、Hb、Hct水平、KSS评分显著高于对照组(P<0.05)。结论:加味当归补血汤联合TXA序贯抗凝及蔗糖铁应用于TKA术后患者,通过降低机体隐性失血量,缓解术后疼痛,从而有效改善术后血虚证相关临床症状,利于术后膝关节功能恢复。Objective:To discuss the clinical efficacy of combination of modified Danggui Buxue decoction and tranatemyclic acid(TXA)sequential anticoagulation and iron sucrose on hidden blood loss after total knee arthroplasty(TKA).Methods:92 patients receiving TKA treatment were selected and divided into control group and experimental group according to random single-blind grouping method,with 46 cases in each group.The control group received TXA sequential anticoagulation and iron sucrose after surgery,and the experimental group was treated with modified Danggui Buxue decoction on this basis.The changes in TCM symptom score,total blood loss,incidence rate of venous thromboembolism(VTE),blood routine indicators(total red blood cell[RBC],hemoglobin[Hb],hematocrit[Hct]),knee function(American Knee Society score[KSS])and pain degree(Visual Analogue Scale[VAS])were compared before and after treatment.Results:Compared with control group,the total blood loss and hidden blood loss were significantly less in experimental group(P<0.05),but no statistical significance was shown in dominant blood loss(P>0.05).After treatment,the KSS syndrome score and VAS score were significantly reduced compared with those before treatment(P<0.05),and the scores in experimental group were obviously lower(P<0.05).The levels of RBC,Hb and Hct and KSS score after treatment were significantly enhanced compared to before treatment(P<0.05),and the levels and score were significantly higher in experimental group than those in control group(P<0.05).Conclusion:For patients after TKA,modified Danggui Buxue decoction on the basis of TXA sequential anticoagulation and iron sucrose can effectively improve the related clinical symptoms of postoperative blood deficiency syndrome by reducing the hidden blood loss and relieving the postoperative pain,and it is beneficial to the recovery of knee function after surgery.

关 键 词：全膝关节置换术 当归补血汤 氨甲环酸 蔗糖铁 隐性失血 膝关节功能 

分 类 号：R687.4[医药卫生—骨科学]