消肿健步汤治疗全膝关节置换术后肿痛的临床观察  

Clinical Study on Xiaozhong Jianbu Decoction in Treating Postoperative Swelling and Pain after Total Knee Arthroplasty

作　　者：邢海洋 张亮 刘浩[1] 赵玲[1] 崔青[1] 于国胜[1] Xing Haiyang;Zhang Liang;Liu Hao;Zhao Ling;Cui Qing;Yu Guosheng(Hebei Cangzhou Integrated Traditional Chinese and Western Medicine Hospital,Hebei,Cangzhou 061000,China)

机构地区：[1]河北省沧州中西医结合医院,河北沧州061000

出　　处：《中国中医急症》2024年第4期687-690,共4页Journal of Emergency in Traditional Chinese Medicine

基　　金：河北省中医药管理局科研计划项目(2022234)。

摘　　要：目的观察消肿健步汤治疗全膝关节置换术(THA)后肿痛的临床效果并探讨其作用机制。方法80例患者采用随机数字表法分为对照组和试验组。对照组40例,1例自行换药治疗而脱落,最终纳入39例,术后给予患者常规西医治疗;试验组40例,无脱落情况,在对照组治疗基础上给予自拟消肿健步汤治疗。术前及术后3、5、7、10 d测量两组患者的患肢周径、切口周缘皮温、膝关节活动度,通过疼痛视觉模拟量表(VAS)评分评价患肢疼痛情况,并检测C反应蛋白(CRP)、D-二聚体(D-D)水平。结果两组术前患肢周径、切口周缘皮温、VAS评分、膝关节活动度、CRP和D-D水平比较差别均不大(均P>0.05)。两组术后3、5、7、10 d的髌骨上缘上及髌骨下缘下10 cm的周径、VAS评分、膝关节活动度、CRP和D-D水平,随时间均逐步改善(均P<0.05)。试验组术后3、5、7、10 d的髌骨上缘上及髌骨下缘下10 cm的周径,VAS评分、膝关节活动度、CRP和D-D水平均优于对照组(均P<0.05)。两组切口周缘皮温术后各时间点比较差别均不大(均P>0.05),两组治疗期间均无明显不良反应发生。结论消肿健步汤治疗THA后肿痛患者,可抑制机体炎症,减轻水肿,缓解疼痛,改善血液高凝状态。Objective:To explore the clinical effect of Xiaozhong Jianbu Decoction in treating swelling and pain after total knee arthroplasty(THA). Methods:A total of 80 patients with knee osteoarthritis treated in our hospital after THA were selected and divided into the control group and experimental group by random number table method. 40 patients in the control group(1 case loss to follow-up and 39 cases were eventually included)were given conventional western medicine treatment after surgery. In the experimental group,40 patients were given selfprepared Xiaozhong Jianbu Decoction on the basis of the control group. The circumference of the affected limb,the skin temperature around the incision,and the range of motion(ROM)of the knee joint of the two groups were measured before and after surgery at 3 d,5 d,7 d,and 10 d. The pain of the affected limb was evaluated by visual analogue scale(VAS)score,and the levels of C-reactive protein(CRP)and D-dimer(D-D)were detected in the two groups. Results:There were significant differences in the peri-extremity diameter,VAS score,knee joint ROM,CRP and D-D in the two groups after treatment(P < 0.05). The experimental group was higher than that of the control group(P < 0.05). Conclusion:Xiaozhong Jianbu Decoction can inhibit inflammation,reduce edema,relieve pain and improve blood hypercoagulability in treating patients with swelling pain after THA.

关 键 词：膝骨关节炎 全膝关节置换术 肿痛 消肿健步汤 

分 类 号：R687.4[医药卫生—骨科学]