益气续骨汤联合加压冷疗法对全膝关节置换术后镇痛及隐性失血的影响  

Effect of Yiqi Xugu decoction combined with compression cold therapy on pain and implicit blood loss after TKA

作　　者：刘利民[1] 王迎彬 张猛 仉智广 宋京涛[1] LIU Li-min;WANG Ying-bin;ZHANG Meng(North China Petroleum Administration General Hospital,Renqiu 062252,China)

机构地区：[1]河北省华北石油管理局总医院,河北任丘062252 [2]河北廊坊文安县医院,河北廊坊065800 [3]河北省盐山县人民医院,河北盐山061300

出　　处：《中国中西医结合外科杂志》2025年第1期57-60,共4页Chinese Journal of Surgery of Integrated Traditional and Western Medicine

基　　金：河北省中医药管理局科研计划项目(2023348)。

摘　　要：目的:观察益气续骨汤联合加压冷疗法对全膝关节置换术(TKA)后镇痛及隐性失血的影响。方法:选取因晚期膝骨性关节炎首次行单侧TKA治疗的患者60例,随机分为对照组和治疗组两组,每组各30例,对照组于TKA术后给予加压冷疗法治疗,治疗组在加压冷疗法基础上口服益气续骨汤治疗,疗程均为14 d。观察两组术后中医症候积分变化,采用视觉模拟疼痛评分(VAS)、膝关节美国特种外科医院(HSS)评分分别评价两组术后疼痛程度和膝关节功能,测定两组治疗前后血红蛋白(Hb)、红细胞压积(Hct)水平,比较两组总失血量、显性失血量和隐性失血量,记录两组术后疼痛控制满意度和术后并发症情况。结果:经治疗,治疗组中医症候积分及VAS评分明显低于对照组,HSS评分及Hb、Hct的水平明显高于对照组(P <0.05),总失血量、显性失血量、隐性失血量均明显低于对照组(P <0.05),治疗组术后疼痛控制满意度明显优于对照组(P <0.05),术后并发症发生率明显低于对照组(P <0.05)。结论:益气续骨汤联合加压冷疗法用于TKA术后镇痛效果明显,可使患者关节功能进一步恢复,同时减少术后隐性失血,降低并发症的发生风险。Objective To observe the effect of Yiqi Xugu decoction combined with compression cold therapy on postoperative analgesia and occult blood loss after total knee arthroplasty(TKA).Methods Sixty patients with advanced knee osteoarthritis who underwent unilateral TKA for the first time were randomly divided into control group and treatment group.The control group was treated with compression cold therapy after TKA,and the treatment group was treated with Yiqi Xugu decoction on the basis of compression cold therapy for 14 days.Observe the change of TCM symptom score after operation in two groups.Visual analogue pain score(VAS) was used to evaluate the degree of postoperative pain and the range of motion of the knee joint.Hemoglobin(Hb) and hematocrit(Hct) levels were compared before and after treatment.Total blood loss,dominant blood loss and recessive blood loss were recorded in the two groups.Satisfaction with postoperative pain control and postoperative complications were recorded in the two groups.Results After treatment,the VAS and TCM symptom scores of the treatment group was significantly lower than that of the control group,while the HSS score,Hb,and Hct levels were significantly higher than those of the control group(P <0.05).The total blood loss,explicit blood loss,and implicit blood loss were significantly lower than those of the control group(P <0.05).The satisfaction of postoperative pain control in the treatment group was significantly better than that in the control group(P <0.05).And the incidence of postoperative complications was significantly lower than that in the control group(P <0.05).Conclusion The combination of Yiqi Xugu decoction and compressive cold therapy has a significant analgesic effect after TKA surgery,which can further restore joint function,reduce postoperative occult blood loss,and reduce the risk of complications.

关 键 词：益气续骨汤 膝骨性关节炎 全膝关节置换术 隐性失血 镇痛 

分 类 号：R684.3[医药卫生—骨科学] R286[医药卫生—外科学]