活血益气汤治疗髋关节置换术后肢体疼痛及肿胀临床研究  

Clinical Study on the Treatment of Limb Pain and Swelling after Hip Replacement Surgery with Huoxue Yiqi Decoction

作　　者：周拓 奚胜华 张启锋 施海泉 ZHOU Tuo;XI Shenghua;ZHANG Qifeng;SHI Haiquan(Department of Orthopedics,Tongzhou District Traditional Chinese Medicine Hospital,Nantong 226300,China)

机构地区：[1]南通市通州区中医院骨伤科,江苏南通226300

出　　处：《中西医结合研究》2025年第1期23-27,共5页Research of Integrated Traditional Chinese and Western Medicine

摘　　要：目的 探究活血益气汤治疗髋关节置换术后肢体疼痛及肿胀的临床疗效。方法 将86例择期髋关节置换术患者按随机数字表法分为试验组和对照组,每组43例。2组患者均进行单髋关节置换术。对照组术前12 h给予低分子量肝素钙注射液,术后根据患者疼痛程度予以布洛芬胶囊。术后早期通过康复器具辅助下床活动。试验组在对照组基础上加用活血益气汤,2组均治疗7 d。比较2组疼痛视觉模拟量表(visual analogue scale, VAS)评分、患侧大腿根部周径、纤维蛋白原(fibrinogen, FIB)、D-二聚体、活化部分凝血活酶时间(activated partial thromboplastin time, APTT)、红细胞聚集指数、全血黏度、血浆黏度、肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)、白介素-6(interleukin-6,IL-6)、C反应蛋白(C-reactive protein, CRP)。结果 术后3 d, 2组静息状态VAS评分、活动状态VAS评分均较术后1 d升高(P均<0.05);术后7 d, 2组静息状态VAS评分、活动状态VAS评分均较术后3 d降低(P均<0.05);术后3 d、7 d,试验组静息状态VAS评分、活动状态VAS评分均低于同期对照组(P均<0.05)。术后3 d, 2组患侧大腿根部周径较术后1 d增大(P均<0.05);术后7 d, 2组患侧大腿根部周径均较术后3 d减小(P均<0.05);术后3 d、7 d,试验组患侧大腿根部周径均小于同期对照组(P均<0.05)。术后7 d, 2组FIB、D-二聚体均较术后1 d降低(P均<0.05),APTT均升高(P均<0.05),且试验组FIB、D-二聚体均低于对照组(P均<0.05),APTT高于对照组(P<0.05)。术后7 d, 2组红细胞聚集指数、全血黏度、血浆黏度均较术后1 d降低(P均<0.05),且试验组上述血液流变学指标均低于对照组(P均<0.05)。术后7 d, 2组TNF-α、IL-6、CRP均较术后1 d降低(P均<0.05),且试验组上述炎症因子均低于对照组(P均<0.05)。结论 活血益气汤用于髋关节置换术后可有效缓解疼痛,减轻下肢水肿,改善凝血功能和血液流变学,并抑制炎症反应。Objective To investigate the clinical efficacy of Huoxue Yiqi decoction in treating limb pain and swelling after hip replacement surgery.Methods Eighty-six patients undergoing selective hip replacement surgery were randomly divided into the trial group and the control group using a random number table,with 43 patients in each group.Both groups underwent single hip replacement surgery.The control group received low-molecular-weight heparin calcium injection 12 hours before surgery,and ibuprofen capsule was given to the patient according to the pain level after surgery.Besides,early postoperative use of rehabilitation equipments were used to assist with getting out of bed activities.The trial group was added Huoxue Yiqi decoction on the basis of the control group,and both groups were treated for 7 days.The pain scores of visual analogue scale(VAS),circumference of the affected thigh root,levels of fibrinogen(FIB)and D-dimer,activated partial thromboplastin time(APTT),erythrocyte aggregation index,whole blood viscosity,plasma viscosity,and tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),C-reactive protein(CRP)were compared in the two groups.Results On postoperative day 3,both groups showed an increase in resting state VAS scores and active state VAS scores compared to postoperative day 1(all P<0.05).On postoperative day 7,both groups showed a decrease in resting state VAS scores and active state VAS scores compared to postoperative day 3(all P<0.05).On postoperative day 3 and 7,the resting state VAS scores and active state VAS scores of the trial group were lower than those of the control group at the same time(all P<0.05).On postoperative day 3,the circumference of the affected thigh root in both groups increased compared to postoperative day 1(all P<0.05).On postoperative day 7,the circumference of the affected thigh root in both groups decreased compared to postoperative day 3(all P<0.05).On postoperative day 3 and 7,the circumference of the affected thigh root in the trial group were lower than those in the

关 键 词：髋关节置换术 活血益气汤 下肢水肿 凝血功能 炎症因子 

分 类 号：R274.9[医药卫生—中西医结合]