骨伤外洗剂对全膝关节置换术后疗效的影响

发布时间：2018-05-28 12:50

本文选题：全膝关节置换术后 + 术后疼痛　；参考：《广州中医药大学》2017年硕士论文

【摘要】：目的:观察骨伤外洗剂对膝骨性关节炎晚期患者行全膝关节置换术后疗效的影响,为中医药缓解全膝关节置换术后疼痛,提高临床疗效,促进早期功能康复提供临床依据与新思路。方法:选取广州中医药大学附属东莞中医院骨一科2015年3月-2016年12月符合本研究纳入标准的60例择期行全膝关节置换术后患者为研究对象。采用随机数字表法将患者分为对照组和观察组,各30例。术后第2天开始两组患者均予常规康复治疗,包括口服西乐葆及功能锻炼。术后2周拆线,拆线3天后观察组在常规治疗基础上给予骨伤外洗剂治疗,连续治疗2周。观察两组患者术后4周后的临床症状及体征,采用美国纽约特种外科医院膝关节(HSS)评分表及疼痛视觉模拟(VAS)评分表进行评估,并用统计学软件及方法对数据统计分析。结果:①两组患者的一般情况包括年龄、性别、病程,差异无统计学意义(P0.05)。②术后4周总体有效率方面,对照组为70.00%,观察组为90.000%,两组患者组间比较,差异有统计学意义(P0.05)。③在HSS的总评分方面,术后2周两组患者对比,差异无统计学意义(P0.05);术后4周两组组内对比,差异有统计学意义(P0.05),两组组间比较,观察组总体评分高于对照组,差异有统计学意义(P0.05)。④HSS各项评分中,术后2周两组患者对比,差异无统计学意义(P0.05);术后4周两组组内对比,差异有统计学意义(P0.05),两组组间比较中,观察组在功能、活动度及肌力的评分中均高于对照组,差异有统计学意义(P0.05)。⑤在VAS评分方面,术后2周两组患者对比,差异无统计学意义(P0.05);术后4周两组组内对比,差异有统计学意义(P0.05),两组组间比较,观察组VAS评分低于对照组,差异有统计学意义(P0.05)。⑥安全性指标:研究过程中未出现术口周围皮肤过敏、肿痛加重或有分泌物渗出。结论:骨伤外洗剂能有效缓解TKA术后疼痛,促进术后膝关节功能康复疗效显著,它能够有效缓解疼痛,显著提高HSS总体评分,包括功能、活动度及肌力等方面均具有改善作用。通过中药外用熏洗的形式发挥作用,避免口服药物对胃肠道刺激及肝肾功能损坏,且使用方法简单、经济实惠,容易被患者所接受,为中医药治疗TKA术后的康复手段增添新内容,值得临床进一步推广。
[Abstract]:Objective: to observe the effect of external lotion of bone injury on the curative effect of total knee arthroplasty in patients with advanced knee osteoarthritis, so as to relieve the pain after total knee arthroplasty with traditional Chinese medicine and improve the clinical efficacy. To promote early functional rehabilitation to provide clinical basis and new ideas. Methods: from March 2015 to December 2016, 60 patients with elective total knee arthroplasty were selected from Department of Bone of Dongguan Hospital of traditional Chinese Medicine affiliated to Guangzhou University of traditional Chinese Medicine. Patients were randomly divided into control group and observation group with 30 cases each. Two groups of patients were treated with routine rehabilitation, including oral Celebrex and functional exercise. The observation group was treated with external lotion on the basis of routine treatment for 2 weeks. The clinical symptoms and signs of the two groups were observed 4 weeks after operation. The clinical symptoms and signs of the two groups were evaluated by HSS scale of knee joint and visual analogue scale of pain in New York Special surgery Hospital. Statistical software and methods were used to analyze the data. Results the general conditions of the two groups included age, sex, course of disease, and there was no significant difference in the total effective rate at 4 weeks after operation (P 0.05.2). The total effective rate of the two groups was 70.00g in the control group and 90.000 in the observation group. The difference was statistically significant (P 0.05) in the total score of HSS. 2 weeks after operation, there was no significant difference between the two groups (P 0.05), but at 4 weeks after operation, there was significant difference between the two groups (P 0.05), and between the two groups, there was no significant difference between the two groups. The overall score of the observation group was higher than that of the control group, and the difference was statistically significant. Among the scores of P0.05U. 4HSS, there was no significant difference between the two groups at 2 weeks after operation, but there was no significant difference between the two groups at 4 weeks after operation. The difference was statistically significant (P 0.05). In the comparison between the two groups, the scores of function, activity and muscle strength in the observation group were higher than those in the control group. The difference was statistically significant (P 0.05) in the VAS score, compared with that in the two groups at 2 weeks after operation. There was no significant difference between the two groups at 4 weeks after operation, the difference was statistically significant (P 0.05). Compared with the control group, the VAS score of the observation group was lower than that of the control group. There was no skin allergy, aggravation of swelling and pain or exudation of secretions during the study. Conclusion: Gushangwai lotion can effectively relieve the pain after TKA and promote the rehabilitation of knee joint function. It can effectively relieve pain and improve the overall score of HSS, including function, range of movement and muscle strength. In order to avoid gastrointestinal irritation and damage of liver and kidney function by external use of traditional Chinese medicine, the method is simple, economical and easy to be accepted by patients. It is worthy of further popularizing for the treatment of rehabilitation after TKA with Chinese medicine.
【学位授予单位】：广州中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R687.4

【参考文献】