桃红四物汤对全膝关节置换术后康复影响的临床研究

发布时间：2018-07-07 22:29

本文选题：全膝关节置换术 + 桃红四物汤　；参考：《西南医科大学》2017年硕士论文

【摘要】：目的:探讨全膝关节置换术后的患者应用桃红四物汤内服对康复过程的影响,以为置换术后膝关节的康复提供治疗思路。方法:选取2015年6月到2016年6月在我科接受治疗并诊断为膝骨关节炎的患者,选取患者均接受单侧全膝关节置换术,并严格参照诊断标准、排除标准、脱落标准,最终所得的研究对象共60例。采用随机数余数分组方法进行分组,由一名非试验参与者首先根据预计纳入的样本量按照随机数字表获得随机数字,制定出随机分组表格。将所得随机数字放入按顺序、不透光的密封信封中,然后由研究人员所确定的纳入研究患者按照就诊顺序获得密封信封中的随机数字,根据随机分组表格来确定该患者所进入的分组。最终获得观察组和对照组各30例患者。所有患者均接受由同一主任医师、同一组医师完成的全膝关节置换术,并在术后接受相同的术后处理,而对照组在术后康复方面仅接受常规的康复训练,观察组除接受常规康复训练外,还接受桃红四物汤口服28天,并观察两组患者的VAS评分、膝关节活动度、膝关节肿胀程度、HSS评分这些指标在术后不同时间点的变化情况,使用统计学软件对这些数据进行处理分析。结果:(1)术后第1天,观察组和对照组的VAS评分没有显著差异(P0.05);在术后第3天、第7天、第14天、第28天,比较两组患者同时间点的VAS评分,观察组均明显小于对照组,差异有统计学意义(P0.05)。(2)术后第3天,观察组和对照组的ROM没有显著差异(P0.05);在术后第7天、第14天、第28天的ROM,比较两组患者同时间点的ROM,观察组均明显大于对照组,差异有统计学意义(P0.05)。(3)术后第1天,观察组和对照组的膝周径没有显著差异(P0.05);在术后第3天、第7天、第14天,比较两组患者同时点的膝周径,观察组均明显小于对照组,差异有统计学意义(P0.05);而在术后第28天,观察组和对照组的膝周径没有显著差异(P0.05)。(4)术后第3天,观察组和对照组的HSS评分没有显著差异(P0.05);在术后第7天、第14天、第28天,比较两组患者同时间点的HSS评分,观察组均明显大于对照组,差异有统计学意义(P0.05)。结论:两组患者在术后28天时肿胀均已趋于正常;对全膝关节置换术后的患者在常规康复训练基础上再使用桃红四物汤内服,能够明显缓解早期术后疼痛、肿胀,提高关节活动度和功能,能快速促进术后早期康复。
[Abstract]:Objective: to explore the effect of Taohong Siwu decoction on rehabilitation of patients after total knee arthroplasty. Methods: the patients who were treated in our department from June 2015 to June 2016 and diagnosed as knee osteoarthritis were all treated with unilateral total knee arthroplasty. A total of 60 cases were studied. By using the method of grouping random number remainder, a non-experimental participant first obtains random number according to the sample size expected to be included, and establishes a random grouping table. The random numbers were placed in sealed envelopes that were sequenced and impermeable, and then, as determined by the researchers, the random numbers in the sealed envelopes were obtained by the study patients in the order in which they were treated. A randomized grouping table was used to determine the group into which the patient entered. Finally, 30 patients in the observation group and 30 patients in the control group were obtained. All patients received total knee arthroplasty performed by the same chief physician and the same group of physicians, and received the same postoperative treatment after operation, while the control group received only routine rehabilitation training in postoperative rehabilitation. In addition to routine rehabilitation training, the observation group also received Taohong Siwu decoction orally for 28 days. The VAS score, knee motion degree, knee swelling degree and HSS score of the two groups were observed at different time points after operation. Use statistical software to process and analyze these data. Results: (1) on the first day after operation, there was no significant difference in VAS score between the observation group and the control group (P0.05), and on the 3rd, 7th, 14th, 28th day after operation, the VAS scores of the two groups were significantly lower than those of the control group. The difference was statistically significant (P0.05). (2) on the 3rd day after operation, there was no significant difference between the observation group and the control group (P0.05); on the 7th day, 14th day, 28th day after the operation, the rom of the two groups were significantly larger than that of the control group. The difference was statistically significant (P0.05). (3) on the 1st day after operation, there was no significant difference between the observation group and the control group (P0.05); on the 3rd, 7th, 14th day after operation, the observation group was significantly smaller than the control group. The difference was statistically significant (P0.05), but on the 28th day after operation, there was no significant difference in the knee circumference between the observation group and the control group (P0.05). There was no significant difference between the observation group and the control group on the third day after operation (P0.05); on the 7th day, 14th day, 28th day after operation, there was no significant difference between the observation group and the control group (P0.05). Compared the two groups of patients at the same time point of HSS scores, the observation group was significantly larger than the control group, the difference was statistically significant (P0.05). Conclusion: the swelling of the patients in the two groups has become normal at 28 days after operation, and the patients after total knee arthroplasty can be treated with Taohong Siwu decoction on the basis of routine rehabilitation training, which can obviously relieve the pain and swelling in the early postoperative period. Improving the range of motion and function of the joint can promote early postoperative rehabilitation.
【学位授予单位】：西南医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R687.4

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