活血疏肝汤对膝骨关节炎全膝关节置换术后患肢肿痛及功能康复的影响

发布时间：2018-04-03 22:47

本文选题：活血疏肝汤　切入点：TKA术后　出处：《湖南中医药大学》2016年硕士论文

【摘要】：目的:观察活血疏肝汤对膝骨关节炎全膝关节置换术后患肢肿胀、疼痛的治疗效果及对患肢功能恢复的影响,探讨活血疏肝汤的临床疗效、作用机理及应用前景。方法:选择2015年1月至2015年12月期间在河南省洛阳正骨医院膝部损伤一科住院治疗并行单侧全膝关节置换术的骨性关节炎患者75例。所有纳入患者均填写完整的病例资料,告知并签署知情同意书后,按照受试者入院的先后顺序,根据随机数字表法将患者随机分成对照组和试验组,试验组38例,对照组37例。所有患者均由同一组医师在相同手术方式下行单侧全膝关节置换术,且植入相同假体类型。术前常规检查、术后常规用药及功能锻炼指导方法相同。治疗组在术后常规治疗的基础上给予口服活血疏肝汤治疗,1日1剂,水煎服,早晚分服,7天为一个疗程,治疗1个疗程。观察并记录两组患者在术后第0、3、5、7天的静息痛及活动痛的VAS评分;术后当天用药前两组患者经髌骨中点上10cm、经髌骨中点下10cm患肢周径及第3、5、7天各测量点的肿胀差值;术后第0、3、5、7天的膝关节主动屈伸活动度;第0、7天的膝关节HSS功能评分。使用SPSS21.0对所得数据进行统计分析。结果:因有5例患者不能耐受中药或因合并内科疾病在研究期间服用其他影响疗效的药物而给予剔除,对照组剩余35例,试验组剩余35例。经统计学处理分析如下:两组患者术前在年龄、性别、部位及体质量指数方面的分布差异均无统计学意义(P0.05),具有可比性。两组患者术后当天用药前静息痛及活动痛的VAS评分差异无统计学意义(P0.05),术后第3、5、7天的静息痛及活动痛的VAS评分差异有统计学意义(P0.05)。两组患者术后当天用药前膝关节主动屈伸活动度差异无统计学意义(P0.05),术后第3、5、7天的膝关节主动屈伸活动度差异有统计学意义(P0.05)。两组患者术后当天用药前膝关节HSS评分差异无统计学意义(P0.05),术后第7天的膝关节HSS评分差异有统计学意义(P0.05)。结论:活血疏肝汤联合西医常规治疗全膝关节置换术后患肢肿痛疗效显著,可促进患者术后功能锻炼积极性,改善患侧膝关节活动度,且经济实惠、服用方便,值得临床推广。
[Abstract]:Objective: To observe the effect of Huoxue Shugan decoction on knee osteoarthritis total knee arthroplasty after limb swelling, pain treatment effect and the influence on the recovery of limb function, to explore the clinical curative effect of Huoxue Shugan decoction, mechanism and application prospect. Methods: from January 2015 to December 2015 period in a hospital for treatment of 75 patients with osteoarthritis parallel with unilateral total knee arthroplasty patients in Luoyang Bone-setting Hospital of Henan province. All the patients were included in the knee injury with complete clinical data, informed and signed informed consent, in accordance with the order of the subjects admitted, according to the random number table method were randomly divided into control group and test group, 38 cases of test group and control group of 37 cases. All the patients were from the same group of physicians in the same surgical underwent unilateral total knee arthroplasty, and the same type of prosthesis implantation. Routine preoperative examination, postoperative medication and routine work Can exercise the same method. The treatment group based on routine treatment after given oral Huoxue Shugan decoction, 1 day 1, Shuijianbi, sooner or later the service, 7 days for a course, 1 courses of treatment. The two groups were observed and recorded in the 0,3,5,7 after the first day of rest pain and active pain VAS score; postoperative day before treatment two patients with patella midpoint 10cm, the midpoint of patella 10cm limb circumference difference and swelling 3,5,7 days of each measurement point; 0,3,5,7 days after the surgery of the knee active flexion and extension; days 0,7 HSS knee function score. SPSS21.0 on the data for statistical analysis. Results: for 5 patients who could not tolerate medicine or due to drug with internal disease taking other effect during the study and give out the remaining 35 cases, the control group and experimental group. The remaining 35 cases were analyzed as follows: two groups of patients before surgery In the age, gender, location and distribution of the body mass index (P0.05) were not statistically significant, comparable. No statistically significant differences in VAS scores between the two groups of patients after the medication before the rest pain and pain activity (P0.05), the difference was statistically significant at 3,5,7 days of rest pain and pain the postoperative VAS score (P0.05). The two groups of patients after the day before treatment for active knee flexion and extension was no statistically significant difference (P0.05), 3,5,7 days after operation of knee flexion extension activity was statistically significant difference (P0.05). The HSS knee score was no significant difference between two groups after the day before treatment (P0.05), the difference was statistically significant HSS knee score after seventh days (P0.05). Conclusion: the therapeutic effect of Huoxue Shugan decoction combined with conventional western medicine treatment of total knee arthroplasty after limb swelling significantly, can promote the postoperative functional exercise product Polarity, improve the knee joint activity of the affected side, and economic benefits, easy to take, it is worthy of clinical promotion.

【学位授予单位】：湖南中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R274.9

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