实用医学杂志 ›› 2023, Vol. 39 ›› Issue (7): 904-909.doi: 10.3969/j.issn.1006⁃5725.2023.07.020

• 中医药现代化 • 上一篇    下一篇

益气养营汤在人工膝关节置换围手术期临床疗效 

李亮 周正新 李文华 刘涛 朱磊 康金平    

  1. 安徽中医药大学第一附属医院骨二科(合肥 230031)

  • 出版日期:2023-04-10 发布日期:2023-04-10
  • 基金资助:
    安徽省自然科学基金项目(编号:2008085MH281)

The study of effect of YiqiYangying Decoction used in perioperation for cases of severe knee osteoarthritis treated by artificial knee resurfacing surgery

LI Liang,ZHOU Zhengxin,LI Wenhua,LIU Tao,ZHU Lei, KANG Jinping.   

  1. The Second Department of Orthopedics,the First Affiliated Hospital of Anhui University of Chinese Medicine,Hefei 230031,China

  • Online:2023-04-10 Published:2023-04-10

摘要:

目的 观察益气养营汤在重度膝骨关节炎人工膝关节表面置换围手术期应用临床疗效。 方法 82 例重度膝骨关节炎住院患者随机分为对照组与观察组,每组 41 例,对照组采用微创板式器械 人工膝关节表面置换手术+常规 ERAS,观察组在对照组治疗基础上,于术后第 2 天应用益气养营汤水煎 剂内服一日一剂,分两次服用,连续 1 周,比较两组手术前、术后第 1 天以及术后第 8 天的血常规红细胞 RBC)和血红蛋白(HGB)以及 D-二聚体数值,手术前以及术后第 8 天的膝关节活动度、膝关节 VAS 评分、 骨关节炎的严重程度指数和中医病证临床疗效。结果 两组 RBC HGB 术后第 1 天较术前显著下降,两 RBC HGB 术后第 8 天较术后第 1 天均显著上升,且观察组 RBC HGB 显著高于对照组。两组 D- 聚体术后第 1 天较术前显著升高,两组 D-二聚体术后第 8 天较术后第 1 天均显著降低,且观察组 D-二聚 体降低幅度显著优于对照组。两组膝关节活动度术后第 8 天较术前均显著改善,且观察组优于对照组。 两组 VAS 评分、骨关节炎的严重程度指数术后第 8 天较术前均显著下降,且观察组优于对照组。观察组 痊愈 26 例,显效 12 例,愈显率 92.7%,对照组痊愈 20 例,显效 13 例,愈显率 80.5%,观察组愈显率显著高于 对照组。结论 重度膝骨关节炎人工膝关节表面置换围手术期应用益气养营汤可改善术后贫血及凝血 功能,缓解疼痛,改善关节活动功能,提高中医病证疗效,加速患者术后康复。

关键词:

膝骨关节炎, 益气养营汤, 人工膝关节表面置换手术, 加速康复外科, 静脉血栓 栓塞症

Abstract:

Objective To study clinical curative effect of YiqiYangying Decoction used in perioperation for cases of severe knee osteoarthritis treated by artificial knee resurfacing surgery. Methods According to the in⁃ clusion and exclusion criteria,82 patients with severe knee osteoarthritis were randomly assigned to one of two groups:the control group and the YiqiYangying Decoction observation group. Patients in the control group under⁃ went artificial knee resurfacing surgery with conventional enhanced recovery after surgery. In the observation group,patients were given YiqiYangying Decoction for seven days in addition to the above ⁃mentioned treatment. To take statistical analysis of RBC,HGB,D⁃dimer of the patients in the two groups before,one day and eight days after the surgery. To compare knee range of motion,VAS and Lequesne MG of the patients in the two groups before and eight days after the surgery. Results RBC and HGB levels in both groups were significantly lower one day after surgery than before. RBC and HGB levels in both groups were significantly lower one day after surgery than before. RBC and HGB levels in the two groups were significantly higher eight days after surgery than one day after surgery. The RBC and HGB of the observation group were significantly higher than those of the control group. D⁃ dimer of the two groups one day after the surgery was significantly higher than before surgery and D⁃ dimer of the two groups eight days after the surgery was significantly lower than one day after the surgery. D⁃dimer of the the observation group was significantly lower than the control group. Knee range of motion of the two groups eight days after the surgery was significantly higher than before operation. Knee range of motion of the observation group was significantly higher than the control group. VAS and Lequesne MG of the two groups eight days after the surgery was significantly lower than before operation. VAS and Lequesne MG of the observation group was significantly lower than the control group. Twenty⁃six inpatients were cured and there were 12 inpatients of conspicuity in the observa⁃ tion group while 20 of cure and 13 of conspicuity in the control group. The rate of cure and conspicuity of the obser⁃vation group was significantly higher than the control group. Conclusion On the one hand,anemia and blood coagulation function were significantly improved,as was the curative effect of TCM diseases and syndromes;on the other hand,pain was relieved and joint motor function was significantly improved. YiqiYangying Decoction could be used to improve recovery after surgery in cases of severe knee osteoarthritis treated effectively with artificial knee resurfacing surgery.

Key words: knee osteoarthritis(KOA),  , YiqiYangying Decoction,  , artificial knee resurfacing surgery (AKRS),  , enhanced recovery after surgery(ERAS),  , venous thromboembolism(VTE)