益气运脾法治疗全膝关节置换术后肿胀临床观察
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摘要
目的:观察益气运脾法治疗全膝关节置换术后肿胀的临床疗效。方法:将38例全膝关节置换术后肿胀患者随机分为对照组与观察组,各19例。对照组常规使用抗生素、低分子肝素钠、甘露醇等基础治疗,观察组采用益气运脾法(药物组成:甘遂0.5 g,京大戟1.5 g,人参12 g,白术10 g,茯苓20 g,猪苓30 g,炒薏苡仁30 g)中药内服治疗以益气运脾、攻下水饮、活血消肿,两组均持续治疗7d。统计两组患者临床疗效及不良反应发生情况。结果:观察组与对照组在术后第1天-第3天术肢肿胀程度比较,差异无统计学意义(P>0.05),在术后第5天、第7天两组患者术肢肿胀程度比较,差异有统计学意义(P<0.05);观察组治疗后第5天、第7天患肢小腿肿胀程度、膝关节周径缩小值均优于对照组,即减轻下肢肿胀的程度优于对照组(P<0.05)。两组患者术后第3天、第5天、第7天,两组疼痛视觉模拟评分法(visual analogue scale,VAS)评分比较,差异均有统计学意义(P<0.05)。结论:在常规治疗基础上,采用益气运脾法治疗全膝关节置换术后肿胀疗效显著,促进术后功能恢复,缩短治疗时间,减轻患者痛苦,无不良反应,是一种合理、有效的治疗方法。
Objective: to observe the clinical effect of Yiqi Yunpi Method on swelling after total knee arthroplasty. Methods: 38 cases of total knee arthroplasty were randomly divided into control group and observation group,with 19 cases in each group. The control group was treated with antibiotics,low molecular weight heparin,mannitol and other basic drugs,while the observation group was treated with Yiqi Yunpi Method(Drug composition: Euphorbia kansui Liou powder prepared with vinegar 0.5 g,Peking Euphorbia Root prepared with vinegar 1. 5 g,Ginseng 12 g,Atractylodes 10 g,Poria 20 g,Polyporus 30 g,fried Yiyiren 30 g,etc.). Patients were treated with traditional Chinese medicine by oral administration in order to benefit Qi and strengthen Spleen,dispel Water,activate Blood circulation and resolving swelling. Both groups experienced continued treatment for 7 days. The clinical efficacy and the adverse reactions occurred of the two groups were examined. Results: There was no significant difference between the observation group and the control group in the degree of swelling of the limbs on the first day and the third day after operation(P >0. 05). On the fifth day and the seventh day after the operation,the difference was statistically significant between the two groups of patients in limb swelling degree(P < 0. 05). The degree of swelling of lower limbs and the reduction of knee circumference of the observation group were significantly higher than those of the control group on the 5 th and 7 th days after treatment(P < 0. 05).There were significant differences in visual analogue scales(VAS) score between the two groups on the 3rd,5 th and 7 th day after operation(P < 0. 05). Conclusion: On the basis of routine treatment,it is effective to treat postoperative swelling with Yiqi Yunpi Method,which can promote postoperative functional recovery,shorten the treatment time,and relieve pain and no adverse reactions in patients.
Objective: to observe the clinical effect of Yiqi Yunpi Method on swelling after total knee arthroplasty. Methods: 38 cases of total knee arthroplasty were randomly divided into control group and observation group,with 19 cases in each group. The control group was treated with antibiotics,low molecular weight heparin,mannitol and other basic drugs,while the observation group was treated with Yiqi Yunpi Method(Drug composition: Euphorbia kansui Liou powder prepared with vinegar 0.5 g,Peking Euphorbia Root prepared with vinegar 1. 5 g,Ginseng 12 g,Atractylodes 10 g,Poria 20 g,Polyporus 30 g,fried Yiyiren 30 g,etc.). Patients were treated with traditional Chinese medicine by oral administration in order to benefit Qi and strengthen Spleen,dispel Water,activate Blood circulation and resolving swelling. Both groups experienced continued treatment for 7 days. The clinical efficacy and the adverse reactions occurred of the two groups were examined. Results: There was no significant difference between the observation group and the control group in the degree of swelling of the limbs on the first day and the third day after operation(P >0. 05). On the fifth day and the seventh day after the operation,the difference was statistically significant between the two groups of patients in limb swelling degree(P < 0. 05). The degree of swelling of lower limbs and the reduction of knee circumference of the observation group were significantly higher than those of the control group on the 5 th and 7 th days after treatment(P < 0. 05).There were significant differences in visual analogue scales(VAS) score between the two groups on the 3rd,5 th and 7 th day after operation(P < 0. 05). Conclusion: On the basis of routine treatment,it is effective to treat postoperative swelling with Yiqi Yunpi Method,which can promote postoperative functional recovery,shorten the treatment time,and relieve pain and no adverse reactions in patients.
引文
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[2]孙帆.地奥司明治疗全髋关节置换术后下肢水肿[J].白求恩医学院学报,2011,9(1):42-23.
[3]涂宏,杨风云,陈岗.活血利湿法治疗全膝关节置换术后肢体肿胀[J].实用中西医结合临床,2010,10(4):34.
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[6]刘桂花.中药离子导人对全膝关节置换术后疼痛和肿胀的影响[J].河北中医,2014,36(4):499-500.
[7]黄小强,王效东,靳卫章,等.关节置换术后下肢肿胀的分度及早期预防[J].中华物理医学康复杂志,2006,28(3):20.
[8]洪坤豪,刘军尬,潘建科.人工全膝关节置换术后下肢肿胀原因分析与治疗[J].按摩与康复医学,2015,6(11):8.
[9]沈忠伟,童培建,邵营钢.止血带对全膝关节置换术后肿胀及功能影响的临床研究[J].浙江临床医学,2010,12(3):261-262.
[10]郭明伟,李金松.髋膝关节置换术后下肢肿胀的诊治[J].中医临床研究,2011,3(21):93-94.
[11]全伟,牛志霞,郭妍.呋喃西林湿敷治疗膝关节置换术后下肢肿胀的疗效观察[J].中国美容医学,2012,21(10)465-466.
[12]杨刚,吕厚山.低分子肝素预防髓膝关节置换术后下肢深静脉血栓形成的研究[J].中华外科杂志,2000,38(1):26.
[13]吕厚山,徐斌.人工关节置换术后下肢深静脉血栓形成[J].中华骨科杂志,1999,19(3):155-156,160.
[14]高福强,李子剑.初次全膝关节置换术后肢体肿胀的影响因素研究[J].中国矫形外科杂志,2011,17(6):218-221.
[15]赵崇智,徐志强,潘海文.中医治疗骨折早期肿胀的研究进展[J].中国中医急症,2016,25(8):1564-1565.
[16]郭维淮.平乐正骨[M].北京:中国中医药出版社,1995:63.
[17]任远,刘如兰.加昧十枣汤联合胸膜腔化疗治疗晚期恶性肿瘤胸腔积液30例[J].陕西中医,2012,33(12):1579-1560.
[18]马俊.十枣汤辨证治疗胸腔积液38例[J].中国中医急症,2007,16(8):8-9.
[19]李航森,肖曼丽.十枣汤治疗恶性胸(腹)腔积液的研究现状[J].中西医结合研究,2012,1(2):93-94.
[20]王泽,蒋忠清,朱延龄.十枣汤治疗四肢新鲜骨折肿胀疗效观察[J].四川中医,2009,27(1):90-91.
[21]郁琴,宋后燕.水蛭素在深静脉血栓治疗中的作用[J].中国心血管病研究杂志,2005,3(5):392-394.
[2]孙帆.地奥司明治疗全髋关节置换术后下肢水肿[J].白求恩医学院学报,2011,9(1):42-23.
[3]涂宏,杨风云,陈岗.活血利湿法治疗全膝关节置换术后肢体肿胀[J].实用中西医结合临床,2010,10(4):34.
[4]中华医学会骨科学分会.骨关节炎诊治指南(2007年版)[J].中华骨科杂志,2007,27(10):793-796.
[5]申世源,陆金荣,李晓东.人工膝关节表面置换治疗严重膝关节骨性关节炎390例[J].实用中西医结合临床,2010,10(4):35.
[6]刘桂花.中药离子导人对全膝关节置换术后疼痛和肿胀的影响[J].河北中医,2014,36(4):499-500.
[7]黄小强,王效东,靳卫章,等.关节置换术后下肢肿胀的分度及早期预防[J].中华物理医学康复杂志,2006,28(3):20.
[8]洪坤豪,刘军尬,潘建科.人工全膝关节置换术后下肢肿胀原因分析与治疗[J].按摩与康复医学,2015,6(11):8.
[9]沈忠伟,童培建,邵营钢.止血带对全膝关节置换术后肿胀及功能影响的临床研究[J].浙江临床医学,2010,12(3):261-262.
[10]郭明伟,李金松.髋膝关节置换术后下肢肿胀的诊治[J].中医临床研究,2011,3(21):93-94.
[11]全伟,牛志霞,郭妍.呋喃西林湿敷治疗膝关节置换术后下肢肿胀的疗效观察[J].中国美容医学,2012,21(10)465-466.
[12]杨刚,吕厚山.低分子肝素预防髓膝关节置换术后下肢深静脉血栓形成的研究[J].中华外科杂志,2000,38(1):26.
[13]吕厚山,徐斌.人工关节置换术后下肢深静脉血栓形成[J].中华骨科杂志,1999,19(3):155-156,160.
[14]高福强,李子剑.初次全膝关节置换术后肢体肿胀的影响因素研究[J].中国矫形外科杂志,2011,17(6):218-221.
[15]赵崇智,徐志强,潘海文.中医治疗骨折早期肿胀的研究进展[J].中国中医急症,2016,25(8):1564-1565.
[16]郭维淮.平乐正骨[M].北京:中国中医药出版社,1995:63.
[17]任远,刘如兰.加昧十枣汤联合胸膜腔化疗治疗晚期恶性肿瘤胸腔积液30例[J].陕西中医,2012,33(12):1579-1560.
[18]马俊.十枣汤辨证治疗胸腔积液38例[J].中国中医急症,2007,16(8):8-9.
[19]李航森,肖曼丽.十枣汤治疗恶性胸(腹)腔积液的研究现状[J].中西医结合研究,2012,1(2):93-94.
[20]王泽,蒋忠清,朱延龄.十枣汤治疗四肢新鲜骨折肿胀疗效观察[J].四川中医,2009,27(1):90-91.
[21]郁琴,宋后燕.水蛭素在深静脉血栓治疗中的作用[J].中国心血管病研究杂志,2005,3(5):392-394.