本文選題：活血疏肝湯　切入點(diǎn)：TKA術(shù)后　出處：《湖南中醫(yī)藥大學(xué)》2016年碩士論文

【摘要】：目的:觀察活血疏肝湯對膝骨關(guān)節(jié)炎全膝關(guān)節(jié)置換術(shù)后患肢腫脹、疼痛的治療效果及對患肢功能恢復(fù)的影響,探討活血疏肝湯的臨床療效、作用機(jī)理及應(yīng)用前景。方法:選擇2015年1月至2015年12月期間在河南省洛陽正骨醫(yī)院膝部損傷一科住院治療并行單側(cè)全膝關(guān)節(jié)置換術(shù)的骨性關(guān)節(jié)炎患者75例。所有納入患者均填寫完整的病例資料,告知并簽署知情同意書后,按照受試者入院的先后順序,根據(jù)隨機(jī)數(shù)字表法將患者隨機(jī)分成對照組和試驗(yàn)組,試驗(yàn)組38例,對照組37例。所有患者均由同一組醫(yī)師在相同手術(shù)方式下行單側(cè)全膝關(guān)節(jié)置換術(shù),且植入相同假體類型。術(shù)前常規(guī)檢查、術(shù)后常規(guī)用藥及功能鍛煉指導(dǎo)方法相同。治療組在術(shù)后常規(guī)治療的基礎(chǔ)上給予口服活血疏肝湯治療,1日1劑,水煎服,早晚分服,7天為一個療程,治療1個療程。觀察并記錄兩組患者在術(shù)后第0、3、5、7天的靜息痛及活動痛的VAS評分;術(shù)后當(dāng)天用藥前兩組患者經(jīng)髕骨中點(diǎn)上10cm、經(jīng)髕骨中點(diǎn)下10cm患肢周徑及第3、5、7天各測量點(diǎn)的腫脹差值;術(shù)后第0、3、5、7天的膝關(guān)節(jié)主動屈伸活動度;第0、7天的膝關(guān)節(jié)HSS功能評分。使用SPSS21.0對所得數(shù)據(jù)進(jìn)行統(tǒng)計(jì)分析。結(jié)果:因有5例患者不能耐受中藥或因合并內(nèi)科疾病在研究期間服用其他影響療效的藥物而給予剔除,對照組剩余35例,試驗(yàn)組剩余35例。經(jīng)統(tǒng)計(jì)學(xué)處理分析如下:兩組患者術(shù)前在年齡、性別、部位及體質(zhì)量指數(shù)方面的分布差異均無統(tǒng)計(jì)學(xué)意義(P0.05),具有可比性。兩組患者術(shù)后當(dāng)天用藥前靜息痛及活動痛的VAS評分差異無統(tǒng)計(jì)學(xué)意義(P0.05),術(shù)后第3、5、7天的靜息痛及活動痛的VAS評分差異有統(tǒng)計(jì)學(xué)意義(P0.05)。兩組患者術(shù)后當(dāng)天用藥前膝關(guān)節(jié)主動屈伸活動度差異無統(tǒng)計(jì)學(xué)意義(P0.05),術(shù)后第3、5、7天的膝關(guān)節(jié)主動屈伸活動度差異有統(tǒng)計(jì)學(xué)意義(P0.05)。兩組患者術(shù)后當(dāng)天用藥前膝關(guān)節(jié)HSS評分差異無統(tǒng)計(jì)學(xué)意義(P0.05),術(shù)后第7天的膝關(guān)節(jié)HSS評分差異有統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論:活血疏肝湯聯(lián)合西醫(yī)常規(guī)治療全膝關(guān)節(jié)置換術(shù)后患肢腫痛療效顯著,可促進(jìn)患者術(shù)后功能鍛煉積極性,改善患側(cè)膝關(guān)節(jié)活動度,且經(jīng)濟(jì)實(shí)惠、服用方便,值得臨床推廣。
[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.

【學(xué)位授予單位】：湖南中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2016
【分類號】：R274.9

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