摘要
目的 探究四物镇痛方结合膝关节穴位针刺促进全膝关节置换术患者康复效果。方法 研究纳入124例全膝关节置换术患者(2019年7月—2021年7月),采取随机数字表法将患者分成两组各62例。两组患者均行全膝关节置换术治疗,对照组患者术后疼痛可口服依托考昔片120 mg,并进行术后主动锻炼;观察组患者在对照组治疗基础上结合四物镇痛方及膝关节穴位针刺治疗,比较各组患者疗效、术后1 d、术后3 d、术后7 d及术后14 d患者视觉模拟疼痛评分(VAS)情况、患者术后并发症情况、治疗前后患者中医证候积分(局部刺痛、皮下瘀斑、离经之血、肢体沉重、气短懒言、面色萎黄或[白光]白等)变化、治疗前后血清炎症因子指标水平变化、膝关节肿胀程度及膝关节活动度变化、膝关节功能评分(HSS)变化、世界卫生组织生存质量评定量表(QOL-BRER)评分变化。结果 与对照组(85.48%,53/62)比较,观察组优良率(98.39%,61/62)更高(P<0.05);术后1 d、术后3 d、术后7 d、术后14 d观察组患者VAS评分均低于对照组患者,P<0.05;观察组患者术后并发症率(3.23%,2/62)低于对照组患者(14.52%,9/62)(P<0.05);治疗前,两组患者中医证候积分(局部刺痛、皮下瘀斑、离经之血、肢体沉重、气短懒言、面色萎黄或[白光]白等)、血清炎症因子指标、膝关节肿胀程度及膝关节活动度、HSS评分、QOL-BRER评分比较(P>0.05),治疗后各组患者中医证候积分(局部刺痛、皮下瘀斑、离经之血、肢体沉重、气短懒言、面色萎黄或[白光]白等)、血清炎症因子指标、膝关节肿胀程度及膝关节活动度、HSS评分、QOL-BRER评分均改善,观察组患者治疗后中医证候积分(局部刺痛、皮下瘀斑、离经之血、肢体沉重、气短懒言、面色萎黄或[白光]白等)、血清炎症因子指标、膝关节肿胀程度及膝关节活动度、HSS评分、QOL-BRER评分优于对照组患者(P<0.05)。结论 四物镇痛方结合膝关节穴位针刺可较好促进全膝关节置换术患者康复,患者术后疼痛缓解,症状改善,并发症率低,膝关节功能恢复好,患者生活质量提升,值得应用。
Objective To explore the effect of Siwu Zhentong Formula(四物镇痛方) combined with acupuncture at knee acupoints on promoting the rehabilitation of patients undergoing total knee arthroplasty.Methods A total of 124 total knee replacement patients(from July 2019 to July 2021) were included in the study.The patients were divided into two groups by random number table method,with 62 patients in each group.Patients in both groups were treated with total knee replacement.Patients in the control group were given etonoxy tablet 120 mg for postoperative pain,and were actively exercised after surgery.The observation group was treated on the basis of the control group and combined with Siwu Zhentong Formula and acupuncture at knee acupoints.The curative effect,pain score(visual analogue pain scale,VAS) of patients at 1 d,3 d,7 d and 14 d after operation,postoperative complications,changes of traditional Chinese medicine syndrome scores(local tingling,subcutaneous ecchymosis,blood from menstruation,heavy limbs,shortness of breath,sallow or white complexion) of patients before and after treatment,changes of serum inflammatory factor indexes before and after treatment,changes of knee swelling degree and knee range of motion,knee function score(HSS) and World Health Organization Quality of life rating scale(QOL-BRER) were compared.Results Compared with that(85.48%,53/62) of the control group,the excellent rate in the observation group(98.39%,61/62) was higher(P0.05).After treatment,traditional Chinese medicine syndrome scores(local tingling,subcutaneous ecchymosis,blood from menstruation,heavy limbs,shortness of breath,sallow or white complexion),serum inflammatory factor indexes,knee swelling degree and knee range of motion,HSS score and QOL-BRER score were all improved in each group.After treatment,those in the observation group were better than those in the control group(P<0.05).Conclusion Combined with acupuncture at knee acupoints,Siwu Zhentong Formula can effectively promote the rehabilitation of patients undergoing total knee arthroplasty,with postoperative pain relief,improvement of symptoms,low complication rate,good recovery of knee function and improvement of patients’ quality of life,which is worthy of application.
作者
李爱强
张锐
柴喜平
柳海平
LI Aiqiang;ZHANG Rui;CHAI Xiping;LIU Haiping(Gansu Provincial Hospital of Traditional Chinese Medicine,Lanzhou 730050,Gansu,China)
出处
《中华中医药学刊》
CAS
北大核心
2022年第8期221-224,共4页
Chinese Archives of Traditional Chinese Medicine
基金
甘肃省自然科学基金(21JR1RA059)。
关键词
全膝关节置换术
四物镇痛方
膝关节穴位针刺
疗效
中医证候积分
并发症
total knee replacement
Siwu Zhentong Formula(四物镇痛方)
acupuncture at knee acupoints
curative effect
traditional Chinese medicine syndrome integral
complications
