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[1]孫京濤,劉宏建,魏瑄,等.電針聯(lián)合三七消腫止痛散外敷在全膝關(guān)節(jié)置換術(shù)后快速康復(fù)中的應(yīng)用[J].中醫(yī)正骨,2017,29(03):10-13,16.
　SUN Jingtao,LIU Hongjian,WEI Xuan,et al.Application of electroacupuncture combined with external application of Sanqi Xiaozhong Zhitong San(三七消腫止痛散)in rapid rehabilitation after total knee arthroplasty[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2017,29(03):10-13,16.
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電針聯(lián)合三七消腫止痛散外敷在全膝關(guān)節(jié)置換術(shù)后快速康復(fù)中的應(yīng)用()
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《中醫(yī)正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第29卷
期數(shù):
2017年03期
頁碼:
10-13,16
欄目:
臨床研究
出版日期:
2017-03-20

文章信息/Info

Title:
Application of electroacupuncture combined with external application of Sanqi Xiaozhong Zhitong San(三七消腫止痛散)in rapid rehabilitation after total knee arthroplasty
作者:
孫京濤1; 劉宏建2; 魏瑄1; 王少華1; 蔡松濤1
1.河南省鄭州市骨科醫(yī)院,河南 鄭州 450052; 2.鄭州大學(xué)第一附屬醫(yī)院,河南 鄭州 450052
Author(s):
SUN Jingtao1; LIU Hongjian2; WEI Xuan1; WANG Shaohua1; CAI Songtao1
1.Zhengzhou Orthopaedic Hospital,Zhengzhou 450052,Henan,China 2.The First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,Henan,China
關(guān)鍵詞:
關(guān)節(jié)成形術(shù); 置換; 膝;  骨關(guān)節(jié)炎; 膝;  電針;  針刺鎮(zhèn)痛;  中藥外敷;  三七消腫止痛散;  康復(fù)
Keywords:
arthroplasty; replacement; knee;  osteoarthritis; knee;  electroacupuncture;  acupuncture analgesia;  external applications(TCD);  Sanqi Xiaozhong Zhitong San;  rehabilitation
摘要:
目的:探討電針聯(lián)合三七消腫止痛散外敷在全膝關(guān)節(jié)置換術(shù)后快速康復(fù)中的應(yīng)用價值。方法:2015年6月至2016年6月,選擇接受單側(cè)全膝關(guān)節(jié)置換術(shù)的膝骨關(guān)節(jié)炎患者60例,隨機(jī)分為觀察組和對照組,每組30例。對照組單純進(jìn)行基礎(chǔ)治療,包括血栓通注射液靜脈滴注、邁之靈片口服、低分子肝素鈣注射液皮下注射; 觀察組在此基礎(chǔ)上采用電針聯(lián)合三七消腫止痛散外敷治療。分別于術(shù)前、術(shù)后第7天、術(shù)后第14天測量2組患者患膝關(guān)節(jié)活動度,采用疼痛視覺模擬評分(visual analoguc score,VAS)評價患膝疼痛情況; 分別于術(shù)前、術(shù)后第14天采用美國特種外科醫(yī)院(hospital for special surgery,HSS)膝關(guān)節(jié)評分評價患膝關(guān)節(jié)功能恢復(fù)情況; 并觀察并發(fā)癥發(fā)生情況。結(jié)果:2組患者術(shù)后切口均甲級愈合。手術(shù)前后不同時間點間膝關(guān)節(jié)活動度的差異有統(tǒng)計學(xué)意義,即存在時間效應(yīng)(F=365.649,P=0.000); 2組患者膝關(guān)節(jié)活動度總體比較,組間差異有統(tǒng)計學(xué)意義,即存在分組效應(yīng)(F=28.432,P=0.000); 術(shù)前、術(shù)后第14天,2組患者膝關(guān)節(jié)活動度的組間差異無統(tǒng)計學(xué)意義(87.167°±3.601°,88.600°±5.512°,t=-2.959,P=0.238; 119.833°±6.497°,119.000°±6.214°,t=0.258,P=0.614); 術(shù)后第7天,觀察組膝關(guān)節(jié)活動度大于對照組(107.700°±7.474°,95.667°±7.858°,t=36.933,P=0.000); 時間因素與分組因素存在交互效應(yīng)(F=14.018,P=0.000)。手術(shù)前后不同時間點間膝關(guān)節(jié)VAS評分的差異有統(tǒng)計學(xué)意義,即存在時間效應(yīng)(F=644.220,P=0.000); 2組患者膝關(guān)節(jié)VAS評分總體比較,組間差異有統(tǒng)計學(xué)意義,存在分組效應(yīng)(F=18.625,P=0.000); 術(shù)前、術(shù)后第14天2組患者膝關(guān)節(jié)VAS評分的組間差異無統(tǒng)計學(xué)意義[(8.433±1.278)分,(8.067±1.172)分,t=1.158,P=0.252;(1.467±1.008)分,(1.400±0.894)分,t=0.271,P=0.787]; 術(shù)后第7天,觀察組VAS評分低于對照組[(4.700±1.207)分,(6.633±1.066)分,t=6.573,P=0.000]; 時間因素與分組因素存在交互效應(yīng)(F=13.644,P=0.000)。術(shù)前2組患者膝關(guān)節(jié)HSS評分比較,組間差異無統(tǒng)計學(xué)意義[(42.733±8.525)分,(42.333±9.087)分; t=0.176,P=0.861]。術(shù)后第14天,2組患者膝關(guān)節(jié)HSS評分均較術(shù)前提高
[86.967±4.979)分,(42.733±8.525)分,t=-24.050,P=0.000;(86.333±5.403)分,(42.333±9.087)分,t=-23.433,P=0.000]; 但組間比較,差異無統(tǒng)計學(xué)意義[(86.967±4.979)分,(86.333±5.403)分; t=0.472,P=0.639]。術(shù)后2組各并發(fā)肌間靜脈血栓1例,經(jīng)患肢抬高制動和低分子肝素鈣注射液皮下注射處理后血栓消失。均無感染、關(guān)節(jié)脫位、假體松動等并發(fā)癥發(fā)生。2組患者并發(fā)癥發(fā)生率比較,組間差異無統(tǒng)計學(xué)意義(χ2=0.000,P=1.000)。結(jié)論:膝骨關(guān)節(jié)炎全膝關(guān)節(jié)置換術(shù)后,在活血、抗凝、消腫等藥物治療的基礎(chǔ)上采用電針聯(lián)合三七消腫止痛散外敷治療,可更快地減輕患膝疼痛和恢復(fù)膝關(guān)節(jié)活動度,安全可靠。
Abstract:
ABSTRACT Objective:To explore the applied value of electroacupuncture combined with external application of Sanqi Xiaozhong Zhitong San(三七消腫止痛散,SQXZZTS)in rapid rehabilitation after total knee arthroplasty(TKA).Methods:Sixty patients with knee osteoarthritis(KOA)who were treated with unilateral TKA were selected from June 2015 to June 2016 and randomly divided into observation group and control group,30 cases in each group.All patients were treated with intravenous drip of Xueshuantong(血栓通)injection,oral application of Aescuven forte tablets and subcutaneous injection of low-molecular-weight heparins calcium injection(LMWHC).Moreover,----------------------------------------------- the patients in observation group were treated with electroacupuncture combined with external application of SQXZZTS.The range of motion(ROM)of knee was measured and the knee pain was evaluated by using visual analoguc score(VAS)before the surgery and at 7 and 14 days after the surgery respectively.The knee joint function recovery was also evaluated by using Hospital for Special Surgery(HSS)scores before the surgery and at 14 days after the surgery respectively.Furthermore,the complications were recorded.Results:All patients got primary healing in the operative incisions.There was statistical difference in the ROM of knee between different timepoints before and after the surgery,in other words,there was time effect(F=365.649,P=0.000).There was statistical difference in the ROM of knee between the 2 groups in general,in other words,there was group effect(F=28.432,P=0.000).There was no statistical difference in the ROM of knee between the 2 groups before the surgery and at 14 days after the surgery respectively(87.167+/-3.601 vs 88.600+/-5.512 degrees,t=-2.959,P=0.238; 119.833+/-6.497 vs 119.000+/-6.214 degrees,t=0.058,P=0.614).The ROM of knee was greater in observation group compared to control group at 7 days after the surgery(107.700+/-7.474 vs 95.667+/-7.858 degrees,t=36.933,P=0.000).There was interaction between time factor and group factor(F=14.018,P=0.000).There was statistical difference in the knee VAS scores between different timepoints before and after the surgery,in other words,there was time effect(F=644.220,P=0.000).There was statistical difference in the knee VAS scores between the 2 groups in general,in other words,there was group effect(F=18.625,P=0.000).There was no statistical difference in the knee VAS scores between the 2 groups before the surgery and at 14 days after the surgery respectively(8.433+/-1.278 vs 8.067+/-1.172 points,t=1.158,P=0.252; 1.467+/-1.008 vs 1.400+/-0.894 points,t=0.271,P=0.787).The knee VAS scores were lower in observation group compared to control group at 7 days after the surgery(4.700+/-1.207 vs 6.633+/-1.066 points,t=6.573,P=0.000).There was interaction between time factor and group factor(F=13.644,P=0.000).There was no statistical difference in the knee HSS scores between the 2 groups before the surgery(42.733+/-8.525 vs 42.333+/-9.087 points,t=0.176,P=0.861).The knee HSS scores increased in both of the 2 groups at 14 days after the surgery(86.967+/-4.979 vs 42.733+/-8.525 points,t=-24.050,P=0.000; 86.333+/-5.403 vs 42.333+/-9.087 points,t=-23.433,P=0.000),while there was no statistical difference in the knee HSS scores between the 2 groups(86.967+/-4.979 vs 86.333+/-5.403 points,t=0.472,P=0.639).The intermuscular venous thrombosis was found in both of the 2 groups after the surgery,1 case in each group.The thrombus disappeared after treating with raising and braking the affected limbs and subcutaneous injection of LMWHC.No complications such as infection,joint dislocation,prosthesis loosening occurred.There was no statistical difference in complication incidences between the 2 groups(χ2=0.000,P=1.000).Conclusion:On the basis of treatment with activating blood drug,anticoagulation drug and detumescence drug,application of electroacupuncture combined with external application of SQXZZTS can alleviate the knee pain and restore the knee ROM more quickly after TKA for treatment of KOA,and it is safe and reliable.

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備注/Memo:
通訊作者:魏瑄 E-mail:[email protected]
更新日期/Last Update: 1900-01-01