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[1]李國(guó)梁,韓廣普,閆國(guó)強(qiáng),等.紅花化瘀湯薰蒸聯(lián)合理筋手法 在膝骨關(guān)節(jié)炎全膝關(guān)節(jié)置換術(shù)后康復(fù)中的應(yīng)用[J].中醫(yī)正骨,2013,25(12):31-34.
　Li Guoliang*,Han Guangpu,Yan Guoqiang,et al.Clinical application of HONGHUAHUAYU decoctions steaming combined with sinew adjusting manipulation in the postoperative rehabilitation of total knee arthroplasty in patients with knee osteoarthritis[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2013,25(12):31-34.
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紅花化瘀湯薰蒸聯(lián)合理筋手法 在膝骨關(guān)節(jié)炎全膝關(guān)節(jié)置換術(shù)后康復(fù)中的應(yīng)用()
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《中醫(yī)正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第25卷
期數(shù):
2013年12期
頁(yè)碼:
31-34
欄目:
臨床研究
出版日期:
2013-12-30

文章信息/Info

Title:
Clinical application of HONGHUAHUAYU decoctions steaming combined with sinew adjusting manipulation in the postoperative rehabilitation of total knee arthroplasty in patients with knee osteoarthritis
作者:
李國(guó)梁; 韓廣普; 閆國(guó)強(qiáng); 陳華; 付強(qiáng); 郭東輝; 沈潤(rùn)斌; 張洪相
河北省滄州中西醫(yī)結(jié)合醫(yī)院,河北 滄州 061001
Author(s):
Li Guoliang*; Han Guangpu; Yan Guoqiang; Chen Hua; Fu Qiang; Guo Donghui; Shen Runbin; Zhang Hongxiang.*
Cangzhou Hospital of Integrated Traditional Chinese Medicine and Western Medicine,Changzhou,061001,Hebei,China
關(guān)鍵詞:
骨關(guān)節(jié)炎; 膝 關(guān)節(jié)成形術(shù); 置換; 膝 中醫(yī)康復(fù) 薰洗 推拿 紅花化瘀湯
Keywords:
Osteoarthritis; knee;  Arthroplasty; replacement; knee;  Rehabilitation(TCM);  Steaming washing therapy;  TUINA;  HONGHUAHUAYU decoctions
摘要:
目的:探討紅花化瘀湯薰蒸聯(lián)合理筋手法在膝骨關(guān)節(jié)炎全膝關(guān)節(jié)置換術(shù)后康復(fù)中的應(yīng)用價(jià)值。方法:膝骨關(guān)節(jié)炎全膝關(guān)節(jié) 置換術(shù)后患者72例,男29例,女43例; 年齡59～78歲,中位數(shù)69.5歲; 左側(cè)24例,右側(cè)33例,雙側(cè)15例; 病程5～10年,中位數(shù)6.5年 。隨機(jī)分為2組,每組36例; 觀察組采用紅花化瘀湯薰蒸聯(lián)合理筋手法進(jìn)行康復(fù)治療; 對(duì)照組單純采用理筋手法進(jìn)行康復(fù)治療; 共治療1個(gè)月。分別于術(shù)前、術(shù)后1個(gè)月、術(shù)后6個(gè)月,測(cè)量2組患者患膝關(guān)節(jié)活動(dòng)度,并依據(jù)美國(guó)特種外科醫(yī)院膝關(guān)節(jié)評(píng)分標(biāo)準(zhǔn)對(duì) 患膝進(jìn)行評(píng)分。結(jié)果:手術(shù)前后不同時(shí)間點(diǎn)間患膝關(guān)節(jié)活動(dòng)度比較,差異有統(tǒng)計(jì)學(xué)意義(F=45.809,P=0.000),存在時(shí)間效應(yīng); 2組 患者間患膝關(guān)節(jié)活動(dòng)度比較,差異有統(tǒng)計(jì)學(xué)意義(F=6.768,P=0.000),存在分組效應(yīng); 術(shù)前2組患者間患膝關(guān)節(jié)活動(dòng)度比較,差異無(wú) 統(tǒng)計(jì)學(xué)意義(92.250°±11.560°,90.140°±11.090°; t=1.131,P=1.000); 術(shù)后1個(gè)月,觀察組患膝關(guān)節(jié)活動(dòng)度優(yōu)于 對(duì)照組(115.159°±6.534°,100.884°±9.024°; t=7.650,P=0.000); 術(shù)后6個(gè)月,2組患者間患膝關(guān)節(jié)活動(dòng)度比較, 差異無(wú)統(tǒng)計(jì)學(xué)意義(122.614°±4.999°,117.558°±7.018°; t=2.709,P=0.108); 時(shí)間因素與分組因素存在交互效 應(yīng)(F=11.344,P=0.000)。手術(shù)前后不同時(shí)間點(diǎn)間患膝評(píng)分比較,差異有統(tǒng)計(jì)學(xué)意義(F=10.359,P=0.002),存在時(shí)間效應(yīng); 2組患者 間患膝評(píng)分比較,差異有統(tǒng)計(jì)學(xué)意義(F=3.218,P=0.002),存在分組效應(yīng); 術(shù)前2組患者間患膝評(píng)分比較,差異無(wú)統(tǒng)計(jì)學(xué)意義 [(37.318±10.108)分,(38.256±13.093)分; t=0.557,P=1.000]; 術(shù)后1個(gè)月,觀察組患膝評(píng)分高于對(duì)照組 [(85.250±4.309)分,(76.140±6.364)分; t=5.411,P=0.000); 術(shù)后6個(gè)月,2組患者間患膝評(píng)分比較,差異無(wú)統(tǒng)計(jì)學(xué)意 義[(88.273±4.321)分,(87.280±4.435)分; t=0.383,P=1.000); 時(shí)間因素與分組因素存在交互效應(yīng) (F=9.725,P=0.000)。結(jié)論:采用紅花化瘀湯薰蒸聯(lián)合理筋手法對(duì)膝骨關(guān)節(jié)炎全膝關(guān)節(jié)置換術(shù)后患者進(jìn)行康復(fù)治療,可促進(jìn)患膝功 能恢復(fù),近期療效優(yōu)于單純理筋手法。
Abstract:
Objective:To explore the clinical value of HONGHUAHUAYU decoctions steaming combined with sinew adjusting manipulation in the postoperative rehabilitation of total knee arthroplasty in patients with knee osteoarthritis.Methods:Seventy-two patients with knee osteoarthritis treated with total knee arthroplasty were randomly divided into 2 groups,36 cases in each group.The patients consisted of 29 males and 43 females,and ranged in age from 59 to 78 years(Median=69.5 yrs)and ranged in disease course from 5 to 10 years(Median=6.5 yrs).The osteoarthritis located in left knee for 24 patients and right knee for 33 patients and both knee for 15 patients.Patients in observation group were treated with HONGHUAHUAYU decoctions steaming combined with sinew adjusting manipulation,while patients in control group were treated only with sinew adjusting manipulation.The total disease course was 1 month.The knee range of motion(ROM)was measured before the surgery and at 1 and 6 months after the surgery,and the knee performance was evaluated according to the Hospital for Special Surgery(HSS)knee performance score.Results:There was statistical difference in the knee ROM between different time points(F=45.809,P=0.000),in other words,there was time effect.There was statistical difference in knee ROM between the 2 groups(F=6.768,P=0.000),in other words,there was group effect.Before the surgery,there was no statistical difference in knee ROM between the 2 groups(92.250°+/-11.560° vs 90.140° +/-11.090°,t=1.131,P=1.000).At one month after the surgery,the knee ROM of observation group was larger than that of control group(115.159°+/-6.534° vs 100.884°+/-9.024°,t=7.650,P=0.000).At six months after the surgery,there was no statistical difference in knee ROM between the 2 groups(122.614°+/-4.999° vs 117.558° +/-7.018°,t=2.709,P=0.108).There was interaction between time factor and grouping factor (F=11.344,P=0.000).There was statistical difference in the HSS scores between different time points (F=10.359,P=0.002),in other words,there was time effect.There was statistical difference in the HSS scores between the 2 groups(F=3.218,P=0.002),in other words,there was group effect.Before the surgery,there was no statistical difference in the HSS scores between the 2 groups(37.318+/-10.108 vs 38.256+/-13.093 points,t=0.557,P=1.000).At one-month after the surgery,the HSS scores of observation group was larger than that of control group(85.250+/-4.309 vs 76.140+/-6.364 points,t=5.411,P=0.000).At six months after the surgery,there was no statistical difference in the HSS scores between the 2 groups(88.273+/-4.321 vs 87.280+/-4.435 points,t=0.383,P=1.000).There was interaction between time factor and grouping factor (F=9.725,P=0.000).Conclusion:The therapy of HONGHUAHUAYU decoctions steaming combined with sinew adjusting manipulation can promote the recovery of knee function after the total knee arthroplasty in patients with knee osteoarthritis,and it is better than the monotherapy of sinew adjusting manipulation in the short-term curative effect.

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備注/Memo

備注/Memo:
2013-02-26收稿 2013-10-12修回
更新日期/Last Update: 2013-12-30