推拿联合疏血通注射液对全膝关节置换术后关节功能的影响

Effects of Tuina and Chinese patent drug Shuxuetong injection on deep venous thrombosis and functional rehabilitation after total knee arthroplasty

目的：探讨在类风湿关节炎患者全膝关节置换术后,推拿联合疏血通注射液预防深静脉血栓形成,促进功能康复的有效性。方法：2008年6月~2009年7月选择上海市光华中西医结合医院骨科病房的120例类风湿关节炎患者,均进行全膝关节置换手术。手术后分为对照组60例,治疗组60例。对照组予持续性被动运动（continuous passive motion,CPM）机、下肢等张性肌肉收缩训练进行功能康复,共2周。治疗组在常规康复基础上加用推拿及活血化瘀中药,共2周。治疗后对患者进行特种外科医院（Hospital for Special Surgery,HSS）膝关节评分,并对深静脉血栓发生情况和关节活动度进行评价。结果：两组患者手术前后HSS膝关节评分、关节活动度比较,差异无统计学意义（P〉0.05）,术后治疗组关节活动度高于对照组,但差异无统计学意义（P〉0.05）。治疗组患者治疗后深静脉血栓形成发生率（13.33%）低于对照组（20.00%）（P〈0.05）。结论：在类风湿关节炎患者全膝关节置换术后,早期予推拿联合疏血通注射液干预,可以有效地预防深静脉血栓的形成。

Objective：To evaluate the efficacy of Tuina and Chinese patent drug Shuxuetong injection in preventing patients undergoing total knee arthroplasty from deep venous thrombosis and in functional rehabilitation.Methods：A total of 120 patients with diagnosed rheumatoid arthritis in the Department of Orthopaedic Surgery,Shanghai Guanghua Hospital of Integrated Traditional Chinese and Western Medicine in China were enrolled for this study.The patients underwent total knee arthroplasty and were divided into treatment group（n=60）and control group（n=60）after surgery.Patients in the control group received conventional rehabilitation training,including using a continuous passive motion machine and training of muscle contractions of the lower limb.Patients in the treatment group were administered Shuxuetong injection and Tuina based on the conventional rehabilitation training.The course of treatment lasted for 2 weeks.Hospital for Special Surgery（HSS）knee score,rate of deep venous thrombosis and range of motion of the knee joint were evaluated before and after treatment.Results：There was no significant difference in HSS knee score and range of motion as compared before and after treatment in two group（P0.05）.The rate of deep venous thrombosis of the treatment group was 13.33%,which was lower than 20% of the control group（P0.05）.Conclusion：Tuina combined with Shuxuetong injection treatment can prevent deep venous thrombosis in patients with rheumatoid arthritis after total knee arthroplasty.