益气运脾法治疗全膝关节置换术后肿胀临床观察

Clinical Observation of Tiqi Yunpi Method in Treatment of Swelling After Total Knee Arthroplasty

目的:观察益气运脾法治疗全膝关节置换术后肿胀的临床疗效。方法:将38例全膝关节置换术后肿胀患者随机分为对照组与观察组,各19例。对照组常规使用抗生素、低分子肝素钠、甘露醇等基础治疗,观察组采用益气运脾法(药物组成:甘遂0.5 g,京大戟1.5 g,人参12 g,白术10 g,茯苓20 g,猪苓30 g,炒薏苡仁30 g)中药内服治疗以益气运脾、攻下水饮、活血消肿,两组均持续治疗7d。统计两组患者临床疗效及不良反应发生情况。结果:观察组与对照组在术后第1天-第3天术肢肿胀程度比较,差异无统计学意义(P>0.05),在术后第5天、第7天两组患者术肢肿胀程度比较,差异有统计学意义(P<0.05);观察组治疗后第5天、第7天患肢小腿肿胀程度、膝关节周径缩小值均优于对照组,即减轻下肢肿胀的程度优于对照组(P<0.05)。两组患者术后第3天、第5天、第7天,两组疼痛视觉模拟评分法(visual analogue scale,VAS)评分比较,差异均有统计学意义(P<0.05)。结论:在常规治疗基础上,采用益气运脾法治疗全膝关节置换术后肿胀疗效显著,促进术后功能恢复,缩短治疗时间,减轻患者痛苦,无不良反应,是一种合理、有效的治疗方法。

Objective： to observe the clinical effect of Yiqi Yunpi Method on swelling after total knee arthroplasty. Methods： 38 cases of total knee arthroplasty were randomly divided into control group and observation group,with 19 cases in each group. The control group was treated with antibiotics,low molecular weight heparin,mannitol and other basic drugs,while the observation group was treated with Yiqi Yunpi Method（Drug composition： Euphorbia kansui Liou powder prepared with vinegar 0.5 g,Peking Euphorbia Root prepared with vinegar 1. 5 g,Ginseng 12 g,Atractylodes 10 g,Poria 20 g,Polyporus 30 g,fried Yiyiren 30 g,etc.）. Patients were treated with traditional Chinese medicine by oral administration in order to benefit Qi and strengthen Spleen,dispel Water,activate Blood circulation and resolving swelling. Both groups experienced continued treatment for 7 days. The clinical efficacy and the adverse reactions occurred of the two groups were examined. Results： There was no significant difference between the observation group and the control group in the degree of swelling of the limbs on the first day and the third day after operation（P〈 0. 05）. On the fifth day and the seventh day after the operation,the difference was statistically significant between the two groups of patients in limb swelling degree（P〈 0. 05）. The degree of swelling of lower limbs and the reduction of knee circumference of the observation group were significantly higher than those of the control group on the 5 th and 7 th days after treatment（P〈 0. 05）.There were significant differences in visual analogue scales（VAS） score between the two groups on the 3rd,5 th and 7 th day after operation（P〈 0. 05）. Conclusion： On the basis of routine treatment,it is effective to treat postoperative swelling with Yiqi Yunpi Method,which can promote postoperative functional recovery,shorten the treatment time,and relieve pain and no adverse reactions in patients.