桃红四物汤治疗膝骨性关节炎关节镜术后肢体肿胀的临床观察

Clinical Observation on Taohong Siwu Decoction in the Treatment of Limb Swelling After Arthroscopic Surgery of Knee Osteoarthritis

目的通过对桃红四物汤加减治疗膝骨性关节炎关节镜术后肢体肿胀的临床观察,评估其有效性及安全性,为治疗膝骨性关节炎关节镜术后肢体肿胀提供临床依据。方法将90例下肢术后出现肢体肿胀的患者,用简单随机数字表法分为3组。治疗组:基础治疗口服桃红四物汤,每日1剂,2次每日;对照组:基础治疗及采用20%甘露醇250 mL静脉点滴,每日1次;基础治疗组:弹力绷带及踝泵功能锻炼,锻炼每日2次,每次约20 min。3组治疗疗程均为2周,术后在治疗疗程中记录比较各组术后肢体肿胀肢体周径、疼痛程度的改善情况和治疗总有效率。结果 (1)术后第2、4、6天患者肢体疼痛程度无明显差异性;(2)术后第5天,肿胀改善有效率治疗组为83.3%(25/30),对照为80.0%(24/29),基础治疗组63%(17/28),治疗组与对照组比较无显著差异(P>0.05);2组均优于基础组,有显著差异。(3)2周后治疗效果,治疗组有效率为97.6%(29/30),对照组为86.2%(21/28),基础治疗组:75.0%,组间比较有显著差异(P<0.05)。结论桃红四物汤加减治疗膝关节炎关节镜术后肢体肿胀有着良好的临床疗效,运用简单,方便;尤其对术后肿胀发挥独特的疗效,为治疗膝关节镜术后肢体肿胀提供一种新的研究思路。

Objective Through the clinical observation of the effect of Taohong Siwu decoction on the limbs swelling after arthroscopic treatment of knee osteoarthritis, its effectiveness and safety were evaluated and analyzed to provide clinical evidence for the treatment of limb swelling after knee osteoarthritis arthroscopy. Methods Ninety patients with limbs swelling after operation were divided into three groups（treatment group, control group, basic treatment group） by simple random number table method. The treatment group used basic treatment of oral administration of Taohong Siwu decoction, daily, 2 times daily. The control group used basic treatment and use of 20% mannitol 250 ml intravenous drip once daily. The basic treatment group used elastic bandages and ankle pump function Exercise, exercise 2 times a day, each about 20 minutes. The three groups were treated for two weeks. After the operation,the circumference of limb swelling in each group was recorded and compared, the improvement of the degree of pain and the total effective rate were recorded. Results There was no significant difference in limb pain between 2, 4 and 6 days after surgery. At 5 days after operation, the effective rate of swelling was 83.3 % in the treatment group, 80.0% in the control group and 63% in the basic treatment group. There was no significant difference between the treatment group and the control group（ P 〉 0.05）. After 2 weeks of treatment, the effective rate was 97.6% in the treatment group, 86.2% in the control group and 75.0% in the basic treatment group. There was significant difference between the two groups（ P 〈0.05）. Conclusion The modified Taohong Siwu decoction in the treatment of arthritis of knee arthritis has good clinical curative effect, which is simple and convenient to use. Especially post-operative swelling exerts more unique curative effect in the condition that other methods are difficult to be effective. It provides a new research idea for the treatment of limb swelling after knee arthroscopy.