五味双柏散外敷缓解疼痛在髋关节置换术后快速康复中的临床应用

Clinical Observation of External Application of Wuwei Shuangbai Powder in Relieving Pain of Patients After Total Hip Arthroplasty for Fast-track Surgery

【目的】探讨五味双柏散外敷缓解疼痛在髋关节置换术(THA)后早期快速康复中的临床应用效果。【方法】选择行单侧THA患者64例,随机分为试验组33例和对照组31例。2组患者均于术后当天、第1天、第2天常规给予静脉注射帕瑞昔布钠40 mg,每日2次,后均改为口服塞来昔布胶囊200 mg,每日2次。试验组在此基础上,术后第1天给予伤口下缘外敷五味双柏散,每日2次。所有患者若仍有疼痛则额外给予盐酸曲马多缓释片口服。记录2组患者住院天数、住院期间所用曲马多剂量,以及术后第2天、第4天患者的疼痛视觉模拟评分(VAS)情况。【结果】(1)试验组患者的住院天数少于对照组,盐酸曲马多缓释片用量少于对照组,差异有统计学意义(P<0.01)。(2)术后第2天,2组患者VAS评分比较,差异无统计学意义(P>0.05);术后第4天,2组患者VAS评分均较术后第2天改善(P<0.05或P<0.01),且试验组对VAS评分的改善作用明显优于对照组,差异有统计学意义(P<0.01)。【结论】五味双柏散外敷可以减轻THA术后患者的疼痛不适,减少镇痛药物的应用,缩短住院周期,促进THA术后患者的快速康复。

Objective To investigate the clinical effect of external application of Wuwei Shuangbai Powder（WSP）on relieving pain of patients after total hip arthroplasty（THA）for fast-track surgery. Method Sixty-four patientsundergoing unilateral THA were selected,and were randomly divided into experimental group（N = 33）and controlgroup（N = 31）. Both groups were injected with parecoxib sodium 40 mg twice a day intravenously right after THAand on postoperative day 1 and 2, and then were given oral use of celecoxib capsules 200 mg twice a day.Additionally,the experimental group was given external application of WSP on the wound margin twice a day onpostoperative day 1,and was given extra oral use of Tramadol Hydrochloride Sustained-release Tablets for thepatients still having the pain. The hospitalization days,tramadol dosage during the hospitalization,and VisualAnalogue Scale（VAS）pain scores on postoperative day 2 and 4 in the two groups were recorded and compared.Results（1）The hospitalization days and tramadol dosage during the hospitalization in the experimental group wereless than those in the control group,the difference being significant（P〈0.01）.（2）The differences of VAS painscores between the two groups were insignificant on postoperative day 2（P〉0.05）;but on postoperative day 4,the scores were much improved as compared with those on postoperative day 2（P〈0.05 or P〈0.01）,and the improvement in the experimental group was superior to that in the control group（P〈0.01）. Conclusion Externalapplication of WSP is effective on relieving the pain of post-THA patients,reducing the total dosage of analgesicdrugs,shortening the hospitalization time and promoting the recovery of patients following THA for fast-track surgery.