当归补血汤防治全膝关节置换术后贫血的疗效观察

The observation of curative effect of Danggui Buxue Decoction in preventing and treating anemia after total knee arthroplasty

目的当归补血汤防治全膝关节置换(TKA)术后贫血的疗效和安全性.方法选择2019年10月至2021年3月接受初次TKA的终末期膝骨关节炎患者60例,分为观察组和对照组.观察组在术前3 d开始服用当归补血汤加减(黄芪30 g、当归6 g、党参10 g、白术10 g、川芎10 g、鸡血藤10 g),疗程14 d;对照组不服用中药.观察术前及术后第1、7、14天血红蛋白(HGB)、红细胞(RBC)及红细胞压积(HCT),术前及术后第14天的膝关节临床评分(KS-C)、膝关节功能评分(KS-F)、中医证候积分量表和不良事件.结果观察组RBC、HGB、HCT、KS-C、KS-F、中医证候积分均优于对照组,差异有统计学意义(P<0.05),且两组均无重度贫血、失血性休克、严重肝肾功能损伤等不良事件发生.结论当归补血汤可提升TKA患者术后RBC、HGB、HCT水平,降低中医证候积分,改善患者术后贫血症状,促进术后关节功能恢复.

Objective To evaluate the clinical eficacy and safety of Danggui Buxue Decoction in the prevention and treatment of anemia fter total knee arthroplasty(TKA).Methods Sixty patients with end-stage knee osteoarthritis who received primary TKA from October 2019 to March 2021 were divided into traditional Chinese medicine group and control group.The traditional Chinese medicine(TCM)group began to take Danggui Buxue Decoction(Astragalus 30 g,angelica 6 g,Codonopsis pilosula 10 g,Atractylodes macrocephala 10 g,Chuanxiong 10 g and Caulis Spatholobi 10 g)3 days before operation for 14 days.The control group did not take traditional Chinese medicine.Hemoglobin(HGB),red blood cell(RBC)and hematocrit(HCT)before and on the 1st,7th and 14th day after operation,knee clinical score(KS-C),knee function score(KS-F),TCM syndrome score scale and adverse events were observed.Results The results on the 14th day after operation showed that RBC,HGB,HCT,KS-C,KS-F and TCM syndrome score in the traditional Chinese medicine group were better than those in the control group,and the difference was statistically significant(P<0.05),with no adverse events such as severe anemia,hemorrhagic shock and severe liver and kidney function injury in the two groups.Conclusion Danggui Buxue Decoction can improve the levels of RBC,HGB and HCT in patients with TKA,reduce the score of TCM syndrome,improve the symptoms of anemia and promote the recovery ofjoint function.