活血舒筋汤辅助治疗在人工髋关节置换术后患者中的应用观察

Application of Huoxue Shujin decoction auxiliary therapy in patients after artificial hip replacement

目的:研究活血舒筋汤辅助治疗在人工髋关节置换术后患者中的应用效果。方法:以2021年7月至2022年4月我院收治的108例行人工髋关节置换术的患者为研究对象,随机将患者分为A组、B组,每组各54例。B组采用常规西药治疗,A组采用活血舒筋汤辅助常规西药治疗。治疗2 w后,采用视觉模拟评分(Visual analogue scale,VAS)评估疼痛程度,简式弗戈梅尔运动功能量表(Fugl-meyer motor function assessment,FMA)评估运动功能,Harris评分量表评估髋关节功能,测量下肢(大腿、小腿)周径差;采用全自动凝血分析仪检测凝血功能指标[活化部分凝血酶原时间(Activated partial thromboplastin time,APTT)、凝血酶原时间(Prothrombin time,PT)、D-二聚体(D-dimer,D-D)、纤维蛋白原(Fibrinogen,FIB)],以酶联免疫吸附法测定血清骨代谢指标[骨形态发生蛋白(Bone morphogenetic protein,BMP)、骨碱性磷酸酶(Bone alkaline phosphatase,BALP)、抗酒石酸酸性磷酸酶5b(Tartrate-resistant acid phosphatase form5b,TRACP5b)、尿脱氧吡啶酚(Urine deoxypyridinoline,DPD)],记录深静脉血栓(Deep venous thrombosis,DVT)发生率。结果:治疗后,A组VAS评分低于B组,FMA、Harris评分高于B组,大腿周径差、小腿周径差减小幅度大于B组,血清BMP、BALP、APTT、PT高于B组,D-D、FIB、TRACP5b、DPD水平低于B组(P<0.05);A组DVT发生率与B组比较,差异无统计学意义(P>0.05)。结论:活血舒筋汤辅助治疗在人工髋关节置换术后患者可有效缓解临床症状,促进病情恢复,改善凝血功能及骨代谢。

Objective:To study the effect of Huoxue Shujin decoction auxiliary therapy in patients after artificial hip replacement.Methods:A total of 108 patients who underwent total hip arthroplasty in our hospital from July 2021 to April 2022 were collected and randomly divided into group A and group B,with 54 patients in each group.Group B was treated with conventional western medicine,while group A was treated with Huoxue Shujin decoction auxiliary.After 2 weeks of treatment,visual analog scale(VAS)was used to assess pain degree,the Fugl-meyer motor function assessment(FMA)was used to assess the motor function,the Harris scale was used to assess the hip joint function,and the circumference difference of the patient's lower extremities(thigh and lower leg)was measured;the coagulation function indexes[activated partial thromboplastin time(APTT),prothrombin time(PT),D-dimer(D-D),fibrinogen(FIB)]were detected by the automatic coagulation analyzer;serum bone metabolic indicators[bone morphogenetic protein(BMP),bone alkaline phosphatase(BALP),tartrate resistant acid phosphatase form5b(TRACP5b),urine deoxypyridinoline(DPD)]were measured by enzyme-linked immunosorbent assay,and the incidence of deep venous thrombosis(DVT)was recorded.Results:After treatment,VAS score of group A was lower than that of group B,FMA and Harris scores were higher than those of group B,the reduction of thigh circumference difference and calf circumference difference were greater than those in group B,the serum levels of BMP,BALP,APTT and PT were higher than those in group B,and the serum levels of D-D,FIB,TRACP5b and DPD were lower than those in group B(P<0.05);the incidence of DVT has no significant difference between group A and group B(P>0.05).Conclusion:Huoxue Shujin decoction auxiliary therapy can effectively relieve the clinical symptoms,promote the recovery of the disease,and improve the blood coagulation function and bone metabolism in patients after artificial hip replacement.