穴位按摩联合伤科散外敷对膝关节置换术后患肢肿胀程度及膝关节评分的影响

Effects of Acupressure Combined with Shangke Powder on the Degree of Swelling and Knee Score of the Affected Limb after Knee Replacement

目的观察穴位按摩联合伤科散外敷运用于膝关节置换术后的效果并探讨其作用机制。方法80例患者按随机数字表法分为研究组与对照组各40例。对照组采取伤科散外敷,研究组使用穴位按摩加伤科散外敷。比较两组患肢肿胀程度、C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)、环氧化酶-2(COX-2)、血浆黏度、全血低切黏度、全血高切黏度、下肢周径差、膝关节活动度、症状积分、视觉模拟量表(VAS)及膝关节功能量表(HSS)评分。结果研究组的肿胀率为15.00%,低于对照组的35.00%(P<0.05)。两组治疗后下肢周径差膝下差、膝上差均小于对照组(均P<0.05)。两组治疗后炎性指标、VAS评分、HSS评分及膝关节活动度、血浆黏度、全血低切黏度、全血高切黏度和各症状积分与治疗前比较均改善,且研究组治疗后CRP、TNF-α、COX-2水平、VAS评分、血浆黏度、全血低切黏度、全血高切黏度、各症状积分均低于对照组(P<0.05),而HSS评分和膝关节活动度则均高于对照组(均P<0.05)。结论穴位按摩加伤科散外敷的效果更为理想,能够促进症状快速减轻,降低疼痛,缓解肿胀程度,消除炎症反应,促进膝关节活动能力增强,并改善血液流变学指标。

Objective:To observe the effect of acupressure combined with external application of Shangke Pow⁃der after knee replacement and to explore its mechanism.Methods:80 patients were divided into 40 cases in the research group and 40 cases in the control group according to random nuonber table method.The control group used external application of Shangke Powder,and the study group used acupressure point massage+external appli⁃cation of Shangke Powder.The degree of swelling of the affected limb,C-reactive protein(CRP),tumor necrosis factor-α(TNF-α),cyclooxygenase-2(COX-2),plasma viscosity,whole blood low shear viscosity,whole blood high shear viscosity,lower limb circumferential diameter,knee range of motion,symptom scores,visual analog scale(VAS)and Hospital for Special Surgery(HSS)knee function scores were compared between the two groups.Re⁃sults:The swelling rate of the study group was 15.00%,which was lower than 35.00%of the control group(P<0.05).After treatment,the circumferential diameter of the lower limbs,the difference in knee and the difference in the upper knee were lower than those in the control group(all P<0.05).The inflammatory indexes,VAS,HSS scores,knee mobility,plasma viscosity,whole blood low shear viscosity,whole blood high shear viscosity and symp⁃tom scores were improved in the two groups after treatment,and the CRP,TNF-α,COX-2 level,VAS score,plas⁃ma viscosity,whole blood low shear viscosity,whole blood high shear viscosity,and symptom scores were lower than those in the control group(P<0.05)after treatment,while the HSS score and knee mobility were higher than those in the control group(all P<0.05).Conclusion:The effect of acupressure combined with Shangke Powder external application is more ideal,which can promote rapid reduction of symptoms,reduce pain,relieve swelling,eliminate inflammatory response,promote knee mobility,and improve blood rheological indexes.