中药穴位贴敷对全膝关节置换术患者康复效果的影响

Influence of Acupoint Application of Chinese Herbs on the Rehabilitation Effect of Patients Undergoing Total Knee Arthroplasty

目的:基于术后加速康复(enhanced recovery after surgery,ERAS)理念,探讨中药穴位贴敷对全膝关节置换术(total knee arthroplasty,TKA)患者康复效果的影响。方法:选取因膝骨关节炎(knee osteoarthritis,KOA)接受初次膝关节置换术的患者72例,按随机数字表法分成观察组和对照组,每组各36例。对照组在加速康复理念指导下进行围术期治疗与护理;观察组在对照组的基础上予以中药穴位贴敷干预,术后第1天开始,连续治疗2周。比较两组髌骨上、下3寸肿胀值、膝关节最大屈曲与伸直角度,采用美国纽约特种外科医院(hospital for special surgery,HSS)量表评定膝关节功能及临床疗效。结果:髌骨上、下3寸肿胀值术后当日两组比较,差异无统计学意义(P>0.05);术后2周两组均降低,且观察组降低更明显(P<0.01)。最大屈曲角度、最大伸直角度术后当日两组比较,差异无统计学意义(P>0.05);术后2周,两组最大屈曲角度增加,最大伸直角度缩小,且观察组改善程度优于对照组(P<0.01)。HSS评分术后当日两组比较,差异无统计学意义(P>0.05);术后2周两组均增加,且观察组增加更明显(P<0.01)。观察组优良率[97.22%(35/36)]高于对照组[77.78%(28/36)](P<0.05)。结论:基于ERAS,对TKA患者给予中药穴位贴敷,可有效减轻术后患膝肿胀程度,恢复关节活动度,提升膝关节功能,提高临床疗效。

Objective:Based on the concept of enhanced recovery after surgery(ERAS),to explore the influence of acupoint application of Chinese herbs on the rehabilitation effect of total knee arthroplasty(TKA)patients.Methods:Seventy-two patients who underwent TKA initially due to knee osteoarthritis(KOA)were selected and divided into the observation group and the control group according to the random number table method,with 36 cases in each group.The control group accepted perioperative treatment and care under the guidance of the concept of ERAS;the observation group was given acupoint application of Chinese herbs on the basis of the care that the control group accepted,for two consecutive weeks,starting from the first day after surgery.The swelling values of the upper and lower three inches of the patella and the maximum flexion and extension angles of the knee joint were compared between the two groups,and the knee joint function and clinical efficacy were evaluated using the Hospital for Special Surgery(HSS)scale.Results:There was no statistically significant difference in swelling values in the upper and lower three inches of the patella between the two groups on the day after surgery(P>0.05);both groups were significantly reduced two weeks after surgery,and the reduction in the observation group was more obvious(P<0.01).The maximum flexion angle and maximum extension angle were compared between the two groups on the day after surgery,and there was no statistically significant difference(P>0.05);Two weeks after surgery,the maximum flexion angle significantly increased and the maximum extension angle significantly decreased in both groups,and the improvement in the observation group was better than that in the control group(P<0.01).There was no statistically significant difference in the HSS score between the two groups on the day after operation(P>0.05);both groups increased significantly two weeks after operation,and the increase in the observation group was more obvious(P<0.01).The excellent rate of the observation group[97.22%(35/36)]was higher than that of the control group[77.78%(28/36)](P<0.05).Conclusion:Based on ERAS,the administration of acupoint application of Chinese herbs to TKA patients can effectively reduce the degree of postoperative swelling of the affected knee,restore joint mobility,enhance knee joint function,and improve clinical efficacy.