Clinical Observation Of Taohong Siwu Decoction In The Treatment Of Periincision Swelling And Pain After High Tibial Osteotomy

Objective:To investigate the clinical effect of Taohong Siwu Decoction on postoperative incision swelling and pain after High Tibial Osteotomy(HTO),so as to provide a comprehensive therapy with better clinical effect.Methods:60 patients with knee osteoarthritis who met the inclusion criteria from January 2020 to December 2020 were selected and randomly divided into control group and experimental group with 30 patients in each group.Control group: Routine treatment after HTO,including: from the day after surgery to 1week after surgery,oral administration of Celecoxib capsule 0.2g,once a day.From the first day after surgery to 2 weeks after surgery,0.45 g diosmine tablet was taken orally,twice a day.The clamped drainage tube was changed to continuous negative pressure drainage 4 hours after the operation,and the drainage tube was removed when the drainage volume was less than 150ml/24 h.Routine dressing change for the incision was done once every two days.If the incision seepage reached the surface of the dressing,the dressing was changed immediately.The incision suture was removed 14-16 days after the operation.Postoperative day to 7 days postoperatively,limb raised 25°,local ice bag cold cure incision for 20 minutes,twice a day,the day after surgery to 2 weeks postoperatively,guide the ankle pump exercise,postoperative day 2 to 12 weeks after surgery,to guide the quadriceps isometric isotonic training,step by step,from 80 to 150 times a day,a moderate amount of activity,in order to increase the quadriceps muscle,can choose to apply sandbags leg press,bed leg press,bow and arrow type knee joint exercise to increase the range of knee flexion.Weight bearing changed gradually within 3 months after surgery.Experimental group: on the basis of control group,added to take Taohong Siwu decoction granules.The specific drugs and methods are as follows: 9g peach kernel,6g red flower,15 g angelica,15 g dried ground,10 g white peony root and 8g chuanxiong.From 1 to14 days after surgery,1 dose per day was taken with 100 ml warm water in the morning and evening,and the medication was adjusted dialectically every 7 days for 2 courses Resting pain around the incision was recorded by Visual Analogue Scale(VAS)at 1,7,14,and 1 month postoperatively in both groups.Measure,evaluate,and record the degree of swelling around the incision;TCM clinical symptom scores of qi stagnation and blood stasis syndrome were evaluated and recorded at 1 day and 1 month after surgery.The clinical efficacy of the two groups was compared before and after treatment.All data were analyzed using SPSS 22.0 statistical software.Results:The number of patients in the control group and the experimental group who completed the final follow-up was 28 and 27,respectively.There was no statistical significance in gender,age,height,weight and surgical side between the two groups(P BBB 0.05),indicating comparability.The experimental group was lower than the control group in postoperative swelling degree around the incision,the change value of calf circumference at the most swollen place around the incision,the pain degree around the incision(VAS),and the Chinese medicine syndrome score of qi stagnation and blood stasis syndrome(P <0.05).Therapeutic effect of symptoms and signs of traditional Chinese medicine: the effective rate of experimental group was 96.3% higher than that of control group(82.14%),the difference was statistically significant(P <0.05).Safety observation: There were no obvious abnormalities in liver and kidney function and biochemical indexes in 2 groups,and no serious adverse reactions or events occurred.In the experimental group,2 patients developed constipation and 2 patients developed dry mouth.The symptoms were significantly improved after adjusting the corresponding drug dose,and the drug was not stopped.Conclusion:1.The application of Taohong Siwu Decoction after HTO surgery can reduce the swelling and pain around the incision,which is conducive to the early recovery of patients after HTO surgery.2.The application of Taohong Siwu Decoction after HTO surgery can reduce the TCM syndrome score of qi stagnation and blood stasis after HTO surgery,improve the symptoms of qi stagnation and blood stasis after HTO surgery,with no obvious adverse reactions and safety.3.Taohong Siwu Decoction is worthy to be popularised and applied in the formulation of the plan of treating periincision swelling and pain after HTO with integrated traditional Chinese and western medicine.