Clinical Observation Of Modified Danggui Buxue Decoction On The Hidden Blood Loss After Total Knee Arthroplasty

Objective: To investigate the clinical efficacy of Modified Danggui Buxue Decoction in the treatment of recessive blood loss after total knee arthroplasty(TKA),and the relationship between postoperative knee function recovery and pain improvement.Methods: A total of 60 patients who underwent primary unilateral TKA due to knee osteoarthritis(KOA)in The Affiliated Hospital of Shandong University of Traditional Chinese Medicine from January 2020 to January2021 were selected.They were randomly divided into observation group and control group,30 cases in each group.On the basis of routine treatment in the control group;The observation group was given flavored Angelica sinensis blood tonic soup,once a day,twice in the morning and evening,from the first day before surgery to the fifth day after surgery.Abdominal blood was evacuated 2 days before surgery and 1,3 and 5 days after surgery,blood routine examinations were performed,hemoglobin(HGB)and hematocrit(HCT)were counted,and hidden blood loss was calculated.The knee HSS score and visual analogue scale(VAS)were recorded on the day of admission,5 and 45 days after surgery to evaluate the knee function and pain degree during the perioperative period.TCM clinical syndrome scores were recorded to compare the clinical efficacy of the two groups before and after treatment,and the relevant safety indicators were monitored.SPSS26.0software was used for data analysis.Results: 1.HGB and HCT: intra-group comparison: The levels of HGB and HCT in the observation group showed a downward trend before,1 and 3 days after surgery,and the difference was statistically significant(P<0.05).The levels of HGB and HCT in the control group showed a downward trend before,1,3 and 5 days after surgery,and the difference was not statistically significant(P>0.05).There were statistically significant differences before surgery,1 and 3 days after surgery(P<0.05),but there were no statistically significant differences 3 and 5 days after surgery(P > 0.05).Comparison between groups: There were no statistically significant differences in the HGB and HCT levels of 2 groups before surgery and 1 and 3 days after surgery(P>0.05).The HGB and HCT levels of the observation group were higher than those of the control group at 5 days after surgery,with statistically significant differences(P<0.05).2.Blood loss: There was no significant difference in dominant blood loss between the observation group(319.33±83.07)ml and the control group(281.33±76.24)ml(P>0.05);There were significant differences in total blood loss between the observation group(1214.44±390.04)ml and the control group(1452.18±383.76)ml and total blood loss between the observation group(1533.78±392.80)ml and the control group(1533.78±392.80)ml(P<0.05).3.HSS score of knee joint: preoperative difference between the observation group(25.23±3.80)and the control group(26.23±3.82)was not statistically significant(P > 0.05);There were statistically significant differences between the observation group(53.70±2.49)points and the control group(50.20±3.17)points 5 days after operation and the observation group(88.53±3.70)points and the control group(77.67±4.87)points 45 days after operation(P<0.05).The scores of the two groups showed an upward trend from preoperative to postoperative 5 and 45 days,and the difference at each time point was statistically significant(P<0.05).4.Visual analogue scale(VAS)of knee joint: preoperative difference between observation group(7.73±1.57)and control group(7.83±1.46)was not statistically significant(P > 0.05);There were statistically significant differences between the observation group(5.03±1.25)points and the control group(5.90±1.30)points 5 days after surgery and the observation group(2.00±1.34)points and the control group(3.07±1.34)points 45 days after surgery(P<0.05).The scores of the two groups showed a downward trend from preoperative to postoperative 5 and 45 days,and the difference at each time point was statistically significant(P<0.05).5.TCM clinical syndrome score: before treatment,there was no significant difference between the observation group(18.50±1.28)and the control group(18.57±1.41)(P>0.05).After treatment,the score of observation group(5.63±1.73)was lower than that of control group(8.03±1.87),the difference was statistically significant(P<0.05),and the score of both groups after treatment was lower than that before treatment,the difference was statistically significant(P<0.05).6.Efficacy of TCM symptoms and signs: the effective rate of the observation group was 96.67%,and that of the control group was 86.67%,with statistical significance(P<0.05).7.Safety observation: No serious adverse reactions or complications occurred in the two groups during the study period,and only 2 patients in the observation group had diarrhea symptoms after taking Traditional Chinese medicine.Diarrhea symptoms were eliminated after timely adjustment of prescription composition,without affecting the study progress.Conclusion: 1.Modified Danggui Buxue Decoction has obvious curative effect on recessive blood loss after TKA,which is beneficial to patients’ quick recovery after surgery;2.Modified Danggui Buxue Decoction can improve HSS score of patients after TKA,which is beneficial to improve postoperative knee function of patients;3.Modified Danggui Buxue Decoction can reduce VAS score of patients after TKA,which is beneficial to improve postoperative knee pain;4.Modified Danggui Buxue Decoction can reduce the TCM syndrome score of qi and blood deficiency after TKA,improve the symptoms of qi and blood deficiency after TKA,and improve the treatment efficiency.