| Objective:To observe the clinical effect of " Sishen decoction " combined with active rehabilitation exercise in the treatment of early joint swelling and pain after total knee arthroplasty(TKA),so as to provide a new idea for the treatment of knee swelling and pain after TKA.Method:From January 2021 to December 2021,60 patients who met the inclusion criteria were hospitalized in the joint surgery of District 9 of Fuzhou integrated traditional Chinese and Western medicine hospital.The patients were divided into experimental group and control group,with 30 cases in each group.The control group took 0.2g "Celecoxib Capsule" orally one night before operation;Intraoperative "Cocktail" joint injection and intravenous drip of"Tranexamic Acid" 2G to stop bleeding;Postoperative analgesia was performed by PCA until the second day after operation;"Celecoxib Capsule" was taken orally to relieve pain on the first day after operation,twice a day.Cold therapy was performed on the day after operation,4 times a day,0.5 hours each time.On the first day after operation,passive knee flexion and extension function exercise and daily life function exercise such as walking on the ground were started until discharge.From the first day after operation,on the basis of the control group,the experimental group took orally "addition and subtraction of Sishen decoction" granules,boiled water,one dose a day,taken separately in the morning and evening for 7 consecutive days.Guide active rehabilitation functional exercise from the first day after operation.The peripheral diameter,VAS pain score,HSS knee function score,joint range of motion,serum D-dimer,serum C-reactive protein(CRP)and other laboratory indexes of patients in the two groups were collected 1 day before operation and 1,3,5,7 and 21 days after operation.Result:Of the 60 patients,3 dropped out and 57 complete cases were obtained.There were no significant differences(P>0.05)between the two study groups with respect to patient genders,ages and operation sides.The general information of both groups was comparable.Swelling degree:after analyzing the swelling value of the two groups one day before operation,it was found that there was no significant difference between the two groups(P>0.05),and the preoperative swelling value of the two groups was comparable(deleted).There was no significant difference between the two groups on the first day after operation(P>0.05).On the 3rd,5th and 7th day after operation,the mean value of the experimental group was lower than that of the control group,and the difference between the two groups was statistically significant(P<0.05).VAS pain score:there was no significant difference between the two groups in VAS pain score on the first day before operation(P>0.05).On the 5th and 21st day after operation,the mean value of the experimental group was lower than that of the control group,and the difference between the two groups was statistically significant(P<0.05).There was no significant difference in VAS score between the two groups on the 1st,3rd and 7th day after operation(P>0.05).dimer:there was no significant difference between the two groups in the value of D-dimer one day before operation(P>0.05).The mean value of D-dimer in the experimental group was lower than that in the control group on the 3rd and 5th day after operation,and the difference between the two groups was statistically significant(P<0.05).There was no significant difference between the two groups on the 1st,7th and 21st day after operation(P>0.05).C-reactive Protein:The C-reactive protein levels of both groups one day before surgery had no significant differences(P>0.05)and they were comparable.The between-group differences were not significant on day 1 and 7(P>0.05).The means of the trial group on day 3 and 5 were lower than those of the control group,and the between-group differences were significant(P<0.05).HSS knee function score:there was no significant difference in HSS score between the two groups at 1 day before operation and 1,3,5 and 7 days after operation(P>0.05).There was significant difference between the two groups on the 21st day(P<0.05).Joint range of motion:there was no significant difference between the two groups on the first day before operation and the first and third days after operation(P>0.05).There was significant difference between the two groups on days 5,7 and 21(P<0.05).Conclusion:Early oral administration of "Sishen decoction" combined with active rehabilitation exercise for the swelling and pain of patients after TKA can significantly improve the swelling and pain of soft tissue around knee prosthesis,which is worthy of clinical application. |
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