Clinical Observation Of Buyanghuanwu Decoction With Directed Penetration In The Treatment Of Swelling And Pain After Total Knee Arthroplasty

Objective: To observe the short-term efficacy of Tonic Yang Returning Five Soup and Chinese medicine directed permeation in the treatment of swelling and pain in the affected limb after total knee arthroplasty(TKA),to provide reference for reducing complications such as swelling and pain in the affected limb after total knee arthroplasty,and to find treatment methods to improve swelling and pain in the affected limb after surgery.Methods: By observing 70 patients diagnosed with KOA and treated with TKA surgery and with postoperative TCM evidence of Qi deficiency and blood stasis,65 patients who met the requirements were grouped by randomized grouping method,including 33 patients in the experimental group and 32 patients in the control group,the experimental group was treated with buyanghuanwu decoction with directed penetration + conventional treatment after surgery,and the control group was treated with conventional treatment only after surgery,both groups received Both groups received the same course of treatment(14 days),and the visual pain score,limb circumference of different parts of the affected knee joint before and 1,3,7 and 14 days after surgery,the HSS score of the knee joint before and 3,7 and 14 days after surgery,the ultrasensitive C-reactive protein,D-2 aggregates and fibrinogen indexes before and 1,14 days after surgery,and the TCM evidence points before and after treatment were recorded in both groups and effective rate,the data at different time points were compared within and between groups,and statistical analysis was performed.Results:1.There was no statistically significant difference in the general data between the two groups of cases(P > 0.05),and there was no statistically significant difference between the two groups of patients in the comparison of various clinical observations and laboratory indexes before and 1 day after surgery(P>0.05).2.Regarding VAS pain score: the VAS score of the test group was smaller than that of the control group after 3 days of treatment,and no difference between the groups was statistically significant(P>0.05).After 7 and 14 days of treatment,the scores of the test group were significantly smaller than those of the control group,and the differences between the groups were statistically significant(P < 0.01).3.As for swelling: comparing the circumference of the limb 10 cm above the midpoint of the patella and 10 cm below the midpoint of the patella,the circumference of the affected limb in the test group was significantly smaller than that in the control group at 3,7 and 14 days after surgery,and the differences between the groups were statistically significant(P < 0.01).4.HSS functional scores: the scores of the test group were higher than those of the control group at 3 and 7 days after surgery,and the difference between the groups was not statistically significant(P>0.05).The scores of the test group at 14 days after surgery were higher than those of the control group,and the difference between the groups was statistically significant(P < 0.05).5.Laboratory indexes: CRP in the test group was smaller than that in the control group at 14 days after surgery,but the difference was not statistically significant(P > 0.05),and D-2aggregates in the test group were smaller than that in the control group at 14 days after surgery,and the difference was statistically significant(P<0.05).The FIB of the test group was smaller than that of the control group at 14 days after surgery,and the difference was statistically significant(P < 0.05)6.In terms of TCM evidence points and efficiency: the TCM evidence points of patients in both groups were improved after treatment,with statistically significant differences(P < 0.01),the total efficiency of the treatment group was 100%,and the total efficiency of the control group was 81.25%,the efficacy of the treatment group was better than that of the control group,with statistically significant differences(P < 0.05).Conclusion:1.Treatment of TKA with buyanghuanwu decoction with directed penetration can promote the swelling of the affected limb in the early postoperative period,reduce the blood D-2aggregates and FIB index,and improve the hypercoagulability and hyperfibrinolysis of the body.2.Treatment with buyanghuanwu decoction with directed penetration after TKA can effectively relieve the pain of the affected limb,improve the HSS score,and promote the early recovery of knee function.3.Treatment with buyanghuanwu decoction with directed penetration after TKA can reduce the TKA postoperative qi deficiency and blood stasis TCM evidence score and improve the patient’s postoperative qi deficiency and blood stasis symptoms.