| ObjectiveTo study the clinical effect of Prescription of Gushangxi ji after surgical release of elbow stiffness, As to optimize the treatment of clinical recommendations, in order to guide clinical application.MethodsIn this study,40 cases were elbow stiffness in-patients. They were collected from August 2005 to August 2014, in Guangdong Province Traditional Chinese Medical Hospital (with the exception of zhuhai branch),who were in accordance with the inclusion criteria without exclusion standard.All the cases were divided into A, B two groups with before-after study in different patients, group A-Gushangxi ji group (21 cases, from September 2012 to August 2014), group B-history control group (19 cases, from August 2005 to September 2012). surgical release of elbow joint stiffness after admission, and were to be given postoperative indomethacin 25 mg tid.Affected limb uses ice compress for 24 hours. Drainage tubes were removed untill 48 h, pull start CPM exercise,2 times everyday,1 time in the morning and night, every time for 30 minutes, at the same time start isometric training 3 times/day, each time for about 30 minutes. Stopped CPM untill 2"d weeks postoperatively. If the wound healed well 2nd weeks later, then group A (Gushangxi ji group) began with Prescription of Gushangxiji fumigation and washing elbow, patients in the process of fumigation and washing activities active elbow flexion and extension (three times A day, in the morning, at noon and in the evening, each 30 minutes). Group B (control group) only for elbow flexion and actively activity (three times A day, in the morning, at noon and in the evening, each 30 minutes). Groups of preoperative clinical information were collected, Measure indexes included:1) Effeteness on detumescene;2) pain intensity;3) elbow rang of motion;4) ulnar nerve symptoms;5) the MAYO elbow function score. Maximum circumference of the elbow was measured on the 3rd day of the postoperative,4th weeks of the postoperative, and calculate the swelling index, evaluation of the degree of swelling; Pain intensity was record by the VAS method preoperative and on the 2nd week of the postoperative,4th weeks of the postoperative,6th weeks of the postoperative and 6th months of the postoperative. Elbow rang of motion was record in group A, B preoperative and on the 2nd week of the postoperative,4th weeks of the postoperative,6th weeks of the postoperative and 6th months of the postoperative. Ulnar nerve symptoms were respectively record in group A, B in the preoperative and on the 2"d week of the postoperative,4th weeks of the postoperative,6th weeks of the postoperative and 6th months of the postoperative. Assess the MAYO elbow joint function score were respectively record in the preoperative and on the 2nd week of the postoperative,4th weeks of the postoperative,6th weeks of the postoperative and 6th months of the postoperative in group A, B. Security assessment and X-ray image were evaluated in the preoperative and postoperative, on the 1st month of the postoperative,3rd months of the postoperative,6th months of the postoperative, which it is concluded excellent and good rate of the two groups at half a year of the postoperative.The all above data was analyzed statistically by SPSS 17.0 statistical software, analysis the difference between the two groups of contrast.Results1. The 40 cases were followed up for 6 months, among them:group A of 21 cases, group B of 19 cases,6 cases were lost to follow up. All patients had no drug allergy and other adverse reactions.2. comparison of general information:the general information of 2 groups preoperative was no statistical significance (P> 0.05), was comparable.3. The comparison of two groups of results:there were significant differences of the swelling effect between two groups on the 4th weeks of the postoperative (P<0.05);Pain intensity and elbow scoring, two groups of patients, respectively, two weeks after surgery is no statistical significance (P> 0.05),4th weeks of the postoperative,6th weeks of the postoperative and 6th months of the postoperative between two groups compared was statistically significant (P<0.01). There was very significant difference in efficacy between the two groups, and excellent and good rate of elbow function were much better than the control group; Improvements in elbow motion, A group-Gushangxiji group was increasing with time much larger than group B, there were significant differences 4th weeks of the postoperative,6th weeks of the postoperative and 6th months of the postoperative between two groups compared (P<0.01).there is a very significant difference between them;Ulnar nerve symptom improvement aspect, two groups of data points is no statistical significance (P> 0.05) each time after surgery;On the 6th months, the excellent and good rate of therapeutic effect identification: between the two groups of patients:A group-Gushangxiji group (85.72%)> B-treatment control group (15.79%), there was very significant difference in efficacy between the two groups (P<0.01). All patients had no drug allergy and other adverse reactions.ConclusionPrescription of Gushangxiji group have better clinical effect on promoting elbow stiffness relieve postoperative elbow swelling, alleviating pain and increasing scope of activities of the elbow join and improving the elbow functional rehabilitation than in purely functional exercise group after surgical release of elbow stiffness. |
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